PAWTUCKET — Pawtucket’s state senators say R.I. Department of Health’s conditions on Care New England’s closure of Memorial Hospital’s emergency department don’t fully address the burden placed on The Miriam Hospital and nearby services, a point Pawtucket Mayor Donald R. Grebien conceded while pledging continuing work with the state to meet community demands.
RIDOH temporarily halted EMS services, new admissions and surgeries at the Memorial on Nov. 30, leaving it open for walk-in patients only. The Miriam Hospital has since seen an untenable surge in demand at its emergency department, said Senator Elizabeth A. Crowley, D–Central Falls.
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“I am told that the emergency department at Miriam Hospital is already overwhelmed, with nurses there being required to work 12-hour shifts,” Crowley said.
Richard Salit, spokesperson at The Miriam Hospital, acknowledged the additional burden from Memorial’s closure, but contested both the characterization of the issue as solely attributable to Memorial patients, and as an egregious situation.
“The Miriam Hospital has seen an increase in Emergency Department volume, as has Rhode Island Hospital, over the last several years. While the situation at Memorial Hospital has contributed to the increase, clearly the growth pre-dates the Memorial ED closure. The Miriam continues to staff its ED to meet the community’s needs and will be opening a new observation unit this winter to help improve the delivery of vital care,” Salit said.
“The Miriam has seen an increase in wait times as have most hospitals during flu season, but it would be inaccurate to characterize these as unacceptable. The physicians, nurses and staff in The Miriam Hospital’s ED triage patients based on the urgency of patient’s medical needs and strive to treat all patients in a timely manner,” he added.
Some of the conditions RIDOH placed on CNE’s closure of Memorial’s emergency department were a result of comments from the community, including the senators, concerned about whether Rhode Island Hospital and The Miriam Hospital can handle patients diverted from the closed emergency room, said Joseph Wendelken, public information officer for RIDOH. Those conditions were numbered 5, 6 and 7 on page 14 of the decision approving the emergency department’s closing.
Condition No. 7 requires Care New England to open a walk-in clinic in Pawtucket.
Condition No. 6 calls for CNE to convene a group of stakeholders to explore and propose immediate solutions and pilot programs that mitigate the impact on the community, other hospitals and other health care providers. The first meeting is required within one month of Jan. 1, 2018.
“Such approaches could include changes in emergency medical dispatching, mobile integrated health care, and directing EMS calls to walk-in or urgent care centers under appropriate circumstances. The funding that we called on CNE to direct to Pawtucket and Central Falls will be used to put these solutions into place,” Wendelken added.
Condition No. 5 requires CNE to pay $500,000 annually to Pawtucket and Central Falls to support Emergency Medical services and offset EMS costs of transporting patients to other hospitals.
Crowley said that while she applauds CNE’s efforts to deal with the impact from closing Memorial’s emergency services, they don’t make up for the loss of the services in Pawtucket. The transportation challenge for some people needing emergency services in Pawtucket is unlikely to be solved by the transportation condition, for instance, Crowley said.
“Many members of our community are elderly and may have mobility issues. They may not have easy access to transportation to get to another facility in the first place. These are factors that need to be considered, particularly as the question as to whether primary care services will continue at Memorial is still pending,” she said.
Grebien said he has shared the concerns with CNE and RIDOH officials, and pointed out the decision to close Memorial’s emergency department shouldn’t happen in a vacuum.
“The closure of a hospital affects all aspects of the larger health care system, as we are seeing from the volume at Miriam Hospital. The senators are right to point out that a larger plan needs to be in place and monitored. The true needs of the patients and population needs to be looked at further,” Grebien said.
“To that end, DOH granted our request and required that a consultant be put in place to assess which other health care services are necessary, determine the long-term impacts of the closure and provide updates every three months. DOH is also convening representatives from the local hospitals, EMS, primary care and cities to gauge the impact on the hospitals in the area and develop pilot programs.
“This is by no means rights the fact that our hospital is closing. However, the application for closure could have been approved with no guarantees for primary care, walk-in services and other conditions,” Grebien said.
