Northwest Medical Center continues to fulfill its promise to see emergency room patients in 30 minutes or less since last October, and plans to continue the program through 2012 and the foreseeable future.
Kim Chimene, marketing director for the Northwest Medical Center, said they started the program last October “after realigning some of our ER processes so that we could get patients to see a physician much faster.”
Chimene pointed out that wait times in many emergency rooms around the country have been increasing, and that Northwest’s ER service pledge was a way for the facility “to provide quality care as efficiently as possible.”
Northwest’s 30 Minutes or Less ER Service Pledge means that when a patient enters the ER, the time of their arrival is noted, which starts the clock ticking.
Joe Akif, R.N., administrative director of the Emergency Department, said the ER staff works diligently to have a physician initially see a patient and begin their evaluation and treatment within the 30-minute window.
“Some of the other hospitals affiliated with our group have done this across the country and we knew we could deliver on this pledge most of the time,” Akif said.
In the Tucson region, Northwest Medical Center and Oro Valley Hospital are both owned by Community Health Systems.
Akif pointed out that most emergency rooms are based on nurse triage, where a nurse is the first point of contact with a patient for treatment.
“When people come to the ER, they come to see a doctor, not a nurse,” Akif said. “We changed the process so the physician is on the front end of the process instead of at the end of it. And that means within 30 minutes the patient will be eye-to-eye with a board certified ER physician.”
Akif said that in the five months that Northwest has had the 30 Minutes or Less Pledge, wait times in the ER have averaged between 16 and 22 minutes, depending on the time of year, day and hour.
“The best wait time we’ve done through this program is 14 minutes,” he said.
“In the evening, we typically will see six to eight patients an hour, but sometimes, on busy nights, that might go up to between 20 and 24 patients an hour.”
While the pledge is to have a maximum 30-minute wait time before seeing a physician, Akif conceded that infrequently that time window cannot be met.
“The most severe cases in an ER will always receive immediate attention,” he said, which could have an impact on wait times, for instance, if trauma victims are brought to the ER.
Northwest Medical Center’s ER is a busy one, averaging 180 patients a day, with a typical load between 145 and 150 patients per day.
Akif said ERs classify patients on the basis of nursing acuity in a 0 to 4 scale, with 4 being the most serious.
“Our nursing acuity average is a 3.7” he said. “We see a pretty sick population here. We have the benefit of four urgent care centers located around us, so we wind up with more acutely ill patients. We also see a lot of ambulance traffic through our ER.”
But patients are getting in and out of Northwest’s ER in a more timely manner, Akif said.
”We’ve been able to cut an hour and a half off the total time of the average patient being seen in the ER and then discharged,” he said. “We’ve also been able to cut three hours off the wait for an in-patient bed, so now the wait is only an hour-and-a-half.”
Akif noted that 18.5 percent of the patients seen in Northwest’s ER are admitted to the hospital, a figure that makes up 50 percent of the hospital’s admissions. Sixteen percent of ER patients becoming in-patients is the national norm, he said.
Northwest’s ER also has a discharge call-back program where hospital staff phone a patient within 72 hours of discharge from the ER to follow up on their care, as well as an ER outpatient survey.
“We call to see how they are doing, if they filled prescriptions when needed, see if they set up follow-up appointments with their primary care doctor, and if they got what they needed from us and if it helped,” Akif said.