The Observation Deck

More about Lakewood Hospital Emergency Department, and its pseudo-replacement as planned by Cleveland Clinic.

1. Lakewood Hospital handles 34,000 emergency visits each year. Only 4,000 of these come in by EMS. (EMS makes 6,000 runs a year but 2,000 of them go outside Lakewood.)

What hasn't been said yet - is that 30,000 of these visits, are YOU - walking in or driving in.

This means that YOU are making the decision that Lakewood Hospital ER can handle your emergency. (Instead of some dispatcher directing EMS to some hospital somewhere.)

Do you have heartburn - or are you having a heart attack? Is Mom's memory fading, or is she having a stroke? Is your ankle sprained, or broken; and can you stand the pain for 20 more minutes driving to Fairview? Your kid put mortar in their eye and you don't know if Lakewood can wash it out? Your kid swallowed a coin and you don't know if Lakewood can do an emergency tracheotomy?

If you think Lakewood can handle your emergency, and you are wrong, and you have to drive (bus?) to Fairview - it is 20 street lights away and you don't have a siren/flashers on your car to get you there without red lights.

And maybe - Fairview is full and can't handle your emergency, either.

2. Cleveland Clinic wants to close our real, 20-bed Emergency Department, and give us only 6 ER beds, and NO surgeries; aka Urgent Care.

They SAY this will accommodate 17,000 of our 34,000 ER visits.
They SAY another 7,000 can be handled at Fairview.

They ADMIT this leaves 10,000 with nowhere to go. When we asked the doctors, they replied we "could go to Lutheran or Huron Road". They said it isn't that far to either of those (but they didn't remember that Huron Road in East Cleveland was closed by the Cleveland Clinic--as if Huron was even ever an option.)

So, 10,000 folks looking for emergency care, will be STUCK. Can't get in at Lakewood, can't get in at Fairview - where do you go?

3. If we let Cleveland Clinic demolish our hospital in September 2016 -- and it takes them 22 months to build their proposed new MOB (medical office building) -- We will be without an Emergency Department for 22 months, that is almost 2 years. September 2016 through June 2018. REALLY??

Can this community afford to be without ANY kind of Emergency Department - when we right now have a fully-functioning ED attached to a fully-functioning hospital with surgical capabilities?

Have no fear, these guys have been hired to handle the overflow.

Marguerite your numbers are nowhere close to fact. There are more EMS units that transport to lakewood hospital then just LFD
LFD does not transport 6,000 patients a year nor have we transported 2,000 to other hospitals.
A dispatcher does not decide where a patient is transported that decision is made by the paramedics after patient assessment. If residents are having a hard time distinguishing heart attacks and strokes the a better system of community education in the form of car training is needed. If a parent with a choking child has not learned to clear an obstructed air way then again community education is the better answer to a trach, which is a procedure that can be done by LFD medics.
As for a six bed ER we see all the submitted plans and no plans for an ER have been forwarded for review and I have not seen any plans that show the current ER closing before a new on is built.
As for 10,000 patients having no where to go how about trying primary care physicians. Many of the back logs in ER's are from patients that should be seeing a family doctor and don't really need the emergency room.

Even with more insured patients under the ACA, energency room use is increasing.

http://www.wsj.com/articles/u-s-emergen ... 1430712061

And here is why:

Medicaid recipients newly insured under the health law are struggling to get appointments or find doctors who will accept their coverage, and consequently wind up in the ER, ACEP said. Volume might also be increasing due to hospital and emergency-department closures—a long-standing trend.

All well and good to ask people to see a primary care doctor instead of using an emergency room, but the fact remains that for many, getting in to see a primary care doctor in a timely manner is a challenge. I have seen nothing that indicates this will be changing in the future.

In fact, when the hospital leaves, doctors will follow and there will be fewer primary care doctors with offices in Lakewood. As many of our residents do not have access to vehicles, bus service to Fairview is time consuming, and there is NO bus service to Avon, the difficulty in getting to a primary care appointment is compounded.

I think it's very arrogant to say "if people went to a primary care doctor we wouldn't need an emergency room," just as it is arrogant to say a caregiver should be able to clear an obstructed airway. It would be nice if that were so, but real life gets in the way. People can't get in to see their doctor on short notice and people panic when a child is choking. None of this is going to change so basing your opinion of future ER usage numbers on those examples is inaccurate and dangerous.

Bridget,

You are spot on as usual.

Shannon Ritchie (CCF's "Chief of Liquidation " at Lakewood Hospital) has acknowledged that doctors have been leaving Lakewood in anticipation of the illegal closing.
So Bridget is right again-- the underserved will become even more underserved--the 60% voter turn out along the Lakefront and Clifton Park decided they don't care about "those people."

Chief Gilman,

I agree with you on the ER plans. You have helped to underscored another HUGE MISSING PIECE OF VITAL INFORMATION to add to the list of gaping holes in the "plan."

Why after 19 months of "negotiations" that started back in May, 2014 do we have NO CLARIITY on the level of care the "ER" will provide?
Answer: CCF doesn't give a damn about Lakewood or "those people."

Can anyone else tell us where the new ER stands under EMTALA guidelines?
Answer: NO!

There is no way of knowing what CCF has concocted for us--its all a BIG SECRET--just like the BIG DREAM.

Deckers should recall Bridget showing us the UCSanFran study that blew away the bogus claims of the "Bleeders."

Without a real ER, mortality rates rise even with nearby ER's---people will die--that's a fact.

lost in all the conversations are what the reality is the closure of the hospital results in the loss of the in patient beds. I have yet to see were it has been shown there is a medical of clinical need for the in patient beds. The proposal has an ER so work to build that ER to serve the needs of the community that have been hurt by the ACA. Since this whole discussion started there have been changes to Ohio law that can better address the health care of residents that don't need in patient care or are forced out of the inpatient beds by the ACA. That is we're the focus of health care is being directed. Bridgett i have been involved in pre hospital EMS for over 35 years it is not an arrogant comment. Training the community to learn CPR and obstructed airway maneuvers has been proven to save lives. Lakewood has implemented Emergency Medical Dispatch. This trains the Lakewood dispatchers to give pre arrival instructions to people on the scene prior to the arrival of the paramedics. This type of instruction has a positive impact on the outcome of patients and has already saved lives. An expanded community CPR and AED program will save more lives.

I'm very glad to see Chief Gilman engaging with us here. Thank you, sir.

The need for inpatients beds in Lakewood is there, just like the need for inpatient beds in Avon. And we have more than double the population here in Lakewood. Is it fair for people to sit in an ER for 10-15 hours, waiting to be transferred out for an admission somewhere else? It is happening. And a high functioning ER is very necessary here in Lakewood. Not an urgent care size 6-8 beds, like what was proposed by CCF in the LOI community discussions. And Chief Gilman, the numbers Marguerite quoted were taken straight from the CCF decanting plan, their Master plan dated 7/12/2012. The 2000 number came from one of your quotes but was not said in the same way you said it-"once Lakewood Hospital closes, city ambulances will increase the number of trips to hospitals outside of the city from about 469 runs per year to about 2,200". Community education in how to handle medical emergencies is very necessary but it does not replace a full service ER nor a full service hospital. And tonight in the Lakewood ER at 9:10 pm, we had 21 patients and Fairview ER had 70 patients..and the flu has not begun to hit us yet.

.
"we see all the submitted plans and no plans for an ER have been forwarded for review"

So there is talk and speculation and rumors and claims but no actual plans.

So neither side has anything to argue about other than the lack of actual plans.

BL cannot claim it will have something and SLH cannot claim it will not.

Unless I'm mistaken, which is always a possibility.

Past comments and expired LOIs would appear to be pretty worthless at this point.

Chief Gilman,

We will agree to disagree on the inpatient issue.

Jeff,

You are right, but keep in mind CCF is in full combat mode to destroy the hospital and ER without committing to any solid plan.

CCF has violated the "spirit and letter" of their current written agreements--those are Summers words and that is a fact.

What makes you think they can be trusted in word or deed in a new written agreement that once signed the City loses all control of the "ER" errr "ERrrrgent Care" thingy?

Since the CCF did a "Community Needs Assessment" a couple years ago, we (and the CCF) have the numbers of ER visits required in a city the size of Lakewood and that is 34,000/yr, per their own records.

If that is the case, why on earth are they planning to build an ER that can only handle (maybe) HALF THE CASES/yr????

Is it really too much to have a facility that can handle Lakewood's needs? And WHY is it too much to ask Dr. Jones, Mr. Ritchie, Mayor Summers, Ms. Madigan, Mr. Bullock, Mr. Juris, Ms. Marx?

Answer that for me because it make absolutely no sense.

scott gilman wrote:lost in all the conversations are what the reality is the closure of the hospital results in the loss of the in patient beds. I have yet to see were it has been shown there is a medical of clinical need for the in patient beds. The proposal has an ER so work to build that ER to serve the needs of the community that have been hurt by the ACA. Since this whole discussion started there have been changes to Ohio law that can better address the health care of residents that don't need in patient care or are forced out of the inpatient beds by the ACA. That is we're the focus of health care is being directed. Bridgett i have been involved in pre hospital EMS for over 35 years it is not an arrogant comment. Training the community to learn CPR and obstructed airway maneuvers has been proven to save lives. Lakewood has implemented Emergency Medical Dispatch. This trains the Lakewood dispatchers to give pre arrival instructions to people on the scene prior to the arrival of the paramedics. This type of instruction has a positive impact on the outcome of patients and has already saved lives. An expanded community CPR and AED program will save more lives.

Fire Chief Gilman

Thanks for jumping in, but you are used to running into burning buildings, so this must seem mild.

Over the past ten years I have covered the work Lakewood Fired Department does, and have seen first hand the incredible work. Recently Kammy and Brian Essi saved my life, and I got to see first hand how amazing modern ambulances are.

So my questions if you get a chance. What percentage of ambulances go to Lakewood?, Fairview? and Metro? Who makes the choice?

An example, a motorcyclist involved in a head on accident, within eyesight of Fairview Hospital, was taken to Metro? I would imagine that that Metro was the best hospital for the accident, or was it another reason?

Thanks again for wading into the hottest water in town.

.

So is Fire Chief Gilman blaming the Affordable Care Act for this debacle?

Why not blame the Hospital Corporations, the Insurance Industry, and the Pharmaceutical Behemoths? ACA is an easy scapegoat for the ills caused by corporate greed.

There are about 5,300 EMS runs every year.

http://www.lakewoodfire382.com/about/fi ... incidents/

Asking the people of Lakewood to use their primary care doctors is a "let them eat cake" opinion.

Primary care doctors are leaving Lakewood and moving to Avon where they will have easy access to hospitals, x-rays, laboratories, imaging, rehabilitation and more. The Clinic will be closing its current offices in Lakewood. The proposed 60,000 square foot medical office building is already being scaled back.

One member of the LHA suggested that people in Lakewood could take the bus to Avon to see their doctors.

One member of the LHA suggested that people in Lakewood could take the bus to Avon to see their doctors.

That must have been the same person, I believe it was Dr Jones, who was "concerned" that about 100 Lorain County residents would have to drive into Lakewood! God forbid!