1000 Genomes Project Promises Closer Look at Variation in Human Genome

Abstract

took issue with the use of boarding and crowding as part of a management strategy. “The financial incentives are out of sync for a variety of services hospitals offer for patients,” Steinberg said. “Hospitals are trying a variety of ideas to address overcrowding, but there is no one-size-fits-all solution.” But some potential solutions are being considered. For example, hospitals could try to reduce the traditional use of the early days of the week for elective surgeries, which limits the number of inpatient beds available at that time. “I see 180 patients a day, and I can’t get them an inpatient bed on a Monday, but I see the same volume on a Friday and have no problems,” said Judd E. Hollander, MD, professor and clinical research director in the Department of Emergency Medicine at the University of Pennsylvania School of Medicine. Using the inpatient services of hospitals on weekends and the evening hours during the week could also ease boarding, Hollander added. Another possible solution to ease crowding is to move patients boarding in the emergency department to hallways of inpatient areas of the hospital. “Instead of having 20 emergency department beds being used, you have 2 patients in hallways on each floor of a 10-story hospital,” said Kellermann, who noted such a scheme is viewed cautiously by inpatient nurses who worry of being overburdened. “What one often finds is the ‘miracle of the elevator’—by the time a patient gets to the floor, there’s a clean bed waiting,” Kellerman said. However, an impediment to trying such solutions is a fear of hospital administrators that being the first and perhaps only institution to do so in a community could lead to that hospital being flooded with uninsured patients, which might overburden the institution financially. Still, said Pines, while one can appreciate a hospital’s desire to be financially stable, the institution must remember why it exists in the first place. “Usually a hospital’s mission statement calls for it to provide the best care to any patient regardless of status,” he said.