"Emergency Department undergoes many changes"

Danville Register & Bee
Sunday, January 20, 2008

Danville Regional Medical Center is making changes to reduce the wait times at the Emergency Department with the arrival of the hospital’s new CEO.
Jerel Humphrey pointed to the Direct Admit program that Becky Logan, the new chief nursing officer, has put into place.
“For example, if a patient in a nursing home has a broken hip, that patient can bypass the ED and be admitted,” Humphrey explained.
“If there is a physician already in the loop who knows the patient needs hospitalization, then we can get the medical crisis in without going through the ED.
“It’s in place now, but it’s too early to tell the impact. It’s just been within the last two weeks.”
Humphrey said the hospital also is improving the organizational structure of the Emergency Department, such as revamping the charge nurse responsibilities, to making sure there is more leadership on each shift.
The administration had hoped that opening up a primary care facility, Urgent Care, across from the hospital would divert a good deal of the non-emergency patients from the Emergency Department, but that hasn’t happened yet, Humphrey said.
“Patients are (still) using the emergency room for primary care,” he said. “Urgent Care has helped a little, but not to the extent we had wanted, and we don’t know why. We are looking into
why people aren’t taking advantage of it.”
Humphrey admits that one problem in the Emergency Department is communicating with the patients about wait times, but said the hospital hasn’t yet figured out how to do that.
“Sometimes we fall short of a patient expectation,” he said, “however, each patient and/or family member concern is reviewed when brought to our attention.”
If a person has been sitting in the Emergency Department waiting for a while and becomes sicker, the change in symptoms should be reported to the triage nurse to be reassessed, Humphrey said.
The size of the Emergency Department also is being evaluated.
“We saw more than 46,000 patients in the ED last year,” Humphrey said. “We may be undersized, and as we move forward with strategic planning, we will have to take the ED into account.”
Contact Susan Elzey at selzey@registerbee.com or (434) 791-7991.
Emergency Department statistics:
• Number of patients seen in the emergency room in 2006 is 40,227 with an average length of stay at five hours and 12 minutes.
• In 2007, the emergency room saw 40,601 patients with the average length of stay four hours and 37 minutes.
(Length of stay is the average of all visits for the acute Emergency Department and Fast Track.)
• Urgent Care is open 40 hours per week. Currently, 80 patients per week are seen there.
Other changes throughout the hospital are in the works:
• “We are looking at making the hospital all private rooms,” Humphrey said. “We are opening up floors that have been vacated because of the new facilities. We are going to go to a more private room concept.”
He said the two new floors that have recently been opened up in the Landon Wyatt Tower are remaining busy.
• “We also have not shut down the open-heart program, and we haven’t closed the loop completely on how we are going to continue with Dr. Lee McCann leaving and with Duke,” he said. “The key thing is that our open-heart program continues with no disruption of clinical care.”
McCann, the medical director of the hospital’s Heart Center of the Piedmont, announced in August that he was leaving to accept a position in Utah.
“The key thing is that we are going to continue, and we will have details on how we will continue, and it will be with Duke,” he said.
• “We’ve also done a lot better job in recruiting nurses in the past three months than the 18 months before,” he said. “We have brought on a nurse recruiter from Moses-Cone in Greensboro, N.C., who graduated from our nursing program.
“She will start in a week or so. She will just focus on and tell nurses in other communities about us.”
• Although the hospital is not fully staffed, he said no hospital is ever fully staffed but constantly has an ebb and flow.