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Laura Levis died waiting for help outside a local hospital. Now, ERs are being required to make changes to improve access.
“My goal has been to make sure no one else ever dies this way, that no family ever loses the one they love due to careless and avoidable safety lapses.”
On an early September morning in 2016, Laura Levis went to her local hospital in Somerville.
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She was suffering an asthma attack, and decided to walk the few blocks from her home to the emergency room.
It was from that point on, her husband, Peter DeMarco, says, that everything that could have gone wrong, did.
Levis tried entering the hospital through a well-lit door but found it was locked. There was no sign directing her to the correct entrance, and no one was at the security desk monitoring surveillance footage. She called 911, but by the time firefighters found her she had collapsed on a bench outside the hospital in cardiac arrest. She was just 29 feet away from the correct door to the emergency room.
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She died days later at the age of 34.
DeMarco wrote about his wife’s death in The Boston Globe in 2018, raising questions about the incident and drawing attention to the lack of regulations around patient access at hospitals and advocating for changes. In 2021, “Laura’s Law” was passed, a measure that regulates and standardizes lighting, way-finding, and other elements related to patient access at hospitals in Massachusetts.
Those regulations have now been issued by the Department of Public Health and the 69 hospitals with emergency departments across the state are being given until Jan. 1, 2024, to comply.
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The changes are ones that DeMarco said Thursday during a press conference could one day save the life of someone who is experiencing a medical crisis.
“I think many hospitals have the mentality that the patient experience doesn’t begin until they arrive at the registration desk,” DeMarco said. “I think that many hospital leaders over time forget what their building or campus looks like through the eyes of a patient. The signs or lights they erected decades ago or security systems they’ve had in place for years are never re-evaluated to see if they are actually working for patients — they just become part of the wallpaper. And if things go missing over the years, they’re never really noticed.”
Now, with regulations stipulating a range of changes, hospitals must pay attention, he said.
The requirements include that hospitals must set up directional signs to their emergency rooms starting from the moment an individual accesses the institution’s campus, that any prominent door that is locked at night (including the main door, ER entrance, and ambulance-bay door) have an audio-visual intercom, and that if the emergency department isn’t located at the hospital’s main address, it have its own unique address for people to access on GPS and view on the hospital’s website.
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The new rules, while not perfect, are both “ground-breaking” and “game-changing,” DeMarco said Thursday.
Massachusetts, he said, is believed to be the first state in the country to have regulations focused on helping patients quickly and easily get into an emergency department.
He said he hopes the new rules will be a “stepping stone” for other states, since they will help everyone find and get inside an ER faster.
Just 10 minutes saved, or wasted, can be life-changing, he said.
“My goal has been to make sure no one else ever dies this way, that no family ever loses the one they love due to careless and avoidable safety lapses,” DeMarco said. “I always say [Laura] had 10 coin flips that morning, and she lost every one of them.
To illustrate the importance of the regulations, DeMarco walked through the ways in which they would have helped his wife, had they been in place that September morning.
“What would it have been like if we’d had these regulations in place then? Here’s my list: Laura could be alive if any of the doors she reached had a duress alarm to push, as is now required,” DeMarco said. “Laura could be alive if any of the doors she reached had a two-way audio/video intercom connecting her to a live operator, as is now required. Laura could be alive if the waiting-bench where she collapsed was flooded with light instead of in darkness, as is now required. Laura could be alive if there was 24-hours a day monitoring of hospital surveillance, with the ability to instantly playback recordings, as is now required. Laura could be alive if the proper emergency door was lighted brighter than any other entrance, as is now required.
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“Laura could be alive if there was a well-thought-out system of directional signs organized so that as soon as she reached one sign she could see the next one, as is now required,” he continued. “Laura could be alive if the emergency department had its own GPS address for the fire department to respond to instead of going to the hospital’s only listed address on a different street, as is now required. Laura could be alive if the hospital had a plan in place and trained staff on how to handle her emergency, as is now required. Laura could be alive if the hospital conducted an annual review of its patient access elements and realized there was no EMERGENCY sign above any door, as is now required.
“It’s quite a list, isn’t it?” he concluded.
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