[Peachie]

Originally Posted by Russ_Boston

It does not take 7-8 hours to get you out of the hospital once you are discharged. I do it every day at TVRH. Perhaps you had 'some' doctor who told you you could go home but I gurantee it was not your admitting doctor. Once the admit doctor says you can go and signs the papers I usually have you out the door in about 1.5 hours, many times less.

What quite often happens is that some consultant doctor (cardio, neuro etc.) says that you are clear to go but the attending physician of record (who sees you every day at least once) must clear you and sign the order. If a consulting doc ever tells you that you can go make sure that he/she has the authority to do so from the attending doc.

I write these things because although TVRH has some issues that need to be worked through I don't like misinformation. In fact our charge nurses are on our butt to make sure we discharge ASAP. We have to clear room for ER
patients ready to come up.

Thanks, Russ, for all the info. It's good to receive details from the inside and not just speculation from us on the outside of the business.

[Madelaine Amee]

Originally Posted by Russ_Boston

It does not take 7-8 hours to get you out of the hospital once you are discharged. I do it every day at TVRH. Perhaps you had 'some' doctor who told you you could go home but I gurantee it was not your admitting doctor. Once the admit doctor says you can go and signs the papers I usually have you out the door in about 1.5 hours, many times less.

What quite often happens is that some consultant doctor (cardio, neuro etc.) says that you are clear to go but the attending physician of record (who sees you every day at least once) must clear you and sign the order. If a consulting doc ever tells you that you can go make sure that he/she has the authority to do so from the attending doc.

I write these things because although TVRH has some issues that need to be worked through I don't like misinformation. In fact our charge nurses are on our butt to make sure we discharge ASAP. We have to clear room for ER patients ready to come up.

Thank you for bringing some professionalism to this thread! I am from the suburbs of Boston where I had my choice of probably five of the best hospitals in the U.S., but you could not walk into the ER and get seen immediately. I was a patient at the Boston Beth Israel and it was a "factory" compared to the treatment we have received here!

My other half was an emergency "life or death" patient at TV hospital and his treatment and care was above reproach.

[Mack184]

Originally Posted by Russ_Boston

I was working in the ER the other day and we had 7 (yes 7) EMS teams waiting in the ER halls with their patient. The rule is that they have to remain until their patient is seen by an ER doc and assigned an ER room.

It is not a matter of under-staffing it is a case of overpopulation. Every single one of our ER rooms was full plus the 7 EMS in the hall with another 20 (?) or so in the waiting room.

We can not release a patient to an admit floor until a room becomes available. So the wait is long. I was down there to act as stop gap nurse as if the patient had been admitted 'upstairs'.

This time of year there are simply too many patients and not enough rooms. In the summer it is just the opposite. The down side of a hospital in a 50% snowbird (plus guests in the winter) community.

To add to this..People are not taken in turn when coming to an ER. Remember..it is an EMERGENCY Department. Each ER has a triage system numbered 1-5. One meaning you're actually dieing right then and there. They trump everybody and anybody coming in. Level 2 is someone who's in very serious danger..life threatening danger. An emergent stroke or MI. Your cut finger is not a 2 and in many cases not even a 3. While it's imporant to you and an emergency to you..to the hospital the Heart Attack in room-1 and the gunshot in room 3 and car accident in room 7 all take predecent. Unless you are TRULY dieing, plan on waiting. A 7 hour ER wait is unfortuantely not a very long wait. In many cases in larger cities the waits can run anywhere from 24-36 hours. Yep, that's right.

Now if you think that calling the big red bus is your ticket to a bed even faster, don't bank on it. Nothing irritates the ER staff much more than you taking the bus to the back door when you're going to be triaged as a 3 or lower. And Mr. Russ is quite correct in saying that the EMS teams have to stay with their deliveries on their gurneys until there is an acceptable bed for them to be handed off to. Of course if you have called the big red bus for a trivial matter, and you get coded somewhere between a 3 and 5, the charge nurse will very likely have you removed from your gurney, and given a seat in the waiting room, and release the EMS team.

[graciegirl]

Originally Posted by OldDave

This is the second such story I've seen just in the last few days here. I wasn't too worried until Gracie also seems to think there is a problem. Frankly as someone who has had more than their share of ER visits, it terrifies me.

Can you explain what is causing these long delays in the ER? Are they understaffed, are they just overwhelmed with too many patients coming to the ER? There must be come explanation for this. Can anyone shed some light on this cause and whether it is like this everyday, or just in some cases..

And what is the closest hospital with a well run ER?

Thanks,

Dave

Someone suggested that the flu epidemic is one of the reasons for the crowding and that seems very logical and of course so many people are here now who are NOT year 'round residents who get sick and don't know what else to do but go to the ER and I suppose a lot of people do NOT see their doctor when a problem is emerging and wait until it becomes an emergency.

It is wise to get yourself a doctor here even if you are a part time resident. I hate to point out to any of you that we are ALL a little older and have more medical problems than we used to have.

I think that finding a doctor here is very difficult because so many people judge physicians primarily on bedside manner and I don't care how curt and abrupt a doctor is, I just want him or her to be knowledgable. So someone liking a doctors personality really isn't all that helpful. AND so many of us are fairly new here ourselves and it is scary to start a new doctor patient relationship. You are placing your life in their hands.

I don't mean to be negative and yet I do sound negative. Our daughter has had some very serious and unusual health situations over time and I became so grateful for the knowledgable physicians that guided us through them and became aware of others who were born with her cardiac difficulties not faring so well in small communities across the country. We continue to go back to Cincinnati for her cardiac check ups because her plumbing is so unusual.

I guess over time I have become a doctor snob. I have not had a bad situation here with our doctor in the four years parttime and one year full time we have been here. But thank heavens we haven't really been sick either.

Dentists are a different story. There are some very unethical dentists in Florida.

[StarbuckSammy]

It is interesting that our insider Russ says that the problem with the ER is not understaffing but overpopulation. But this has been a problem for the past several years and from my perspective The Villages Hospital has not solved the problem. What in the world happens when the next 20,000 or so residents move in? This is not the developer problem..it is the hospital. I don't know about you, but the thought of more possible patients the next few years makes me worry.

[Mikeod]

Originally Posted by StarbuckSammy

It is interesting that our insider Russ says that the problem with the ER is not understaffing but overpopulation. But this has been a problem for the past several years and from my perspective The Villages Hospital has not solved the problem. What in the world happens when the next 20,000 or so residents move in? This is not the developer problem..it is the hospital. I don't know about you, but the thought of more possible patients the next few years makes me worry.

The problem may be more the limitations of the physical plant, i.e., the number of rooms, rather than staff. There are plans to expand the hospital rather than build another facility near Brownwood. In my experience, it requires less time to expand an existing facility than to build a new one as far as getting through the local permitting process and the state and federal approvals. But it still takes years to accomplish this. The hospital has been expanded once before and will expand again. Hopefully this will help the wait times in the ER. It would appear the administration is taking some steps, but one may question whether they are projecting appropriately for the increased population.

[Russ_Boston]

Originally Posted by StarbuckSammy

It is interesting that our insider Russ says that the problem with the ER is not understaffing but overpopulation. But this has been a problem for the past several years and from my perspective The Villages Hospital has not solved the problem. What in the world happens when the next 20,000 or so residents move in? This is not the developer problem..it is the hospital. I don't know about you, but the thought of more possible patients the next few years makes me worry.

I think we have a total of 24 ER rooms at this point. I know the other day each nurse had 4-5 rooms assigned. It's mostly a snowbird problem the way I see it. The population swells during the winter months and the physical plant (while due for expansion over the next two years) can not (and maybe should not?) be made with the highest number in mind. There were many times last summer when we called off nurses and other staff due to lack of patients! We are increasing the number of beds by almost 1/3 in the next two years and perhaps that will free up ER holds (holds = ER beds awaiting an admit room in another unit such as cardio, medical, surgery etc.)

[Mack184]

Originally Posted by Russ_Boston

I think we have a total of 24 ER rooms at this point. I know the other day each nurse had 4-5 rooms assigned. It's mostly a snowbird problem the way I see it. The population swells during the winter months and the physical plant (while due for expansion over the next two years) can not (and maybe should not?) be made with the highest number in mind. There were many times last summer when we called off nurses and other staff due to lack of patients! We are increasing the number of beds by almost 1/3 in the next two years and perhaps that will free up ER holds (holds = ER beds awaiting an admit room in another unit such as cardio, medical, surgery etc.)

So what you are saying is that you need 15-20 ED beds from May-November and a minimum of 45 beds from December-April.

[sharonga]

When we first moved to the villages 8 months ag o, my daughter had an accident and needed stitches in her hand. The villages emergency room were wonderful.yes we were there a few hours but that was expected. She was seen immediately. Everyone was so wonderful. The past month my husband had to be taken to thr er twice by ambulance, again wonderful care. If anyone is very sick, call 911, they wwill send an ambulance and will take you right into the emergency room. Or go to urgent care and they will call an abulance.

[Happinow]

I, too, have been a bit worried about the possibility of getting quality emergency care. Thankfully, neither myself or my husband have needed it thus far. I have no experience with TV hospital or urgent care centers, so my thoughts and opinions are solely based on what I have read and heard. I have told my husband that if I need to be hospitalized please get me to Ocala. What I wonder is if I go to TV hospital by ambulance, and want to be transported to Ocala hospital, will an ambulance transport me if my condition warrants?? I do worry about needing immediate, quality medical care. And I had no idea the medical care was so poor before I moved here. Not something I even thought about checking out. I figured since there were 90,000+ people the medical care had to be pretty good. Apparently not.....

[Grannynance]

Happinow- I don't think they will taxi you from place. Try leesburg, but then again it is a few years older I know how you feel about older buildings

[Challenger]

In my experience ERs throughout the nation are nearly all experiencing the same kinds of pressures that we experience in TV. I served as a director of a 235 bed critical care hospital in a small town (100,000 ) in Md for 17 years. We were constantly rebuilding, renovating, expanding that operation during that entire time and still were unable to satisfy the more than 70,000 people who arrived asking for care . Even with the enormous proliferation of urgent care centers throughout the country, the pressure on ERs has continued to grow. My family has had three evperiences with the TV ER in the last two years and our care (quality and wait) was no different than we had experi ernced at Johns Hopkins Hosp in Baltimore or several other MD facilities.

[Madelaine Amee]

Originally Posted by Happinow

I, too, have been a bit worried about the possibility of getting quality emergency care. Thankfully, neither myself or my husband have needed it thus far. I have no experience with TV hospital or urgent care centers, so my thoughts and opinions are solely based on what I have read and heard. I have told my husband that if I need to be hospitalized please get me to Ocala. What I wonder is if I go to TV hospital by ambulance, and want to be transported to Ocala hospital, will an ambulance transport me if my condition warrants?? I do worry about needing immediate, quality medical care. And I had no idea the medical care was so poor before I moved here. Not something I even thought about checking out. I figured since there were 90,000+ people the medical care had to be pretty good. Apparently not.....

If you have not yet needed to avail yourself of the medical care here in TV how do you come to make the statement "I had no idea the medical was so poor before I moved here".

The medical care available to you here is good to excellent. You have a hospital right here in TV. You have a hospital in Leesburg. You have Florida Watermans. You have two hospitals in Ocala. You then move into the very high end hospitals, namely - Orlando General, Tampa General, Moffatt, Gainesville and Mayo in Jacksonville. The farthest one is a three hour ride from here and how bad is that?

This thread has vilified TV hospital, but there are hundreds of residents who have had excellent treatment from our local hospital.

[Mack184]

To clarify a point..both The Villages Hospital & Leesburg General are operated by the same company...Central Florida Health Alliance. So in essence if you like the care you get at TV you shouldn't have a problem with Leesburg, but if you don't like the care at TVH then you most likely won't like the care at Leesburg.

There also seems to be a rather big discrepancy between doctors affiliated with Munroe and those at TVH/Leesburg. If you read each hospital's website, they list the background & schooling of many of their physicians. TVH/Leesburg seems to have a rather large amount of 3rd world doctors educated at medical schools that are not well known, while the majority of doctors at Munroe Regional have been schooled at well-known American medical schools.

[Grannynance]

one trip to er at the village received good care. Two heart attacks care for in leesburg still here so that was OK. The medical care in the area is very good. As for where the drs come from Americans go overseas the people overseas come here that is the way it is.