10 (or 20) hour wait for a bed at Mass General

March 2, 2005

The front page of today’s Boston Globe has a picture of stretchers lined up in the hallway because the ER is overcrowded. It’s what we might expect after a natural disaster, but apparently this is business as usual at Mass General Hospital:

Typical is the situation recently at Massachusetts General Hospital… It was 1:30 pm on Thursday, and 20 patients in Mass. General’s emergency department needed to be admitted to the hospital for more extensive care. But the hospital had beds for only eight new patients. The electronic chart listed how long patients had been waiting for beds on a medical floor. The longest: two patients for 21 hours and one patient for 22 hours. A half-dozen recent arrivals were parked temporarily in hallways.

In classic fashion, hospital administrators say they’re doing all they can and need more capacity. Some hospitals in Boston are adding beds. Deep in the article there is a reference to Eugene Litvak, professor of healthcare and operations management at Boston University. He believes the problem is poor planning and I think he’s mostly right.

We wouldn’t expect factories to simply add new, expensive capacity as a first resort every time demand increases, and we shouldn’t expect it of hospitals either.

2 thoughts on “10 (or 20) hour wait for a bed at Mass General”

  1. It’s not surprising that Mass General is experiencing such a demand for services. We’ve created a system in which hospitals advertise regularly – listen to the number of Mass General radio spots currently running and you’ll see where some of this is coming from. Add in their reputation, as well as the American way of wanting the best quality for the minimum price, and you’ll find that the doors are being beaten down.

    There’s some sort of a happy medium here in which administrators need to do a more comprehensive job of planning – looking at weekly, monthly, seasonal trends – and adding in a good bed management or capacity management software system, as well as looking seriously at expansion where necessary.

    No, we don’t expect factories to add new capacity every time demand increases, but if the situation is serious enough to assign nurses to “hallway shifts,” a trend analysis should be able to pick up on more predicatable patterns or prologned demands that can be accommodated with increased capacity.

    The alternative – turning patients away at the door because the hospital is full – is unthinkiable and unconscionable.

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