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Hospital and State Leaders Call on Rhode Islanders to Seek Medical Care in the Right Setting

In advance of holiday gatherings and the height of flu season in Rhode Island, State health and hospital officials gathered today to again urge the public to only go to emergency departments for health issues that require emergency care. Hospital emergency departments in Rhode Island continue to experience significant crowding and prolonged waiting times.

At a press event outside Rhode Island Hospital's emergency department, leaders reminded Rhode Islanders that many health issues can be treated quickly and effectively by a primary care provider or in an urgent care facility. This includes less severe cases of the flu, back pain, minor cuts, sore throats, low-grade fevers, and most cases of norovirus (the "stomach flu"). Patients will experience long wait times in the emergency department for non-urgent symptoms or may board there for a significant period before hospital admission.

"Emergency departments are perfect for emergency situations. If someone is experiencing a serious health issue, they should absolutely call 911 or go to an emergency department right away. However, emergency departments treat patients with the most serious health issues first, which means that people with less severe conditions will experience long waits," said Director of Health Nicole Alexander-Scott, MD, MPH. "Keep the phone number for your primary care provider handy and know where your nearest urgent care facility is. An urgent care facility, or other type of express care facility is often a more convenient, less expensive option."

At the press event, Dr. Alexander-Scott highlighted health.ri.gov/rightplacerightcare. This new page has links to lists of primary care providers, urgent care centers, and health centers in Rhode Island, and guidance on when and when not to go to the emergency department. RIDOH will continue directing Rhode Islanders to this page and other resources through a statewide communications campaign, to be launched in the coming weeks.

"In working with our health systems in Rhode Island, it has become abundantly clear that hospital overcrowding has emerged as a priority concern for the state," said Executive Office of Health & Human Services Assistant Secretary Ana Novais. "I am thankful for our interagency team that is reviewing these challenges, implementing some immediate relief, and planning strategies to address these issues long-term."

"The healthcare of all Rhode Islanders is Care New England's top priority, so we want to make sure that patients understand where they are able to receive the most appropriate care, in the quickest time possible. With wait times at EDs at an all-time high, people statewide are waiting many, many hours to be seen. While Emergency Departments are appropriate for life-threatening injuries and symptoms, they are currently not ideal for less-severe conditions. That's why we encourage people who have ailments that are non-life-threatening to schedule an appointment with their primary care provider or arrange for a telehealth visit, which saves time and money," said James E. Fanale, MD, President and CEO, Care New England Health System.

"It's important for the public to understand that the pandemic-related health care crisis is not over for our emergency departments. Adult and pediatric EDs in Rhode Island and across the country are experiencing staffing shortages, more patients seeking care for behavioral health, and patients boarding for days or weeks waiting for appropriate placement. We urge patients to keep up with their regular medical appointments so that minor issues do not become major ones, notify their family physician if they have medical concerns, and to get their COVID and flu vaccines. These important steps will help reduce or prevent health issues and promote the delivery of appropriate and efficient treatment to patients," said Lifespan Physician-in-Chief of Emergency Medicine Jeremiah Schuur, MD. "For patients coming into the ED, please understand that there are currently long wait times for non-urgent conditions. We know that this can be frustrating and we ask for patience as our care teams triage the most critical patient needs with limited staff. Our amazing staff are working tirelessly to provide the best care possible and ensure that all patients receive the treatment they need."

Also present at the event were Jeffrey Liebman, the CEO of Charter Care Health Partners; Dr. Matthew Sarasin, the Medical Director of Landmark Medical Center, and Teresa Paiva Weed, President of the Hospital Association of Rhode Island.

Hospitals across the country are experiencing a shortage of clinical staff, requiring many to reduce the number of available beds, and to use the emergency department to board admitted patients. This limits the capacity of emergency departments to serve new patients and makes it difficult to manage standard emergency department care and to respond to the behavioral health crisis that Rhode Island and other states are facing.

When to seek emergency care

If someone is showing any of these signs, seek emergency medical care immediately:

- Trouble breathing

- Persistent chest pain or chest pressure

- New weakness in an arm, leg, or face

- New difficulty speaking or confusion

- Inability to wake or stay awake

- Pale, gray, or blue-colored skin, lips, or nail beds, depending on skin tone

If you are going to an emergency department for COVID-19-like illness, notify the facility that you (or the person you are accompanying) is seeking care for COVID-19. Masks are required in all healthcare facilities.

Measures being taken at the State level

An interagency team across the Executive Office of Health and Human Services (EOHHS) is working toward the development and implementation of strategies to address the challenges facing hospitals. They include:

- Emergency regulations to assist increase the workforce and pre-hospital transportation availability.

- Partnerships with urgent care centers to explore developing capacity to expand emergency treatment options.

- Development of step-down capacity for behavioral healthcare and increased treatment initiation within emergency room settings.

- Provision of staffing supports, including direct care workforce recruitment and retention initiatives for home and community-based services.

- Planning for mobile crisis response for behavioral health and increased behavioral health system capacity through Certified Community Behavioral Health Clinics.

Steps people can take to help stay healthy and out of the hospital

- Get a COVID-19 vaccine. COVID-19 vaccine is available to Rhode Islanders ages 5 years old and up. For more information, see c19vaccineRI.org.

- Get a flu shot. Everyone older than 6 months of age should get a flu shot every year.

- Cough or sneeze into your elbow.

- Wash your hands carefully with soap and water throughout the day.

- Stay home if you are sick and keep children home from school if they are sick.

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