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People enter through the Emergency entrance on April 9, 2010, at the Contra Costa Regional Medical Center in Martinez.

MARTINEZ -- Long waits and overcrowding in the emergency room at the Contra Costa Regional Medical Center are endangering patients, say medical staffers, who are pushing for an expansion of the emergency department.

But administrators say building costly additional space is only part of the solution. The hospital also should increase access to primary care and find ways to move patients more efficiently from the emergency room to a hospital bed, they contend.

At a meeting Thursday with hospital administrators and Supervisors John Gioia and Mary Piepho, ER staffers described examining patients in the lobby and in the hallways on gurneys behind flimsy screens that provide little privacy.

Each year, about 1,500 patients sick enough to be admitted to the hospital leave the ER without seeing a doctor because of long waits for an exam room, and patients admitted to the hospital wait hours or even days for an inpatient bed, according to Dr. Ori Tzvieli, medical staff president.

"The experience of patients coming into our emergency department is probably the worst experience in the county," Tzvieli said.

The emergency department at the county hospital in Martinez has 18 exam rooms and is designed to accommodate 30,000 patients per year, but doctors say double that number show up seeking treatment. Just 10 percent of ER patients are admitted to the hospital, and 35 to 40 percent don't need emergency care, according to Dr. Brenda Reilly, director of the emergency department.

The hospital has 146 beds, 20 of them reserved for psychiatric patients.

Hospital administrators point out that by November the hospital will have six new exam rooms for urgent care patients, which should reduce some of the demand for the ER. In addition, the new health center in San Pablo, an expansion of the Concord center and changes to the appointment booking system should expand patients' access to regular doctor visits.

"Too many people are getting primary care through the emergency department by default," said Anna Roth, Contra Costa Regional Medical Center and Health Centers CEO.

Reilly, however, expressed doubt that the additional six exam rooms will do much to decrease the number of seriously ill people who leave the ER without being seen by a doctor.

Staff members say the hospital should convert the unused former psychiatric ward to emergency care use. But even if the hospital had the estimated $15 million for that project, it wouldn't be completed until 2017. A less ambitious $2 million construction project could be finished by December 2014, but that's still a long time to wait for a solution to the urgent overcrowding problem, said Dr. William Walker, health director and health officer.

Piepho and Gioia pressed hospital administrators and staff to come up with short-term solutions to reduce the time emergency room visitors wait to see a doctor and to be transferred to an inpatient bed.

Administrators decided Thursday to hire a consultant to examine ER staffing and the process for transferring patients from the emergency room to a hospital bed, with a goal of having a report to review with the supervisors at the June 3 meeting, Walker said.

Piepho acknowledged staff's frustration with conditions in the ER, describing workers as overworked, underpaid, under-benefitted and working in an unsafe environment.

"We can't fix all of those, but we have to start fixing some of those," she said.

Lisa P. White covers Martinez and Pleasant Hill. Contact her at 925-943-8011. Follow her at Twitter.com/lisa_p_white.