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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com




Sunday, January 11, 2015

Protocolo de capacidad completa (FCP)

Hospital crowding and flow
Hospital crowding and flow - By Peter Viccellio - 2014
"I am a practicing emergency physician and clinical director of the emergency department at Stony Brook on Long Island. Our institution believes that the ED is a vital community resource, and must be able to deliver needed services at all times. We do not consider ambulance diversion a responsible option. We also believe that admitted patients are best cared for by health care providers whose specialty is inpatient care, in a quiet and calm place where that care can be best provided. 
To responsibly shepherd limited and expensive resources, hospitals must do what they can to maximize the capacity they have, through scheduling, smoothing, addressing length of stay issues (see the 24/7 hospital), in addittion to a multitude of other issues that impact on overall throughput. 
In spite of processes that maximize the availability of resources, the reality of modern day health care requires that hospitals operate at close to capacity. This necessarily means that being overcensus should be an expected and routine occurance. In short, this is a problem by design. As such, there should also be a responsible plan for how best to care for admitted patients during times of full/over capacity. 
When faced with a full census, we use the "Full capacity protocol" (FCP) at Stony Brook, which moves patients upstairs when we're full, allowing us to address high hospital census in a distributive and safe fashion. This protocol, in existence since 2001, has been broadly applied in many hospitals in the United States and Canada, although many institutions unfortunately continue to choose to leave the problem of boarding of admitted patients in the emergency department. As noted below, this is not the wiser choice.
Included here are some articles on overcrowding, our FCP, and some rulings by the DOH on this matter. The articles may be helpful in changing the culture which surrounds the issues related to hospital overcrowding. Use them as you see fit. You are welcome to contact me if you have questions about our initiative to assure our patients' safety and provide care in a humane fashion."