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VEPMG Celebrates the Success of Woodland Healthcare Emergency Department's Revolutionary Change in Triage Method
Jul 23rd, 07
Yolo hospital speeds up ER response
Woodland Healthcare upgrade means shorter waits for critical care
By Lakiesha McGhee - Bee Staff Writer
Last Updated 12:55 am PDT Monday, July 23, 2007
Story appeared in METRO section, Page B2
The growing number of patients in emergency rooms has put the squeeze on hospital administrators to improve efficiency and lower wait times.
In California, emergency room visitors can expect an average stay of about 4 1/2 hours, according to a recent study.
In Yolo County's primary hospital, officials have shaved the waiting time down to less than 30 minutes, thanks to a campaign launched this year.
Woodland Healthcare initiated the campaign "When Every Second Counts" in January to fund $1.5 million in emergency room enhancements as part of an overall $40 million hospital upgrade. More than half a million dollars donated by the community so far has funded a new "rapid response" triage area, an upgraded nursing station and high-tech medical and informational equipment. The improvements helped reduce the average wait time from about 1 1/2 hours to less than 30 minutes, hospital officials said.
"We are really working hard to improve efficiency," Woodland Healthcare president Kevin Vaziri said. "Even when the wait time is short, it can feel like forever to a patient in pain."
The Woodland Healthcare Foundation is asking the community to help fund the second phase of the project, which would use existing space in the emergency department to enlarge a patient and family reception area and private registration area by summer 2008. A bulk of the total $40 million cost will be covered by Catholic Healthcare West, a system of 42 hospitals and medical centers in California, Arizona and Nevada.
"Typically, you want the community to feel they own their emergency department," Vaziri said. "They participate (in the funding) for pride and a sense of community."
Other Sacramento area hospitals are responding to the urgency for emergency care. UC Davis Medical Center -- the area's only Level 1 trauma center -- has established a "24-7 fast track" area for minor illness and injuries. Thirteen nurses were added to the emergency department staff, and shifts were overlapped by two hours so that time spent on paperwork doesn't impact patient wait times, hospital spokesman Charles Casey said.
"If someone's illness or injury requires immediate care because it is life-threatening, the wait time is zero," Casey said. "Such patients are seen immediately. Non-life-threatening problems are triaged as quickly as possible. There are longer wait times for those types of patients because it is typically a very busy emergency department."
To accommodate more patients, UC Davis Medical Center is spending $424 million on a new Surgery and Emergency Services Pavilion scheduled to open in about two years, Casey said.
Woodland Healthcare is often the first stop for emergency care in Yolo County. Its emergency department sees an average 2,000 patients a month and 24,000 patients a year. On a recent day, nurse Mike Mahoney said he was having a slower shift than usual. His biggest case: a young mother whose baby fell out of a stroller. The mother was distraught but the baby was smiling.
"The five-minute visit was more of a comfort to mom to know that nothing was wrong," Mahoney said after seeing the patient.
Confirming one's well-being is another role of the ER. Typically, cases in the department include everything from children with earaches and fevers to life-threatening conditions.
One reason for longer wait times in general is that there are more patients, said Matt Mulherin, spokesman for the health care research firm Press Ganey Associates Inc.
"The growing volume of patients are significantly up in emergency departments because of the growing number of uninsured patients who use the ER for primary care needs," Mulherin said.
Press Ganey last month released its 2007 "Emergency Department Pulse Report: Patient Perspectives on American Health Care." The study found a correlation between lower patient satisfaction and higher amounts of time spent in the emergency department. The study ranked California 42nd in the nation in the average amount of time spent in the ER, which was 276 minutes. The national average is 240 minutes or four hours, according to the study. It examined 1.5 million patients treated at 1,500 hospitals in 2006.
Mulherin said many hospitals are upgrading facilities to meet increasing numbers of patients, "but the cost is getting higher and reimbursements are becoming less."
Lourdes Edralin, spokeswoman for Woodland Healthcare, said the emergency department has seen patient visits increase 5 percent each year the past two years and that visits are expected to grow steadily with the population. The emergency department enhancements are part of a master plan that includes expanding the hospital and construction of new office buildings in Davis and Woodland, she said. Instead of expanding its ER, Woodland Healthcare has focused on improving technology and work flow. The new rapid response triage was designed to have patients treated quicker. Traditionally, patients have to wait twice, said Marc Hudock, a physician assistant at the hospital.
Under the new model, patients are greeted, and then assessed by a physician assistant. Oftentimes they are treated in the four-bed triage area quickly, then given a prescription and instructions before being released, hospital officials said. The patient does not need to go to other areas of the hospital for these services. Other new technology at Woodland Healthcare includes diagnostic and radiologic equipment, an automated medication dispensing system, new patient monitors and an electronic medical records system.
Emergency department upgrades were funded by individuals and organizations, including $250,000 from the Rumsey Band of Wintun Indians and $250,000 from Woodland Clinic physicians.
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