"The Ronan Report" provides insight about the activities at the Western Maryland Health System in Cumberland, Maryland, and about the changes taking place in healthcare today from a CEO's perspective.

Monday, July 25, 2016

Unfortunately, There Is No End In Sight

The other day, I asked for an update about the number of opiate-related overdoses that our ED has treated from January 1, 2016 through June 30, 2016.  There have been a total of 198 overdoses, with 142 being opiate or heroin related.  Those 142 overdoses have resulted in 26 deaths.  For emphasis, that’s 26 sons, daughters, moms and dads who have died due to an overdose of heroin.  If the police, and now the public, didn’t have Narcan to be administered when an overdose occurs, the death rate would be much higher.  
Our ED is treating practically an overdose per day.  But, if it was only that easy.  On July 12, our ED staff treated five heroin overdoses in one evening.  As you can see, our July numbers aren’t even reflected in the total for the first half of calendar year 2016.  
Our ED staff and our EMS providers throughout the region are now dealing with an absolute crisis in our community.  On the evening of July 12, our staff not only dealt with the five overdoses, but also with nine behavioral health patients, a series of critical care patients and a host of other patients with a variety of emergent needs in our ED.  We were forced to go on diversion sending patients to another ED for a period of time with our staff being overwhelmed with a full ED and waiting room.  That diversion put a significant burden on the EMS community, which then had to travel much farther to an ED outside of Cumberland.  
To demonstrate just how significant our ED has changed, last weekend a Cumberland police officer was attacked outside our hospital when he went to question an individual who was wanted in another county.  Both the police officer and the suspect were treated in our ED.  The suspect came into the ED in a rage, knocking over a computer on wheels and threatening staff.  Such behavior is fast becoming an almost everyday occurrence as our ED staff and providers are being spit upon, threatened and assaulted.  
We now have an armed police officer in our ED from 7 PM to 3 AM every day.  We are reaching out to our ED staff and providers to get their input as we reassess security in the ED.  Knowing that an armed police officer is in our ED during peak times previously gave some comfort; however, that now isn’t even enough.  Our staff are dealing with challenging patients morning, noon and night.  We will be having an upcoming ED Summit to determine what changes need to occur to enhance the safety and security of our patients and staff.  
So, the next time you hear how long someone had to wait in our ED or the staff could have been nicer, please understand what these ED professionals are dealing with each day.  In no way am I condoning having anything less than a professional, courteous staff in the ED for our patients, but I am trying to enhance the community’s awareness of what has become a typical day in our Emergency Department.


  1. Well said and thank you for all of your support.

  2. I posted a comment to this earlier this week. My suggestion is an overdose unit. Keep this unit separate from the regular ED. Separate entrances. This specialized unit could have staff specifically trained to handle the recent surge in heroin overdose patients. It could be staffed with mental health experts, and police. Specific safety precautions could be built in to protect both staff and patients. This keeps a separate ED free for trauma, Cardiac emergencies and other ED needs.
    I happened to be a patient in the ED yesterday at the WMHS. I witnessed an unconscious female being rushed through the waiting room by an nursing assistant. Every effort was being made by the staff and on-site officers to get this young woman back to the ED. I waited a long time for my room. After getting in a room, I watched the ED staff run up and down the halls in front of my room. Not walk but run. There was a multitude of staff working and they were all working. Everyone that entered my room introduced themselves and told me who they were and why they were there. They functioned as a team. They all looked beat and professional. They looked tired and haggard but proffessional. My care was right on target. I was transferred to the observation unit by a sweet and friendly nurse who was very polite and conversational. I know this profession. It is a difficult one. I can tell you that my care yesterday was spot on. Courteous, professional and accurate. When you go to the ED, you must remember that you are not the only one there. Your loved one is your number one priority but each patient is treated by evaluated and treated by priority and this priority is constantly re-evaluated based on the patients present. Please remember this. If you have experienced a mistake or misdiagnosis that has caused you or your family member ongoing issues, this is a different matter entirely.

  3. My suggestion is to build a separate overdose unit. Specifically staffed for overdose patients. This staff could be specially trained to deal with the recent overwelming increase in overdoses in our local region. This unit could have its own entrance and be staffed 24 hours a day with armed police to promote the safety of staff and all involved. This unit could provide on-site mental health providers for both patient and family. And resources for outside agency and community support. Meanwhile it would free up the other ED for the regular trauma, cardiac and other ED patients.

  4. Just curious ... is WMHS looking to provide a service called DETOX for patients who need to go to rehab?

  5. Just a suggestion, but I wonder if making an Emergency room for just over-doses would work... maybe it is not a solution, but would help having a separate area for these situations. Having the Emergency room separate from the trauma/accidents and other acute care not related to over-dosages. And, then also a clinic for non-emergent and less serious illnesses. Maybe having two front-line venue for emergency care.
    I know it won't fix the problem in community, but maybe separating the problematic areas will enhance safety of employees and other patients.