Narcisse asks about complex patient needs and ER operational challenges

Within the last several years, have patient needs become more acute or complex?

And has that affected emergency department throughout in the wait times?

I would say over the course of my career, I've seen a lot of complexities of care.

The drugs are changing, the pathology is changing, our knowledge is changing, and so all of it's becoming more difficult to navigate.

Connecting patients to resources is always challenging, and I think the more options and the more needs will always make that more difficult.

What are the primary operational challenges contributing to Pulong Emergency Department wait times?

I'm coming back to that again.

Yeah, I know.

Yeah, I mean, when you think about a patient who comes to the emergency department, there's so many needs they have, right?

So whether that patient needs laboratory assessment, whether they need radiographic assessment, whether they need medication administration, all those things take time.

The time it takes to draw blood, send it to a lab, get results back, all these things add up.

And depending on the complexity, they keep multiplying, right?

It's not just a one-plus-one scenario.

And you add that with the fact that a facility that gets 37 patients an hour trying to accommodate that many patients at once also makes it more complicated and complex.

Have you...

Think about exploring having those clinics closer to the hospital where you see the emergencies coming all the time that don't need, because I know you have the data.

You just have to go back to triage to see what's going on.

So if all the, like let's say if it's mental, so maybe we can anticipate partnering or having a place where you're not putting it and then you can move people out of the emergency room a little faster.

Absolutely.

I mean, part of the issue is...

You don't need transportation because we already have problems with...

I mean, EMS, you know, to come and get those patients.

Yeah, so I mean, part of it is we do have clinics in our facilities as well.

But under the federal EMTALA laws, we have to do an emergency treatment and screening exam for all patients that present, right?

And a lot of times in some of these lower QD patients, by the time I'm done with my EMTALA screening exam, I can pretty much diagnose you and send you on the way.

And so simply diverting them to another clinic isn't always the right answer, but educating them on the opportunities available next time instead of presenting to the emergency department might give that option.

So as I said before, a lot of my time is educating the public on what options do exist, how to search for help, how to ask for help, and what other resources might exist for health care besides the emergency department.

I'm going to ask one more question, and I'm going to try to get it back to chair because I have a lot of questions more that we, because today is about what can we do together

that we can decrease the wait time in the ER and how fast our...

EMS can get to the patient.

FDNY is helping us.

We're just looking for solutions to the problem we're facing.

And that's the reason I'm going to come back for more questions.

I'll ask you the last one, and I'll come back again.