NCPA - National Center for Policy Analysis


February 12, 2009

Parkland Memorial Hospital, the county hospital for Dallas, Texas, announced changes in emergency room procedures to improve care and reduce long waits.  Included is a new process for evaluating patients entering the ER, allowing them to confer immediately with a nurse or paramedic.

Some of the changes were the result of an Oct. 21 evaluation of Parkland's emergency operations by the Joint Commission, a national health-care accreditation agency:

  • The evaluation followed the death of Mike Herrera, a 58-year-old Dallas man who checked into the ER Sept. 19 and died of cardiac arrest after waiting 19 hours for treatment.
  • The commission cited 11 deficiencies in Parkland's ER, including inadequate check-in procedures, failure to offer proper pain medication to waiting patients, and ineffective leadership in some areas.

Parkland's ER has become overwhelmed with nonemergency cases due to the rising number of uninsured Texans needing basic medical care:

  • Last year, the ER handled more than 130,000 patient visits.
  • With the new procedures in place, last month, only 14 percent of ER patients left without seeing a physician, compared with the 24 percent who walked away in July.

John Haupert, the hospital's executive vice president and chief operating officer, said public hospitals throughout the nation are struggling with the flood of nonemergency patients.  "This is not just a Parkland issue," he said:

  • Parkland determined that its sickest ER patients last year waited an average of 2.7 hours to see a doctor and spent an additional 10.7 hours being treated or waiting for a hospital bed.
  • Patients who were not as sick waited an average of 5.6 hours for care and spent an additional 4.8 hours being treated and discharged.

Source: Sherry Jacobson, "Parkland hospital streamlines emergency room procedures," Dallas Morning News, February 11, 2009. 


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