Piedmont Fayette Hospital’s emergency room has become so busy at times that hospital officials ask local paramedics to warn patients that service there might be slow.

That practice, called “diversion,” doesn’t apply to patients experiencing a life-or-death situation, hospital officials insist. Local EMS officials for Peachtree City and Fayette County say they’ve had no problems with having the most critically injured patients seen quickly at Piedmont Fayette’s emergency room.

Occasionally, however, the ER will be so busy that county paramedics and EMTs will help provide extended care once inside the building until the hospital nurses and doctors can assume care, said Allen McCullough, deputy chief of the Fayette County Department of Fire and Emergency Services.

When the decision is made to go on ER diversion, a physician and other staff have input and the final call is left to an administrator, Duffy said.

“It’s a matter of what’s the best thing for the patients,” said hospital spokeswoman Ryan Duffy, noting that the problem is not with staffing. “... We’re saying you may want to look somewhere else where they can see you sooner.”

At the same time, “If you walk in the door here, we’re not going to send you away,” she added. “We’re just not willing to cut corners on quality of care.”

The main factor in the hospital’s decision to go on ER diversion is due to patient volume and the size of the current ER, not staffing concerns, Duffy said. Last year, 47,000 persons were treated in the emergency room here and this year the ER is on track to break that record.

“We need the space so badly because our patient volumes are so high,” Duffy said.

The number of patients treated in the ER here is so high that Piedmont Fayette’s ER saw almost as many patients last year as its sister hospital, Piedmont, in downtown Atlanta.

Peachtree City Fire Chief Stony Lohr acknowledged that Piedmont Fayette is on ER diversion “more than we would like.” But, he added, “A lot of folks are working to figure out how to make it better.”

The increased demand on emergency rooms has become a nationwide problem in large metropolitan areas like Atlanta, officials said. Too often, local emergency officials say, other nearby hospitals such as Southern Regional in Riverdale or Newnan Hospital are on diversion the same time Piedmont Fayette is.

There is some relief coming in the near future at Piedmont Fayette Hospital.

This August the hospital is projected to open its expanded emergency room, which will almost triple the number of patient beds available, said Duffy. More staff will also be hired to take on the workload, she added.

That will help, local EMS officials agreed. But until then, the backlog in the ER will take its toll on patients waiting with non-life threatening maladies, many of whom are being urged to use the hospital’s Minor Emergency Care Center just a mile down Ga. Highway 54 on Yorktown Drive in Fayetteville. Many times, the MECC can provide quicker care and it has the same qualified staff as the ER does.

Some of the patients come to Fayette from Clayton and Coweta counties, bypassing other ERs, she added. And some folks use the emergency room in place of a primary care physician for relatively minor ailments that build their way up to being a significant nuisance, Duffy said.

McCullough said when the local hospital ER is on diversion, most patients using Fayette County EMS choose to go to Piedmont Fayette Hospital anyway, most likely because their physician is already based at the hospital. Also, in some cases, patients the county picks up have already had contact with their physician, who has recommended they come to Piedmont Fayette, McCullough added.

Only 10 to 12 percent of the patients transported by Fayette County EMS are injured to the point of being considered critical, where their lives are in the balance, McCullough said. Those patients, however, are less likely to go to Piedmont Fayette anyway because the hospital is not equipped to handle significant trauma cases.

Lohr said the expansion of Piedmont Fayette’s ER likely will help. Though no hospital is staffed to meet contingency plans for a “worst case scenario” area hospitals should be prepared for “what happens routinely,” he added.

“It comes down to a money issue,” for hospitals, Lohr said, noting that Peachtree City hasn’t had any problems with the most severely injured patients being seen even when Piedmont Fayette Hospital is on diversion.

McCullough said Fayette County EMS has an excellent working relationship with Piedmont Fayette Hospital and routinely meets with hospital officials to smooth out kinks in the system and look ahead to trends they need to be proactive about.

“We look at them as part of our team, and I know they think of us and Peachtree City in that way too,” McCullough said.

It can be upsetting to have to wait in the emergency room with an injury such as a kidney stone for example, McCullough said. But at the same time, behind the ER doors, hospital staff could be working on an extremely critical patient who may be having a heart attack or another life-threatening condition in which possibly half the ER staff is working on that patient because the next 15 minutes of care may determine whether that patient lives or dies, he added.

“You don’t want to wait when you feel bad,” McCullough said.

If you have a finger cut, or maybe a broken bone or a really bad sinus infection, you should consider the hospital’s Minor Emergency Care Clinic, less than a mile away, Duffy said. The waits are usually much shorter but patients there get the same level of care as they do in the main emergency room, she said.

If you’re having a heart attack or other grave condition, however, don’t hesitate to use the main ER, Duffy added.

“If you have a heart attack you need to be here and you’ll be brought in and treated appropriately,” Duffy said. “It may make the guy in the waiting room with a finger cut wait a little longer. But we will prioritize as necessary.”

It’s ideal for local ambulances to take patients to Piedmont Fayette because it’s here in the county, thereby reducing the turnaround time to get an ambulance back in service to answer calls. Still, it can take a county ambulance crew 30 minutes for example, just to turn around an ambulance that has come to Piedmont Fayette Hospital, McCullough said. The paperwork that must be completed these days is significant and the ambulance must be cleaned and restocked, he said.

The workload has increased such for the county EMS that a new ambulance will be going online in the next few months, McCullough said. The established threshold is if any one ambulance runs more than 2,000 calls in one year, that meets the criteria for needing another ambulance for the county. That will give the county six ambulances, one of which will be kept in reserve and used when necessary, McCullough said.

Peachtree City has four ambulances. If all of those get busy and assistance is needed, the city has an agreement with Fayette County to have a county ambulance respond; Peachtree City in turn provides the same courtesy to the county.

Lohr said a similar system possibly could be developed to help keep hospitals from going on ER or critical care diversion because they get swamped with so many patients.

“We don’t say we’re on diversion,” Lohr said of the city’s ambulance service.

Hospitals don’t like going on diversion, but there are many other factors that combine on the workload for emergency rooms across the state, said Kevin Bloye, spokesman for the Georgia Hospital Association.

“It’s a classic case of demand exceeding supply,” Bloye said, citing the growth in the state’s population, and a shortage of qualified staff.

“One thing we’ve got to do is a better job of increasing our hospital workforce, and we’re working on that,” Bloye said.

The population is also aging quickly, and some uninsured patients are using emergency rooms as their primary caregiver, Bloye said.

That said, diversion is not a tactic hospitals want to use, Bloye added.

“It’s certainly a last resort for hospitals. Their job is to serve every patient. But when you run out of beds and you run out of staff, you have no other option.”

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