Hospitals here have seen record numbers of emergency-room visitors so far this year, and in some cases overall record admissions. Administrators say the high level of activity is likely due to population growth here, though some suspect an increased number of flu-like cases might be a factor.


Valley Hospital & Medical Center posted roughly a 20 percent increase in ER visits during the first three months of this year, compared with the year-earlier period, while Sacred Heart Medical Center & Childrens Hospital recorded a 9.5 percent jump, and Deaconess Medical Center and Holy Family Hospital both had an 8 percent increase, the respective hospitals say. Kootenai Medical Center logged a 4.6 percent increase.


Sacred Heart, the second largest medical facility in the state of Washington, had nearly 6,000 visitors to its emergency department and admitted 2,900 patients in March, both single-month records, says Mike Wilson, the hospitals president. For the quarter, Sacred Heart had 17,291 ER visits. Hospital admissions, meanwhile, grew a modest 2.5 percent during the quarter, compared with the year-earlier quarter.


Were seeing more people in the hospital, they are staying a little longer, and they are sicker, says Wilson


Though KMCs ER visits didnt increase as dramatically as such visits did at hospitals in Spokane and Spokane Valley, KMC did record a single-month record 1,422 admissions in March and a 14.1 percent increase in hospital admissions in the first quarter, compared with a year earlier.


Valley Hospital had a record 3,355 ER visits in February, Holy Family posted a near-record one-month tally of 5,609 ER visits in March, and Deaconess emergency department had one of, if not the, busiest months ever in its ER in March, at 3,067 visits, says Dr. Jim Nania, medical director of that hospitals emergency department.


Both Sacred Hearts Wilson and Dr. Wayne Tilson, medical director of Valley Hospitals emergency department, attribute some of the patient growth to the Spokane-Coeur dAlene areas growing population.


Spokane Countys population grew by an estimated 1.7 percent last year to about 443,800 people, according to the Washington state Office of Financial Management. Kootenai Countys population is up 3 percent to about 131,500 as of July 2006, according to the U.S. Bureau of the Census.


Tilson says ER visits at Valley Hospital jumped 12 percent last year, to 36,000 patients, and are growing at about that same annual rate so far this year. He says the obvious reason is the population increase in the greater Valley, especially in Liberty Lake.


Influenza


Another factor, however, might be a reported rise in upper respiratory infections here, especially in children, say both Wilson and Carmen Brochu, vice president of patient care at KMC. Such infections are commonly associated with the flu.


Deaconess Nania, who regularly works with disease-related statistics here, claims emergency rooms at Spokane Countys four largest hospitals recorded an influenza spike in February and March that likely magnified the number of people seeking ER services here, as well as those admitted to hospitals.


Yet, tracking specific reasons for the record rates of ER visits this year is more complex than normal, other administrators say.


We had a sustained high census for a five-week period, and now were back to an average census, says KMCs Brochu. Normally, high rates like this can be related to the flu season, but thats not the case this year.


There are a wide variety of illnesses this year, a little bit of everything, and theyre so diverse its hard to predict if this will be repeated.


Similarly, Wilson says Sacred Hearts high volume of ER visits and hospital admissions in March were recorded in every department at the hospital, from cardiac care to pediatrics to psychiatric, and cant be blamed merely on flu.


Tom Corley, president of Holy Family, says an aging population is another factor in the rise in patient volumes at hospitals here. Also, the growth isnt necessarily new. Corley says ER visits at that North Side hospital grew 10 percent in 2006, compared with the previous year.


Wilson says Sacred Hearts jump in ER visits and hospital admissions in March stretched workers in the large Spokane hospital. Sacred Heart, which has 623 licensed beds, has averaged 420 full beds per night this year, and had some nights in March during which more than 500 beds were full, he says.


Those numbers, however, can be misleading for three reasons, he says.


First, filling all 623 beds is unrealistic, because men and women normally cant stay in the same non-private room; beds reserved for certain types of patients, such as cardiac patients, normally arent available to other patients; psychiatric beds arent available for general use; and pediatric beds arent suitable for adults, among other limitations, he says.


Second, because the daily census is taken at midnight, there are times in the morning, after new patients have checked into the hospital but before others have been discharged, that inpatient population numbers exceed that days census figure.


During this time of overlap in the mornings we might have up to 590 patients in the hospital, Wilson says. At such times, we are reaching a point where our capacity is limited.


Then, theres the problem of staffing, and keeping the optimum number of employees on the job when the need is greatest, he says.


Weve got to have the availability of retaining staff at times of higher census, but we need the flexibility to adjust staff numbers downward at times of lower census, Wilson says.


He says that although the average length of patient stay at Sacred Heart, estimated in March at about three days, is minimally higher than a year ago, the hospitals numerical rating to measure the severity of the average patients health condition is up markedly. Compared with a year ago, the average patients score in that severity rating is 3.5 percent higher, he says.


Contact Rocky Wilson at (509) 344-1264 or via e-mail at rockyw@spokanejournal.com.