Printable Hospital Call Monthly Calendar

Hospital backups are bad for our health. Something must be done.

Lawmakers seek a way to boost the role of guardians

Re “Patients in hallways, long waits for beds: Hospital bottlenecks reach crisis levels”: Thank you for your Oct. 2 editorial on hospital backups, a crisis for patients, hospitals, insurers, and the Commonwealth. You cite the lack of guardians for patients incapable of making decisions as one of the most common reasons cited for the crisis in a recent report from the Massachusetts Health and Hospital Association, and you suggest that courts consider expediting guardianship proceedings for hospitalized patients.

Unfortunately, expedited court proceedings will not help patients with no family and friends to serve as guardian to approve a prompt discharge. This gap was cited in a Globe article last December. Experts and advocates estimate that there are at least 3,000 such so-called unbefriended people. Massachusetts, unlike many other states, has no statewide public guardianship program and no funding for guardians of indigent, incapacitated, unbefriended people.

One solution is legislation introduced by state Representative Sally P. Kerans and Senator Joan B. Lovely that would establish guardians as medical “providers.” The bill would provide reasonable Medicaid payment to guardians for indigent, incapacitated people to provide prompt access to appropriate medical care. The bill would expand the pool of qualified guardians in a cost-effective way and help alleviate some of the backlog described in your editorial.

Get Today in Opinion

Globe Opinion’s must-reads, delivered to you every Sunday-Friday.

Wynn Gerhard

Fellow

Guardianship Policy Institute

Andover

As population ages, we must address key gaps in care

Your editorial rightly details the health care crisis leaving older patients stranded in hospital hallways. A large part of the problem is that beds aren’t available due to a lack of access to post-acute care. To address this problem in Massachusetts — and nationwide — policy makers must act.

As our population ages, we must address the crisis of post-acute care access and find ways to prevent seniors from being hospitalized to begin with. We need to address the gaps in primary and preventive care while also tackling unmet housing, mental health, and caregiving needs.

While patients and their providers are struggling with workforce shortages and bureaucratic delays, the Centers for Medicare and Medicaid Services announced more than $25 billion in cuts to Medicare home health services. Instead of cutting essential services, it is time for expanded investments and creative solutions to grow the number of health care practitioners taking care of seniors.

Policy makers must work to expand home, long-term, and post-acute care and help create the innovative care of the future. The current challenges are fixable if we recognize the strategic importance of preparing for an aging society and make smart policy choices focused on helping more seniors live with the independence and dignity they deserve.

Dr. Steven Landers

President and CEO

Hebrew SeniorLife

Boston

The writer is also a member of the faculty at Harvard Medical School.

Hospitals need to explore ways to be creative

I echo the editorial board’s assessment that there is no single answer to emergency department boarding issues facing hospitals across the state. Not only are these conditions distressing for patients and clinicians, but they are also key drivers of the financial challenges facing many health systems in Massachusetts and beyond. Overcoming these problems requires creativity, innovation, and perseverance from health care leaders, in partnership with policy makers. However, while these problems are complex and daunting, there are promising real-world solutions that hospitals and health systems can take to mitigate the impact of this crisis.

Your editorial focused on bottlenecks affecting patients who needed to be discharged to a rehabilitation center, skilled nursing facility, or home health service. We experienced the ED boarding crisis acutely at Lowell General Hospital as a result of an influx of behavioral health patients unable to see their providers for treatment due to COVID-19 restrictions and other factors. We moved swiftly to implement both short- and longer-term facilities improvements and recruited behavioral health nurses, mental health technicians, and psychiatric nurse practitioners to start treatment the moment patients arrive in the ED.

While these local changes have made a clear difference and have helped reduce our ED boarding by 70 percent compared with a year ago, more must be done. We must continue to look beyond our hospital walls and work with the Commonwealth to tackle these complex issues. Creative solutions to the significant challenges in transporting patients to inpatient behavioral health hospitals, state funding to support crisis stabilization and EmPATH units (emergency psychiatric assessment, treatment, and healing), and close community collaborations are critical to helping those who need us most.

Amy Hoey

President

Tufts Medicine Lowell General Hospital

Lowell

The writer is a registered nurse.

Meanwhile, these institutions keep placing ads to attract even more patients

I read the editorial “Patients in hallways, long waits for beds: Hospital bottlenecks reach crisis levels” with great interest.

At the same time that patients are stuck in emergency rooms and hospital beds waiting to be transferred or discharged, I turn on my television and am barraged by advertisements from our world-renowned hospitals.

Is this the best use of our health dollars? Why are they spending who knows how much to attract more patients when they can’t accommodate those already in their care?

Who is monitoring this?

Marilyn Broder Segal

Salem