09.24.2018

Kudos to Lawrence General (and a Caution About Ratios)

Congratulations to Lawrence General Hospital which treated a large influx of patients from the gas explosions that rocked the towns of Lawrence, Andover, and North Andover on September 13.

LGH reported treating 13 patients from the blasts, one of whom was med-flighted to a Boston trauma center. The trauma patient required many staff members to stabilize him for transport. There were already 25 patients in the ED when the first patients began to arrive. A call went out for additional doctors and nurses, and the hospital reported that many “helping hands” showed up on their own to assist.  

Interestingly, if the ratios mandated in the Question 1 ballot question were in place, the surge of patients into its ED would have pushed LGH out of compliance with the ratio law and subjected the hospital to $25,000-per-incident, per-day fines. That’s because the “at all times” ratio law only allows for exemptions in the event of a declared state or national “public health emergency.” Click here for a blog clarifying this stipulation.

Gas explosions, casualties from mass transit accidents, flu outbreaks and other such surges are not enough to trigger lifting of the rigid ratio scheme.

While Governor Baker ultimately declared a “state of emergency” due to the natural gas explosions, that is an entirely different designation than the more rare “public health emergency.” There have been only four public health emergencies in Massachusetts since the 1970s and their declaration involves a drawn-out regulatory process. The last public health emergency was declared by Governor Deval Patrick in 2014 in response to the opioid crisis.