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1st appeared 22 November 1999

Mount Zion Emergency Department to Close Tuesday

UCSF Stanford Health Care will close the emergency department at UCSF/Mount Zion Medical Center at midnight on Tuesday (November 23). The UCSF chief medical officer, chief of staff, and vice president of nursing determined that adequate emergency services staffing at Mount Zion cannot be guaranteed beyond that point and decided to take the action to ensure patient safety.

Hospital officials had hoped to keep the Mount Zion emergency department open through December 23, but a combination of complex staffing issues forced the decision to take this action earlier, said Theodore Schrock, MD, chief medical officer for the UCSF Medical Center at Parnassus and Mount Zion.

Among the reasons for the decision:

• Emergency physician staffing – The physician group currently under contract to provide care in the Mount Zion emergency department has given notice that it will no longer provide the service after midnight November 24. UCSF Stanford had negotiated a contract with another physician group to provide service until December 23. Although the new group of physicians would not be familiar with Mount Zion, they would have been able to provide emergency room coverage if other staffing issues could have been resolved.

• Nurse staffing -- As a consequence of holding nursing positions open at Parnassus for Mount Zion nurses, staffing at both facilities is now at a critical point. Temporary nurses might be able to fill the vacant positions, but they would be unfamiliar with Mount Zion, its facilities, and its procedures.

Without an adequate nursing staff, beds in the critical care units of both hospitals would have to be closed to preserve the highest quality of care and standards of safety. The closure of these inpatient beds would, in turn, reduce emergency department capacity at both locations because critical care beds must be available to handle emergency cases when necessary. The nursing staff shortage will worsen with the resignation and departure of several experienced emergency nurses from Mount Zion on November 23.

• Consulting specialists – Consultation in the Mount Zion emergency department by medical specialists poses additional problems. Specialty services began transferring from Mount Zion to Parnassus on November 1 and other specialists have gone to other Bay Area hospitals. Without sufficient specialists available at Mount Zion, it will become impossible to ensure the highest quality care for emergency room patients who need specialty care. UCSF physicians from Parnassus could help fill the gaps, but they also would be unfamiliar with Mount Zion.

"Although each of these issues – unfamiliar physicians, a shortage of nurses, and a shortage of specialists -- is problematic alone, the combination of these issues poses an unacceptable threat to patient safety," Schrock said.

With the consolidation of the staffs at Parnassus and the addition of 10 emergency beds at the Parnassus emergency department – the same number being closed at Mount Zion – the UCSF Medical Center will be in a position to provide the same level and quality of care, Schrock noted.

UCSF Stanford will put a complete information program in place to inform the public about the change in an effort to prevent emergency patients from arriving at Mount Zion after November 23. The program will include letters to 113,000 individuals who live near Mount Zion, letters to patients, notification of public agencies, newspaper advertisements, and signs in multiple languages informing that the emergency department has closed.

Effective November 23, the Adult Urgent Care Service will be available at 2380 Sutter St. (2d floor) across the street from the hospital. The center will be staffed by UCSF internists and will include x-ray and laboratory facilities and will treat minor wounds and other non-emergent problems. The center will offer extended hours on weekends and evenings.

Links:

UCSF Stanford Health Care Daybreak Archive

Source: Bill Gordon, News Services

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