Jan 13, 2017
Antelope Valley Hospital CEO to work on hospital backlog
LANCASTER - Antelope Valley Hospital Chief Executive Officer Michael Wall, who was hired Jan. 3, said he understands concerns raised by some emergency medical personnel about overcrowding in the emergency room.
Antelope Valley Hospital's emergency room, the fourth busiest in California, saw 120,421 patients in 2015, the most recent year available, according to the Office of Statewide Health Planning and Development, or OSHPD.
"It is a real issue," he said. "Nobody's sweeping anything under the rug."
Wall said that in the week since he has been hired, he has made several trips to the emergency department.
"I'm seeing almost 400 patient visits a day in an area that was designed for 180," he said. "When I was at Northridge, a busy day was 150, 175."
Antelope Ambulance assistant general manager Matthew Ware said the entire region is busy with ambulance calls for places like Antelope Valley Hospital, Kaiser and urgent care facilities.
"The hospital gets busy, it's the area we live in," he said. "It's a busy area. We have a large population of people. We have a lot of calls that come out of here.
"Once we get to the hospital, the long wait times affect everything from every company because we only have so many units," he added. "It doesn't matter how many calls we run, we only have enough to run that many, but when we get stuck at the hospital, we're there for a good two to three hours; there's not a lot we can do about it. It definitely hurts, but it's part of the area we live in and the situation we have to deal with."
Ware said he figured that most of the time, wait times at Antelope Valley Hospital's emergency room average about three to six hours and the number of waiting ambulances can average 15 to 18.
Wall said he understands that lengthy wait times impact ambulances.
"This is revenue for them, it's tying up their driver and I get that because it's the cost of doing business," he said. "They want to get the patient, bring them here, drop and move onto their next run. I get that."
David Nieto, a business development specialist for Antelope Ambulance, pointed to staffing as a concern.
"From what we're hearing, there's a staffing issue upstairs, not so much in the ER," he said. "They work hard and they're doing what they can with what they have available. But when there's beds upstairs and you have people who have been admitted to the hospital, but are sitting in the ER taking a bed and can't be moved upstairs because of it, that bottlenecks us where we can't move those patients up and make beds available and make the whole operation run smoother."
Wall said there is a staffing issue at the hospital. Last year, officials with the nurses' union said nearly 100 nurses left the hospital, 30 of which were in critical care.
"There's no question about staffing issues," he said. "They're real. Now, I'm authorizing to try to bring back some of these people, but they don't grow on trees. Management in terms of supporting the hiring of additional nurses is important, yet I've got an (emergency department) that's over-utilized and under-sized. These people are doing the best they can under really difficult circumstances. What I'm trying to do is pay attention to the issues and work with my team."
Wall said he wants to eliminate logjams to help streamline how patients come into the emergency room, the epicenter of health care for many in the Antelope Valley, and receive care.
"This is a county hospital by default and a private hospital," he said. "What you've got are patients that don't have access to primary care and they use the emergency department or urgent care here. That's not going to change overnight."
Wall said that while capital improvements are needed, his immediate concern is supporting staff.
"There's no question we need newer facilities, but in the meantime, that's not going to happen tomorrow," he said. "How can I improve the flow, how can I support my staff that's doing incredible work to try to remove as many of these logjams as possible."
"I've got to win the hearts and minds of my staff, but particularly nurses," he added. "If they believe - it's not my talk, it's my action - that I've got their back, they will help me re-recruit people that potentially left the organization. That's what we're trying to do and I'm being told we're having some success, but it's early. I've got the nucleus of people here that have that passion, I just need to tap into it."
Ware said he thought Wall would improve the hospital.
"I've heard a lot of good things about him coming in," Ware said. "I think everybody expects him to do a lot for this area, that's why he's here. I know he comes with high praise from a lot of people."
"From what I understand, he's very realistic," he added. "I think he will make a big change, it's just obviously going to be a matter of time because, of course, you can't expect them to change something overnight. I think they finally have the right player in the right spot to make the proper changes."
Wall likened himself more as a coach, not a player.
"You're talking about people who have trained in some of the best places," he said. "You've got some caliber of physicians and some of the dedicated nurses who have stayed here. The nucleus is here. What I've got to be able to do is just tap into that and help bring the organization to this next level.
"The coach has got to have the athletes to win. They're here," he continued. "If we focus on quality, everything we do is going to be quality-driven, we're going to do fine financially. We're going to invest in this place. We're going to have to put millions of dollars back into some of the (hospital)."
Wall also said he wants to invest in a culture change, nurse educators and support staff.
"I love this place. This place has incredible assets," he said.
Ware said residents should not be afraid because of the wait times.
"They're still going to get the appropriate amount of care," he said.