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any given hospital in the country, a busy day can mean overcrowding,
delayed care and even refused admissions to emergency rooms. The
problem is so widespread that the practice of ambulance diversion—telling
emergency crews that a hospital can’t take any new patients—is a
widely recognized public health problem. Typically hospitals have
considered two equally problematic solutions: rationing resources
or wastefully expanding their operations.
But a recent study by Michael
McManus, MD, associate director of Children’s Medical/Surgical
ICU, James
Mandell, MD, president and CEO of Children’s, and several
of their colleagues, suggests that there may be a better way. Their
analysis shows that often, spikes in patient caseload are more closely
associated with scheduled cases—elective surgeries, for example—than
with unscheduled emergency admissions. That means patient flow is
more controllable than previously thought. The next step, says Mandell,
is figuring out what operational changes will help smooth out caseloads.-CM
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