Law Takes Aim at Crowded Emergency Departments

California’s emergency departments are packed. As the ranks of the uninsured and underinsured across the state have grown, and their health problems have tended to fester and grow more acute, patients have been heading to emergency rooms in record numbers.

That means wait times have become much longer in emergency departments, and patient care is more likely to be compromised under the crush of increased demand.

A bill to address that problem — AB 2153 by Assembly member Ted Lieu (D-Torrance) — is one Senate floor vote away from going to the governor’s desk.

It would require emergency rooms at acute care hospitals to keep a tally of overcrowding every four hours — and to eventually get a “crowding score” for its emergency room performance.It’s called a full-capacity protocol, and proponents of the new law say it has been successfully implemented at LAC+USC (Los Angeles County and University of Southern California) Medical Center.

This approach has shown dramatic results in the reduction of wait times at USC’s medical center,  said bill author Lieu. “They were able to increase ER inflow and outflow. And to me, it’s generally always more helpful to have a plan in place than to not,” Lieu said.But according to Sheena Nash of the California Department of Public Health, this bill focuses emergency workers on paperwork and self-monitoring, rather than on patient care. And during emergencies, she said, that’s just too much to ask of health care providers.

“We don’t believe it will reduce overcrowding. We do believe this bill is unnecessary,” Nash said. “And it might actually take ER personnel away from the task at hand.”

But a simple task of recording overcrowding levels is at least a start, Lieu said.

“What ERs have been doing,” Lieu said, “has not been working. So if it’s pretty clear the current system is not working, why not try something different?”

Last legislative session, a similar bill was passed and the governor vetoed it. But not this time, Lieu said. Now he has the California Medical Association and the American College of Emergency Physicians lined up in support. “This governor has been known to veto bills and later support them,” he said. “And some of the sponsors of this bill have worked with his staff on this.”