TMH Living Well: Emergency departments called to improve under health reform law
November 22, 2013
A buzzword we keep hearing these days is "health care reform." As you know, it refers to changes the government is requiring of health care facilities to improve the care they give. Despite the problems with the launch of the health care exchange, the overall intentions of health care reform are good — to make health care more comprehensive and accessible for everyone. Simply put, to make sure that when people need care, they get it fast and that it's effective and affordable. One specific area of hospital services that's mandated to improve is emergency departments.
"Under health care reform, emergency departments are called to provide care to patients more quickly and more easily. For example, hospitals no longer can require pre-authorizations and there is no co-pay like there would be in a doctor's office. These changes make emergency care more accessible for the patient at the time they need it the most," said Elizabeth Metcalf, RN, ED manager and trauma coordinator for The Memorial Hospital.
Most hospitals across the nation are working to improve the care they provide and to eliminate some of the things people dislike about EDs, and long wait times and personal attention are at the top of the list.
One common improvement in hospitals, including TMH, is moving to an electronic health records system. EHRs speed up the admissions process, making it so staff simply can review key information with patients, rather than re-entering all of the information each time. EHRs also enhance accuracy.
"Electronic health records allow staff and doctors to access patient information in a more timely manner. Physician orders are put in directly for appropriate departments, such as lab and radiology, so they can be accessed quickly. This means less wait time for patients," Metcalf explained.
Patient-centered care — care that puts a patient at the center of care choices and medical decisions — has been an ongoing movement for years in health care, and fits nicely with health care reform's goal to provide better care to patients.
Recommended Stories For You
"At TMH, we see the patient as a member of the team. We all work toward the best care and the best solutions. In the ED, our visitor's policy allows family to be at the bedside. We are also using a best practice called AIDET that guides staff in including patients in their care," she added.
AIDET stands for Acknowledge (greet, interact), Introduce, Duration (tell how long a procedure might take), Explanation (details about the care plan) and Thank you (for entrusting us with your care).
One of the hopes of health care reform is to lessen the load on emergency departments, which often care for people who do not have insurance or a family doctor. Theoretically, newly insured people will stop using the ED for urgent care or less serious illnesses and will see a doctor, instead. Yet many experts think it won't play out that way — at least at first. Some say if people are used to going to the ED for all their care, they will keep doing it. There's also a fear that we don't have enough family doctors in the United States to handle the load.
The TMH emergency department sees between 400 and 500 patients per month. Recently, the department hired two ED physicians and is looking to hire another, bringing the total to four.
"We are thrilled to have a group of dedicated, full-time ED physicians on staff. As a group they are invested in TMH and invested in people in our community," she added.
As far as wait times go, TMH is ahead of the game: "I have worked in hospitals where wait times for non-emergent care could be 2 hours with a total length-of-stay of 3 to 4 hours. At TMH, wait times are minimal. On our busiest days, total length-of-stay times are 1.5 to 2.5 hours. That being said, we are always looking for ways to improve and we welcome input from our patients," Metcalf said.
This weekly article with tips on living well is sponsored by The Memorial Hospital at Craig — improving the quality of life for the communities we serve through patient-centered health care and service excellence.