Hospital works to speed emergency care
BY AMELIA HARPER
Saturday, September 22, 2018
Rumors of the closure of Nash UNC Health Care’s Pediatric Emergency Room are not true, said Lee Isley, president and CEO of the hospital.
In an interview with the Telegram this week, Isley and members of his staff said the confusion stems from ideas the hospital has batted around with employees about ways to make the adult emergency room more efficient and to improve wait times for patients.
“We did ask employees if there was a better way to address the issue so we did not have as many empty beds and we did have a discussion about moving the pediatric department to another location in the emergency room, but we have decided that it will remain where it is,” Isley said.
Isley said Crystal Hayden, chief nursing officer, has been working hard to improve the patient experience in the emergency department.
“What we really wanted to do is to align our volume and capacity and see where we have space to see added patients. A 10-bed pediatric unit is not always utilized fully. We see about 13,000 to 14,000 pediatric patients a year. So if we have empty space and empty beds and we have adult patients waiting, it seems the responsible and prudent thing to see adult patients in the pediatric department,” Hayden said.
This past year, Isley said, the pediatric emergency room treated about 13,230 patients compared with about 52,800 patients in the adult emergency department.
However, Isley said the change in the process for lower-needs adults who may be shifted to rooms in the pediatric emergency room during spikes in emergency room traffic is a subtle shift from the way patient care was handled in the past.
“Before this situation, the pediatric department has always been an overflow space. Under Crystal’s leadership, we have just organized the process better so it is not as haphazard as it has been in past,” Isley said. “We have clearer protocols in place.”
Some of the impetus for seeking new ways to improve patient experience in the emergency room comes from the hospital’s desire to improve patient satisfaction scores captured in surveys after patient care. These scores are important because they are used as a factor in Leapfrog hospital ratings and are also used in determining the level of reimbursement the hospital receives from Medicare, Medicaid and some insurance companies.
The new approaches being used in the adult emergency department are seeing results, Isley said. A year ago, the average time it took a patient coming to the emergency room to see a provider was about an hour. Over the past three months, that time has consistently been in the 21- to 23-minute range.
“That’s a huge improvement,” Isley said.
Based on responses to patient surveys, patients are noting the difference. A year ago, the rating of overall care in the emergency room placed the hospital in the 11th percentile nationwide. Now, the hospital is rated at the 70th percentile.
Recent patient surveys also indicate that 84 percent of patients are likely to recommend the emergency room to others, a figure that places the hospital in the 61st percentile nationwide. A year ago, only 69.8 percent said they would recommend the emergency room, a figure that placed the hospital in the bottom 2 percent of hospitals in the nation by that measure.
“I think the community can feel the difference. I certainly hope they can,” Isley said.
With all the focus on improving numbers and patient experience in the adult emergency room, Isley said the hospital is still committed to retaining the pediatric emergency room.
“When we opened the pediatric department, we committed ourselves to focused pediatric care. It is not about the space they are in, it is about focus and approach and specialized training of the people who are caring for the pediatric patients — and that has never changed, never wavered and never been drawn into question,” Isley said.