More cars, more people, and more patients at Beebe

The hallways, the operating rooms, the laboratory, the waiting rooms, patient rooms, the parking lots, the helipad and all three shifts - they’re all busy these days and nights at Beebe Healthcare’s main campus in Lewes.

They’re not just signs of the high summer season. Rather, they’re a reflection of more cars on our highways, more houses and more neighborhoods. In a nutshell, more people. The steady wail of sirens and drone of ambulance engines over the July Fourth weekend accentuated the busyness of the area’s medical infrastructure. But it’s more than that.

“We’re continuing to transition from a seasonal resort area to a 24/7 year-round area,” said Mike Knapp, director of patient care for Beebe. “We’re busy year-round.”

Dr. Paul Cowan, chief of the emergency medicine department, said the emergency department and the hospital in general have been extremely busy since February. “It used to be we in the emergency department were busy in the winter followed by a lull in the spring. It was typical to see a decline in patients in March, April and May. But there was no decline in the spring this year. We had record volume. And the people we’re seeing now tend to be sicker. We used to see more minor things. People would be in and out. We’re still seeing those kind of patients, but we’re also seeing more complex issues now.”

The result is more people in the emergency room and more people filling the beds of Beebe’s inpatient facility. “We are seeing people,” said Cowan, “who 10 years ago may not have survived their illness, but they are still living now in our communities, but with a number of problems. In a way, the healthcare industry is a victim of its own success in terms of helping people live longer lives. Not just here but across the nation. We also have many people moving here with complex issues, which tend to be more time- and labor-intensive.”

Cowan said the emergency department acts as a canary in the coal mine in terms of predicting what’s ahead for the hospital. In the days before sophisticated sensing instruments, miners would hang cages with canaries in mines. More sensitive to poisonous but often odorless gases that came from below, the canaries would succumb to the gases before the miners, and so warn the miners to get out.

Average census on the rise

“We’ve had record patient censuses in the hospital for months now,” Cowan said. “Even though we’re licensed at Beebe for 210 beds, we’ve been tending to run in the 140- to 150-bed range for inpatients. But this year our maximum census reached 180, which I believe is a record. It used to be that in the summer we would see higher numbers resulting from people coming in from different towns and states who would then go home. Now we’re filling up with people who live here and who are staying here.”

Cowan said a hospital task force is looking to identify ways to accommodate the upsurge in patients. “We’re looking to reclaim spaces that may have been used previously for inpatients, and we’re looking for ways to become more efficient - ways to turn beds over more quickly.

“Over the years I’ve seen this before,” he said. “Here and at other hospitals. The patient load will be flat for a while; then there will be a huge spike and it will flatten out again. But that will become the new number, and we will grow accustomed to being efficient at the higher number. I don’t think we will be going back to those previous numbers.”

Cowan said people ask him if he thinks changes in healthcare laws are impacting the situation. “They want to know whether this is a matter of people having access who didn’t have access before. But I don’t think so. I haven’t been hearing people saying that or making any comments about having insurance. I’m not getting the sense that this is about a change in insurability. I think it comes down to a simple matter of increase of volume in the community.”