Baton Rouge General to close its Mid City emergency room _lowres

Advocate staff photo by BILL FEIG -- Baton Rouge General's mid-city campus.

At 7 a.m. Tuesday, Baton Rouge General Medical Center’s Mid City emergency room will close, pulling the plug on what hospital officials call a financial money pit that threatened hospital operations.

It’s the second emergency room shutdown within two years in the urban environs of Louisiana’s capital city. The first came as LSU’s charity hospital closed for good in April 2013 and the nearby Mid City emergency room saw a sharp rise in uninsured patients entering its doors.

The Mid City ER closure will create similar ripple effects that other hospitals in communities across the nation have experienced, said Lorrie Metzler, of the American College of Emergency Physicians, predicting increased demand on facilities outside Mid City.

“Those patients have to go somewhere,” Metzler said. “This is happening all over the country.”

Six percent of the nation’s emergency rooms have closed in recent years, including many that serve poor, inner-city areas such as Mid City.

In Baton Rouge, state and area health care interests are bracing for what’s to come as the Mid City ER unit, which registered 45,000 visits last year, is no more.

Our Lady of the Lake Regional Medical Center in south Baton Rouge has added 27 additional patient beds, bringing the total number of available adult and pediatric beds in its ER to 86. Five new exam rooms and 14 minor care treatment spaces have been opened. Two critical care rooms have been refurbished and enlarged. Another new addition is a “quick look” nurse who talks to the patients entering ER doors and helps determine what level of care they need, whether it be through the ER’s “fast track” unit, which handles doctor’s office type ailments, or stepped-up midlevel care involving a more serious medical complaint that falls short of the need for critical care treatment.

The Lake reports nearly 140,000 emergency room visits each year.

“We are trying to be as prepared as we can,” said Randy Olson, chief executive officer of Lane Regional Medical Center in Zachary, also about 30 minutes away from Mid City.

Olson said the hospital has added to the list of standby emergency room personnel “people we can call in if we need them.”

Baton Rouge General Medical Center’s Bluebonnet location is increasing staffing in anticipation of patient volume shifts. Hospital management will monitor the situation and make adjustments based on demand. But, nobody knows what to expect.

The state health agency, as well as the General and Our Lady of the Lake Regional Medical Center, which has a trauma center, launched community education campaigns.

The idea is to steer many patients who use emergency rooms for primary care to doctor’s offices and urgent care clinics.

“We have tried to make people realize there are other options available to them, more appropriate options,” state Department of Health and Hospitals Secretary Kathy Kliebert said.

For instance, brochures went out to schools, churches, grocery stores and other places to advertise the location of LSU Health urgent care clinics in Mid City and north Baton Rouge and to encourage making a doctor’s appointment.

The underlying message: Emergency rooms are for serious medical problems, such as heart attacks, strokes, respiratory distress and head injuries.

“I feel comfortable where we are in the short period of time we have,” said Kliebert, noting increases in traffic at both of the LSU Health clinics serving the area in the past week or so, as a sign the message is being heard.

Baton Rouge General abruptly announced it would close the Mid City emergency room about two months ago, bringing an outpouring of community protests.

The LSU Mid City clinic on North Foster Drive expanded its hours last week to 9 a.m. to 9 p.m. The always-open north Baton Rouge clinic at 5439 Airline Highway expanded hours for advanced diagnostic services, including CT scans and MRIs.

The Lake is putting a stronger push on its Lake Line Direct program, where a nurse is available around the clock to give people advice about medical problems.

The Lake’s Chief Operations Officer Terri Sterling said the hospital is “weighing the pros and cons” of putting an urgent care center on its campus off of Essen Lane.

Olson said Lane will be working on getting people into the LSU system, “where they do have a primary care doctor.”

A robocall sponsored by Baton Rouge General tells of Mid City’s ER closure and advises those with medical emergencies to dial 911.

“These first responders start emergency medical procedures immediately, similar to emergency protocols that would be in an ER,” said Metzler, a New Orleans area physician. “They are doing that (ER protocols) within the minutes of when they arrive and are on the phone with a physician in the ER.”

Kliebert echoes Metzler’s sentiment.

She said the state agency has asked emergency medical services responders to report immediately if ER backlogs start preventing them from getting back out on the streets to help others in medical distress. “We want to make sure there are no barriers to that happening,” Kliebert said.

Medical emergency responders have said ambulance transport times likely will increase for many people in the Baton Rouge area when the Mid City ER closes, which East Baton Rouge Parish Coroner Beau Clark said could lead to more deaths.

EMS officials have said the closure also will likely result in increased “drop times” — the time it takes to transfer a patient from a waiting ambulance into the ER, thus tying up the ambulances.

Sterling said Lake officials have met with every area hospital to streamline the process for transferring patients to the Lake when they need a higher level of care. There’s a central number that can be called to trigger a patient transfer.

A separate 12-bed mental and behavioral health ER is under construction at the Lake and should be finished by June. Patients would go to the unit after they have been medically cleared so they can be mentally stabilized to go home or stay while an inpatient placement can be found instead of taking up a bed in the medical ER.

Follow Marsha Shuler on Twitter, @MarshaShulerCNB. For more coverage of the State Capitol, follow Louisiana Politics at http://blogs.theadvocate.com/politicsblog.