Columbus ER wait times high as hospitals balance COVID patients with other health emergencies

When Amanda Kachaylo walked into a Columbus emergency department on a late September afternoon, she expected a wait, but could never have imagined how long.

Kachaylo, 25, of Victorian Village, was suffering from an infected cat bite. Unfortunately, on the day she headed to the emergency department, Ohio's COVID hospitalizations were peaking.

One hour of waiting turned into two and eventually stretched to five.

After being spared earlier in the pandemic, emergency departments have been hit hard during the latest surge in COVID cases, which has prolonged wait times and forced providers to juggle a new wave of infections and patients like Kachaylo.

COVID in Columbus:Little pushback from Columbus hospital workers over COVID vaccine mandate

It was 2 p.m. when Kachaylo arrived to a filled waiting room at Ohio State University's Wexner Medical Center. After an hour or two, a worker took her vitals and checked her in before leaving her to wait again.

"Two or three years ago, I remember walking straight in and was seen pretty much upon arriving," she said. "This time was different, though, because you could visibly see how packed they were, and you could tell that the staff seemed busy."

As Kachaylo waited, another woman who had been waiting for hours and believed she was having a miscarriage began to complain that she was in extreme pain and needed to be seen by a doctor right away.

Five hours after she arrived, Kachaylo was admitted and put on an antibiotic drip for the night. It was 7 p.m.

"I was still with a lot of people who came in around me. ... You could tell tensions were a little high," Kachaylo said.

Columbus hospitals and COVID:Little pushback from Columbus hospital workers over COVID vaccine mandate

'An impossible task'

Early in the pandemic, emergency departments actually saw the number of visitors plummet.

Visits to hospital emergency wings declined nationwide by 42% as people stayed home to combat the coronavirus, according to the Centers for Disease Control and Prevention. Although the decline took stress off of emergency departments in the initial days of the pandemic, doctors fear it might be part of the reason they're now overwhelmed.

Possibly out of fear of being exposed to the virus, many people put off medical care. Nineteen months later, it's likely people can no longer ignore those medical problems, said Dr. Adam Heringhaus, medical director of the emergency department at Mount Carmel East hospital.

Doctors are seeing more chronic illnesses pop up and health issues that have progressed much more than usual, he said.

'Twindemic' fears:Possibility of a COVID and flu 'twindemic' depends on the actions of Ohioans

"The short version is things are very busy," he said. "Now (patients) are coming in with health conditions that have been exacerbated."

These days, doctors like Heringhaus are working to treat the latest wave of COVID-19 patients as well as people who put off care. Wait time data that hospitals are required to report to the Centers for Medicare and Medicaid Services show just how overwhelmed some emergency workers were at the end of July.

Wexner Medical Center, for example, reported an average wait time just a few minutes shy of five hours, while OhioHealth's Riverside Methodist Hospital reported a wait of three hours, 37 minutes, according to federal data. Mount Carmel St. Ann's reported the third longest emergency time in the Columbus area with patients waiting an average of three hours, 17 minutes.

The average emergency department wait time in Ohio is two hours, 14 minutes, while the national average was comparable at two hours, 23 minutes, federal data shows.

Before the pandemic, wait times had shrunk to an average of 40 minutes nationally, said Paul Shafer, an assistant professor of health law, policy and management at the Boston University School of Public Health. Current wait times may just be a reflection of what happens when an emergency department is expected to do everything, Shafer said.

"We expect the emergency department to just handle the world," he said. "It has to be ready for anything all the time, and it's sort of an impossible task."

'It's been a challenge'

While hospitals are required to report wait times to federal officials, they don't always report that information directly to patients.

The Dispatch called 12 Columbus-area emergency departments to ask for wait times on the afternoon of Oct. 4. Responses varied at different hospitals and health systems.

Workers answering phones in emergency departments at OhioHealth's Riverside Methodist Hospital, Dublin Methodist Hospital, Marion General Hospital and Mansfield Hospital told The Dispatch they couldn't provide a wait time because it would depend on what someone needed to be seen for.

An emergency worker at OhioHealth's Doctors Hospital on the Far West Side said there were five people waiting for beds, and someone who answered the phone for OhioHealth Grant Medical Center's emergency wing Downtown hung up when asked for a wait time.

>>Read More:Ohio State Wexner Medical Center to pay out $1,000 bonuses next month

"When someone calls to ask about the ED, we can’t give a wait time because we don’t know what their need is until they can be triaged in person..." OhioHealth spokeswoman Katie Logan said via email. "Patients should be told that they’ll be triaged upon arrival and then seen in order of urgency based on the triage findings."

A Mount Carmel East worker said that nine people were waiting in the emergency department, while someone answering phones at Mount Carmel St. Ann's said there were 17 people waiting to be seen. People answering the phone at both locations declined to provide an exact wait time and said it likely would depend on the severity of a medical issue.

Someone answering phones in Mount Carmel Grove City's emergency department said the longest someone had been waiting was about two hours, 30 minutes, and that the hospital was diverting ambulances.

Ambulance diversion has been a somewhat regular occurrence throughout the pandemic, as hospitals struggle to keep up with the on-and-off influx of COVID patients, Heringhaus said.

An emergency medical squad still can come to a hospital that's diverting ambulances if a patient is in dire condition, Heringhaus said. The decision to try to divert ambulances is more of a safeguard as capacity dwindles at any given hospital.

"It's not a decision a single person makes. It's a decision between multiple people," he said. "It's been a challenge over the last year and a half and speaks to the capacity of the overall health care system."

A person who answered the phone at Wexner Medical Center told The Dispatch there was about a four-hour wait in the emergency department. At Ohio State East Hospital, an employee said the wait was around five hours.

Wait times have always been a hot-button issue, which is why it's important for hospitals to be open about them, said Dr. Mark Conroy, medical director of the emergency department at Wexner Medical Center.

While any wait time comes with the caveat that anything could change it, Conroy said he understands why patients would want to know how long they might need to wait so they can make an informed decision. It's important, he said, for patients to have as much information as hospitals can give them, whether that be about wait times or anything else that might affect their care.

"I think transparency in medicine is important. We want to set honest expectations early," Conroy said. "The wait time is not a punishment, it's not something that we're trying to inflict on someone. ... It's especially important for (patients) to understand we are trying to do the best we can with the resources we have."

Emergency versus urgent care

The continuing pandemic has taken a toll on health-care workers, a factor doctors said has led to significant turnover since the virus first showed up.

Even before COVID-19, there was a shortage of health-care workers. That shortage has likely grown, though, and prevents emergency physicians and nurses from treating patients as quickly as they'd like, Dr. Tom Gavin, an emergency medicine physician and president of the medical staff at OhioHealth Grant Medical Center.

Another factor fueling wait times has to do with why patients choose to come to emergency departments, Gavin and other doctors said. While emergency departments often see patients with serious injuries, they also see many with minor problems.

Columbus doctors:Ohio State cancer doctor's own diagnosis helps him relate to his patients

"For something like a minor cough, cold or back sprain, those are really well taken care of in the urgent-care environment," Gavin said. "If you're scared, you need to be in an emergency department. If you're just inconvenienced by your problem, it's good to go with an urgent care."

Lack of insurance coverage can push more patients toward an emergency department rather than an urgent care or doctor's office. A 1985 federal law requires emergency departments to treat everyone, regardless of their ability to pay for care.

It's not that doctors don't understand that some people may be more comfortable coming to an emergency department. But during a pandemic, seeking care elsewhere or consulting a primary care doctor first can ease the burden on frontline worker, Gavin said.

Not everyone has that trusted physician though, said Amy Rohling McGee, president of the Columbus-based Health Policy Institute of Ohio, a nonprofit focused on independent, nonpartisan health policy analysis.

People who don't have a primary care provider in their neighborhood, or might not have a doctor in the first place, often don't know who to ask for advice, McGee said.

Lacking a go-to medical professional, she said, leads some to visit the emergency department even when it's unnecessary.

Ohio ranks 42nd out of all 50 states and Washington, D.C., for the most avoidable emergency department visits, according to Health Policy Institute of Ohio's 2021 health dashboard. That means for every 1,000 Ohioans between the ages of 18 and 64 who have employer-sponsored insurance, there were nearly 169 avoidable emergency visits.

"We know it all comes down to trust and having those trusted relationships," McGee said. "You need a person who kind of understands and can give you advice on where to go."

That's exactly what Kachaylo did before heading to the emergency department at Wexner Medical Center last month.

A friend of Kachaylo's who works in health care advised that she head to the emergency department because of her symptoms. That advice ended up working out, as doctors chose to keep Kachaylo in the hospital overnight.

Although her wait was long and the emergency department was busy, Kachaylo said she was treated well throughout her visit. She appreciated that, especially since she got a first-hand view of how hectic an emergency department can be in the middle of the deadliest pandemic in a century.

"I was just shocked it took so long," Kachaylo said. "But I didn't have anyone who was rude to me or short with me. Despite everything, they still gave me the attention I needed."

Average Columbus-area ER wait times

The average wait time in an emergency wait room in Ohio is two hours and 14 minutes while the average wait nationally is slightly higher at two hours and 23 minutes. Doctors told The Dispatch that wait times often fluctuate and could change at any time depending on patient needs and what happens. Data that follows is from the Centers for Medicare and Medicaid Services as of July 21, the most recent date for which details are available.

Longest wait times

Ohio State Wexner Medical Center: 4 hours, 57 minutes

OhioHealth Riverside Methodist Hospital: 3 hours, 37 minutes

Mount Carmel St. Ann's: 3 hours, 17 minutes

Shortest wait times

OhioHealth Mansfield Hospital: 1 hour, 59 minutes

OhioHealth Grant Medical Center: 2 hours, 9 minutes

OhioHealth Dublin Methodist: 2 hours and 11 minutes

mfilby@dispatch.com

@MaxFilby