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OPINION

For Laura’s Law to succeed, DPH must heed our advice

A working group offers recommendations for hospitals to take to make sure patients can find and get inside emergency departments as quickly as possible.

Laura Levis died outside CHA Somerville Hospital in 2016.

After pushing two long years for Laura’s Law to be passed by the Legislature and seeing it signed into law by Governor Charlie Baker last January, I thought my work was over trying to make a difference in my late wife’s name. I couldn’t have been more wrong. There was plenty more to do to implement the law.

Since August, I have been meeting with a group of experts and concerned leaders — officially the Patient Access to Emergency Care (Laura’s Law) Workgroup — to come up with a list of recommendations for hospitals to adhere to ensure patients can find and get inside emergency departments as quickly as possible. Common-sense safety checks you might reasonably assume are already in place at your local hospital but, shockingly, often are not.

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Things like splashing more light on patient drop-off areas, strategically locating signs leading to the emergency department so that after you pass one you immediately see the next, and outfitting a hospital door a patient might mistakenly go to (such as a main door that’s locked at night) with a live, two-way intercom connecting them to immediate help.

If the hospital Laura went to had even some of these elements, she would have made it inside the emergency department. Instead, she became confused and lost, collapsing from a fatal asthma attack virtually on its doorstep.

The law requires that the state Department of Public Health formulate and enforce across-the-board standards to ensure proper patient access to emergency departments. Earlier this month, our workgroup finished our task and handed a set of recommended hospital regulations to DPH that cover emergency department signage, lighting, “wayfinding,” and the security monitoring of doors and campuses. (We would have finished earlier this year were it not for COVID-19 delays.) It’s not a perfect list, but it’s strong, and will absolutely save lives — but only if it has DPH’s full backing.

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As our group was merely advisory, DPH officials are under no obligation to take our recommendations to heart as they go about writing formal regulations. But I hope they do.

Yet it won’t be enough for DPH to cut and paste our ideas into standardized rules. They’ll have to stand up for what we’ve produced during a public comment process in which hospitals or other special-interest groups might try to water down the regulations out of self-interest.

That would be tragic for anyone who ever has to go to an emergency room — that is to say, most of us.

Every hospital should assign a GPS address to its emergency department and disseminate that information to Google Maps, Apple Maps, and ride-hailing apps so people don’t mistakenly drive or walk to the main door of the hospital when the emergency department isn’t anywhere close to it.

The moment you reach a hospital campus, you need to see illuminated signs with clear directions to the emergency department. And extra “reinforcement” signs wherever you might turn a corner and get lost, or along confusing stretches where you wonder whether you’re still on the right path.

If you can’t make it inside the emergency department but are still able to reach a hospital door — the main entrance, the ambulance bay door, another prominent public entrance that might be locked, or the ED door itself — there should be an emergency intercom immediately connecting you to someone who can help. And that intercom should include both video and audio features so that anyone, including people with low vision, hearing loss, or difficulties with speech or cognitive processing, can communicate effectively and know that help is on the way.

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Hospital security, facilities, risk management, and emergency department leaders must conduct annual comprehensive reviews of every aspect related to getting a patient safely to and inside an ED, adjusting to changes, and making such reviews available to DPH.

Laura came ever so close to getting saved that morning, calling 911 for help before losing consciousness just 29 feet from the emergency room entrance. But, unbelievably, there is no current requirement for a hospital to send someone out the door to save someone in such a life-threatening condition. If it chooses, a hospital can call an ambulance company to find the person even if it takes the ambulance 10, 15, or 20 minutes to arrive.

If you’re in the midst of a heart attack, stroke, or asthma attack, or if you have overdosed on drugs, you might be dead by the time an ambulance arrives. DPH must require hospitals to have personnel on-site who can rush outside to provide medical care to someone, with protocols and staff drills in place to make sure that happens.

I have been on a mission to improve patient safety ever since the Globe published “Losing Laura” in 2018, the shuddering story I wrote that exposed how both our emergency 911 system and our emergency health care system failed my wife, Laura Levis. But these suggestions aren’t mine alone — our group included Bonnie Michelman, head of security at Mass General Hospital; Edward Browne, advisor to the national Facilities Guidelines Institute for health care; Polly Welch, a 30-year architect focused on human needs, wayfinding, and public policy; and Dr. Assaad Sayah, CEO of Cambridge Health Alliance, which implemented dozens of changes at CHA Somerville Hospital following Laura’s death. You can read our report on the workgroup’s mass.gov web page.

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Laura’s Law — officially, “An Act Ensuring Safe Patient Access to Emergency Care” — is still several months away from going into effect. DPH will draft formal regulations over the next several weeks, and a hearing will be held to take in public comment. After a review period, the regulations will be finalized and implemented.

I hope DPH backs and implements strong, comprehensive regulations based on our work that fulfill Laura’s Law and will save lives in memory of my wife. Maybe even the life of someone you love.

Then, maybe, my work will be done.

Peter DeMarco has worked to promote asthma awareness, better 911 training, and improved patient safety since Laura’s death in 2016. He can be reached at peterdemarco@hotmail.com.