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Waves Of ER Patients Challenge Fort Worth's JPS Hospital

Christopher Connelly
JPS Hospital in Fort Worth

The emergency room at Tarrant County’s public hospital faced its own emergency last week. Patients swamped John Peter Smith hospital’s emergency department in Fort Worth following the Memorial Day holiday.

Hospital officials said they were in “disaster mode” last Tuesday, leading the hospital to issue a Code Yellow emergency declaration in order to shift resources and solve the problem. Hospital staff worked extra hours and came in on days off to help with the patient surge.

This was the second time in a 30-day period such a declaration was made in response to high patient volume in the emergency department. Following the previous Code Yellow on April 30, hospital officials borrowed patient beds from the North Central Texas Trauma Regional Advisory Council to set up temporary triage sites.

“Over the last six weeks, we have seen a larger volume of psychiatric-related complaints,” said Jesse DeWaard, executive director of JPS Emergency Services Division. “Around 23% of the patients we see must get further care either in the observation status or as an inpatient. In addition, some of the patients we see have very challenging environmental and social issues related to their care.”

JPS uses the National Emergency Department Overcrowding Scale to measure the strain on hospital resources. The scale looks at the number of beds in the emergency department and the hospital, the number of patients coming in, how long people are waiting to be seen, and the time it takes to admit someone to the hospital. Any emergency room that scores over 180 on that scale is considered dangerously overcrowded. The score last Tuesday was 298.

Part of the surge last week may have been holiday-related: people often wait until after the holiday to go to the hospital. The ER saw a larger number of people than usual who were very sick or had complicated medical cases and needed to be admitted. They also saw many more psychiatric cases than usual.

While the JPS emergency department treated more patients in May than any of the last six months, it is generally a busy hospital with a busy emergency room.

As the county’s public hospital, JPS tends to get more people without insurance, which can mean patients who are less likely to have chronic conditions like diabetes or high blood pressure under control. Uninsured patients are less likely to get the kind of preventive care that keeps folks healthy and often avoid going to see a doctor until they’ve been sick for a while.

JPS is also the only place to go in Tarrant County for emergency psychiatric services.

Tarrant County is one of the fastest-growing counties in the country. Last fall, voters there approved a huge bond measure to help fund a $1.2 billion expansion of the JPS Health Network.

That expansion includes new and upgraded facilities at the main hospital in central Fort Worth, a new cancer center and ambulatory surgery center. When complete, it will triple the number of available psychiatric beds. And new health care facilities will be built in the surrounding suburbs to help folks get care closer to home.

Christopher Connelly is a reporter covering issues related to financial instability and poverty for KERA’s One Crisis Away series. In 2015, he joined KERA to report on Fort Worth and Tarrant County. From Fort Worth, he also focused on politics and criminal justice stories.