The State of ER Services
 

I would like start a discussion on the state of ER services in TV. I know this issue has been beaten to death over and over.

However its a new day and with the 2 new ER centers that have opened, has there been any improvement?

Has anyone used either of these new ER centers?

How are these new ER centers staffed?

Has the TVRH ER gotten any better with additional centers to absorb the load?

UF Health is operating the hospital now I don't know if TV other facilities are being run by them. Maybe the question should be " with UF Health taking over are things improving"?

In my opinion, one of the the biggest problems with ERs is that they try to make a lot of money by charging emergency prices for non-emergency treatments, rather than tell non-emergency patients to go somewhere else. So, people with real emergencies have to wait hours for treatment. There is a huge misconception that Federal law requires everyone who shows up to be treated as an emergency. Read the law. It doesn't.

You pretty much said it..."it's been beaten to death". The new ER's are just opened so how would you compare? ER's ALL over the country have issues like we have here....that would be my 2-cents.

If people would stop using the ED as a non emergent visit.Then EDs would be more productive in what they were designed to do.

Blame the ER. They should tell people with non-emergencies to go somewhere else. But, they don't because they want the money.

Actually they want to mitigate liability.

My question would be: "Do you have a vascular physician "on site" 24/7? Are you able to determine if I'm having a stroke (clot) or cerebral bleed? And if I'm having a stroke (clot) are you able to administer tPA to clear the clot? I'm guessing none of them can do that.
That's what worries me about the "box" ER's. I think they bring a lot of positives. But for people that have life-threatening issues... are they able to deal with them? Or do they just transport them to a higher-level trauma center?

It might be too early to start a comparison discussion since all the new changes.
I suspect we will get a better idea in about 3-6 months.
We've got a new variable coming in with this virus...respiratory capabilities will possibly be a new priority...

Slm
 

I went to the ER at the Villages' Hospital on Sunday, Feb. 23 with possible heart attack. I was immediately taken into an office for an EKG, chest x-ray and catheter put into my arm in case meds needed.
I was then sent back to the waiting room where I sat from 8:00PM until I decided to go home at 11:15PM hoping that if my tests showed a heart attack, someone would have come to get me and since they didn't, it probably was because I was okay. I decided to leave and the doctor came out and told me not to leave.
I told him that if I had had a heart attack, I would probably have been dead by then so I was going home.
Another patient sitting near me for a much longer time was told by the receptionist that there were no beds in triage and none in the hospital for admittance. I then told the receptionist to take out the catheter (she got permission) and I went home. I am fine.
I was told by the nurse that had I gone to one of the ER centers, I would have immediately been sent to the hospital as they do not treat stroke or heart patients.
Perhaps United Health will help things get better.
I went to the ER at the Villages Hospital several years ago with the unbearable pain of a kidney stone--sat in the waiting room from 4:00AM until 12:30PM climbing the walls in pain. My husband begged for some type of pain pill but they would/could not give me anything.
We are in reasonably decent health but if we were not, we might have to consider moving out of The Villages.

They can’t turn away anyone, no matter what the issue is, or if they have insurance.

Went to the one on 44 for my husbands kidney stone. It was very good!

Tvrh er
 

I was in the TVRH ER yesterday and -yes, there was a little glitch but considering that at one point there were 70 people in the waiting room and I heard two stroke codes called plus a heart attack, I think everything was handled as well as possible. Hospital ER’s across the country are overwhelmed as the population continues to grow exponentially. We have an unusually unbalanced population with a higher percentage of over 65ers than anywhere especially during season. I had an ER situation but not an imminently life threatening situation and in spite of that, I was registered, triaged, treated, and discharged in 5 hours (including the glitch of not being able to locate chart info). I do not think that is unreasonable considering how swamped they were. The entire staff was caring and knowledgeable.

To actually address the question....
 

My husband injured his ankle 3 days after the Ocala Health Tradewinds Freestanding ER opened on 466a. We had had a great experience at the related ER in Summerfield so we decided to head to the new one. There is a “self check in” kiosk, and once that was completed someone came out and got us. The nurse come in right away, he was triaged and vitals taken. Within minutes the doctor was in. X-rays were done right in the room he was in. We were in and out, with a splint and a correct diagnosis within 1 hour. I would definitely recommend...and both of the new ER’s are a HUGE boost to our community!!

In the past my husband and I have used the Ocala Health ER in Summerfield and it was well worth the 10 minute drive. We were seen immediately by a PA in my case and a doctor in his case. Couldn’t have asked for better care. With the new Ocala Health ER at 466a and Buena Vista, we expect to get the same great care even closer to home.

It's hard to turn people away. Weill Cornell in NYC has an Urgent Care Facility attached to the ER, and people who are triaged are sent to either UC or passed on the the ER. That way, real emergencies are treated immediately, and even the people who are passed on to UC are seen in a more timely manner.

Used the ER in Bellevue. Awesome experience. The people were very nice and we were treated immediately.

Give UF some time. A year. It takes time to change personnel and culture.

Not true. The ER doesn't have to treat non-emergencies.

More importantly, if people would stop using the ER as their PCP, healthcare would be cheaper.

To the many who cannot afford health insurance, ER is their PCP!

ER
 

The Ocala ER that is just past the Walmart on 441 about a mile or two is excellent. The wait time is zero to 5 minutes. The staff is very good. I've been there three times and have never had a long wait and they have good medical care. WAY better than The Villages ER!

The Villages Hospital ER has not gotten better. I unfortunately had to use it a week or so ago and it was very poor. Granted there are a lot of people in the villages, however, after 6-7 hours in a recliner chair parked by the noisy nurses with heavy traffic, it took another 5 hours to finally get some pain medication that I had been requesting for over 2 hours. Finally after 12 hours I was moved to a ER bed until a room was available for me to be admitted.

My suggestion is to wait a year and ask this same question. With the new centers just having recently been opened, it's too early to tell the impact. Wait a year. And, yes, this topic HAS been beaten to death! So, wait a year and see if the new additions have made a change.

New ER in the VILLAGES
 

I was having shortness of breath ..heaviness in my chest & went to OCALA ER
on 466 A.. I was very satisfied with their prompt professional service..I was hooked up to many devices..took many blood tests..CT scans etc.When all was medically necessary done, I was transferred to West Marion hospital in OCALA
by SUMTER CO. ambulance, because OCALA ER is an OCALA free standing ER
So I learned..Only inconvenience was the fact they are not connected to the VILLAGES system, so therefore I had to have all my labs repeated..CT etc.
And now I have to get all my medical records etc..from West Marion Hospital
HOWEVER I AM SO EVERY GRATEFULL they were close by..

I’m confused. Are you saying Ocala Health won’t share test results with The Villages Hospital?

In my opinion, the decision makers have known and know the problems with the ineffectiveness of their ER locations. The fact that over the many years there has been no improvement is testimony that the ER is not a priority.

There must be reasons why the stand alone ER in Bellview and those in Ocala get it right....knowledgeable management with the ER as a priority.

IMHO!

yes, unfortunately we needed to use the new Brownwood ER last weekend. for a new facility, i was impressed on the staff, equipment & performance of the Dr's. we had no wait time, were seen right away, and very pleased @ the overall operations. i'd go again, when need be

[QUOTE=HelenLCSW;1723656]I was in the TVRH ER yesterday and -yes, there was a little glitch but considering that at one point there were 70 people in the waiting room and I heard two stroke codes called plus a heart attack, I think everything was handled as well as possible. Hospital ER’s across the country are overwhelmed as the population continues to grow exponentially. We have an unusually unbalanced population with a higher percentage of over 65ers than anywhere especially during season. I had an ER situation but not an imminently life threatening situation and in spite of that, I was registered, triaged, treated, and discharged in 5 hours (including the glitch of not being able to locate chart info). I do not think that is unreasonable considering how swamped they were. The entire staff was caring and knowledgeable.[/QUOTE i agree. they were VERY good when my husband was admitted, caring & attentive. we never had any problems, & met wonderful doctors.

[QUOTE=PugMom;1723766]Good to hear good experiences.
Thanx for posting.

While it would be medically better if only patients with real "emergencies" went to the ER it would not necessarily save money for the health care system unless many ER's closed. The ER needs to have on site the equipment and medications needed for real emergencies. The facility must be constructed to allow patient and staff flow to optimize care. The base cost of all the requirements to be an ER are huge. This cost is then spread over the charges applied to the users of the ER. Fewer patients, higher per user cost. So the runny nose that really doesn't belong in the ER gets socked with a high bill which represents that person's contribution to the cost of having a facility equipped to handle emergencies.

Fewer patients in the ER and the ER can't survive economically. So like it or not, the ER's financial viability depends on having people in the beds, and the waiting room.

A couple random thoughts. The training to become a board certified ER specialist is college, 4 years of medical school, and then 4 years of residency/fellowship training. That is 7-8 years post college in a very intense program. And no PA or NP does anything even approximating that kind of training. So when I see that the PA is providing care I know that the ER is having staff available for the very low level of medical urgency that a PA or NP is qualified to handle. Saving money on staff costs.

As to the insistence that the ER is not required to care for you if you do not have an emergency that is both true and wrong. The ER cannot send you away until after they have determined that you do not have a condition requiring emergency care. So they must evaluate you first. As the evaluation usually is more complex than the management there is little reason for a general policy of declining care when the triage secretary may think it is not an emergency. And they are not really qualified to make that decision. A runny nose may be just a mild URI or allergy. Or it can be a fractured cribriform plate which if ignored will rapidly lead to bacterial meningitis.

Making that differentiation requires a good history and if appropriate a urine glucose dipstick. So even runny nose can be, extremely rarely, a true emergency. That's what the ER doctor spent all those years learning. Sometimes it is a zebra.

Thanks, couldn't have said it better

I suggest that the people who insist that an ER can turn you away read the COBRA of 1987

That's Ocala Health Summerfield ER

https://scontent-mia3-2.xx.fbcdn.net...2b&oe=5E97F857

Same facility as Summerfield, Ocala Health ER now open in Trailwinds Village on 466A

https://scontent-mia3-2.xx.fbcdn.net...e7&oe=5E861B3E

New University of Florida ER now Open on SR44 across from Brownwood

https://img.particlenews.com/image.p...L5K_0NsyX5CP00

I would say that ER Services are up 200% in the Southern Areas.

I did read it. As understand it, if the patient is stable, they can be transferred to another facilty. If they are not stable, the ER can stabilze them and then transfer them to another faciility. Post No. 16 describes how that process can work. It sounds more efficient to me, but not as profitable for the ER.

That is correct. But the ER has to evaluate the patient first and determine stability. Then there has to be an acceptable reason for the transfer, the most common being patient request and the availability of a specific service at the accepting facility that is not available at the originating ER. Lack of insurance in and of itself is not an acceptable reason. Then the paperwork at both ends has to be filled out correctly. There was a time, and I don't know if it has changed, that filling out the paperwork incorrectly was considered a COBRA violation. The fine for violating COBRA starts at $50,000 AT EACH END and goes up from there. As you can imagine, there is a great deal of care taken in any transfer.

Unfortunately, It could be like that all over. Need some good NYC care! LOL

As of 2 weeks ago, Unless our ED was full we turn away no one. But then again only been doing this for 4O plus years. The chance of sending someone out of ED without evaluation, could be a toe tag. We always try to avoid toe tags, it’s a lot of paperwork.

Beats my 37 years and dozens of transfers under COBRA regulations. But this is TOTV----people have OPINIONS on subjects they know nothing about.:1rotfl::1rotfl::1rotfl:

So not true. The insurances, Medicare included pay very little for emergency services.

You are correct, beaten to death.