No, I don’t mean the 1 am impacted esophageal food bolus, the bane of the the Gastroenterologist’s existence. I mean the patient bolus. There is nothing worse than when a boatload of people arrive in the ER at once. It doesn’t matter if they are sick or not (even a whole bunch of relatively simple and quick patients can screw you). when 10-12 people arrive in one hour, you are instantly overwhelmed. You could be chugging along, dispo-ing 2 patients or more per hour per provider and then, WHAM, you’re done. It’s even worse when you get a mix of walk-in’s and ambulances. Even if your ER is fully staffed and on the top of it’s game, you are going to see a rise in the wait times to be triaged, roomed, and to see and doctor. End of story. You can’t be expected to just suddenly see 5 people at once. You go into a different, damage control mode and just try to see the sicker ones and then whittle away at the pack.
Metrics get worse, patient satisfaction scores plunge, left without being seens go through the roof. That’s life. Patients, the public, private doctors, and administrators have to realize that. Eventually you’ll catch up – if you get 2 hours where no one shows up. Not likely in this day and age.