Jagim to Testify Before Congressional Committee On Homeland Security

Mary Jagim, RN, is a lifelong emergency department (ED) nurse. She's managed MeritCare's Emergency Center, and is now devoting her time to leading MeritCare's pandemic and emergency preparedness planning work.

Mary Jagim, RN, is a lifelong emergency department (ED) nurse. She's managed MeritCare's Emergency Center, and is now devoting her time to leading MeritCare's pandemic and emergency preparedness planning work.

In the past, Jagim has been tapped for national posts including president of the national Emergency Nurses Association (ENA), and as a committee member on the Institute of Medicine's (IOM) Committee on the Future of Emergency Care in the U.S. Health System, but she's never gotten a call like the one she received earlier this month.

Jagim has been asked to testify before the U.S. House of Representative's Committee on Homeland Security's Subcommittee on Emergency Preparedness, Science and Technology and will be traveling to Washington, D.C. to do so on Tuesday, July 25. The hearing is titled, "Emergency Care Crisis: A Nation Unprepared for Public Health Disasters."

Recent reports from the IOM and other organizations have revealed the overwhelming problem facing hospitals and the emergency medical response system in the United States. The committee is particularly concerned about the ability of hospitals to handle great influxes of patients during mass trauma and other types of events. The IOM and others point to hospitals having problems in their emergency departments on average Saturday nights, so a mass trauma event is not only a public health problem, but also a homeland security concern.
Additional information from iom.edu:
IOM - The Institute of Medicine (IOM) provides the nation science-based advice on matters of biomedical science, medicine, and health. It "…provides a vital service by working outside the framework of government to ensure scientifically informed analysis and independent guidance."

Key findings from the IOM report:
  • Many emergency departments and trauma centers are overcrowded
  • Emergency care is highly fragmented
  • Critical specialists (e.g. neurosurgeons) are often unavailable to provide emergency and trauma care
  • The emergency care system is ill-prepared to handle a major disaster
  • Emergency medical services (EMS) and EDs are not well equipped to handle pediatric care


Recommendations from the IOM:
  • Create a coordinated, regionalized, accountable system
  • Create a lead agency
  • The federal government should consolidate functions related to emergency care that are currently scattered among multiple agencies into a single agency in the Department of Health and Human Services (DHHS).
  • End ED boarding and diversion
  • "Boarding" patients means holding them in the ED, often in beds and hallways, until an inpatient bed becomes available
  • Half a million times a year - an average of once every minute - an ambulance carrying an emergency patient is diverted from an ED that is full and sent to one that is further away.
  • Increase funding for emergency care
  • Enhance emergency care research
  • Promote EMS workforce standards
  • Enhance pediatric presence throughout emergency care