Informed - Parma Community General Hospital

DOC AT THE DOOR
Walk right in – the ER doctor is waiting for you
Tom Basista hardly believed it was
possible. So when he needed urgent
care the night before a cross-country
flight, he hesitated. Recalling long nights
in the Emergency Department with various
family members through the last
several decades, he feared he’d get little
sleep before heading to the airport at 7
a.m.
“I thought I’d be there for hours,”
said Basista, who had never experienced
an ED visit that lasted less than several
hours. “But this was a unique experience
from start to finish.”
Doc at the Door puts a physician-led
team on the front line of care. The team
registers and assesses each patient,
usually within 30 minutes of arrival, performing
EKGs, starting IVs and ordering
tests. Parma Hospital is the first hospital
in the Cleveland area to handle ED patients
with this efficient new approach,
says Jesse DiRando, MD, chairman, Department
of Emergency Medicine.
Testing can be ordered and treatment
begun before the patient even
goes back into an ED room. Some – like
Basista – are discharged without ever
having to enter a patient bed. On a
Monday night late last summer, he was
taken care of and on his way home in
less than 30 minutes.
“The nurse came right to me in
the front of the hospital,” said Basista,
whose hand was swollen and sore after
a kitchen accident. “The wonderful part
was that the care was not in stages. Everything
was assessed and treated immediately.”
Basista received a tetanus shot,
had his antibiotic prescription filled at a
24-hour pharmacy and made his 9 a.m.
flight the next day.
“I woke up the next morning and I
felt like a new man,” said Basista, 52.
“This was the fastest experience I’d had
in an ED in 30 years. The nurse and
physician were phenomenal. They were
very cordial and compassionate.”
Hospitals from as far away as Hawaii,
Oklahoma and Connecticut have
traveled to Parma Hospital to study and
learn from Parma’s success. Introduced
nearly two years ago, the program was
expanded
recently to
be available
from noon
to 10 p.m.
everyday,
including
weekends.
The
ED recently
completed
renovation to
remove registration
areas
off the waiting room and replace them
with more private triage rooms. Since
patients are registered at the bedside,
separate registration suites are no longer
needed.
“We put the whole team at the front
door to support patient needs, making
the delivery of care quicker and more
efficient,” says Dawn Beljin RN, director
of ED operations.
The success of Doc at the Door is
evident in the Hospital’s recent patient
satisfaction scores, which are in the 90th
percentile for the past three months. In
that same period, compared to other
hospitals across the nation with more
than 40,000 patient visits per year,
Parma Hospital has averaged 30 minutes
from the time the patient walks in the
door (or arrives by ambulance) and is
evaluated by an ED doctor. The national
average is over 60 minutes.
“We beat all national benchmarks,”
says Jesse DiRando, MD,
chairman, Department of Emergency
Medicine. “These are key indicators
of patient satisfaction, department efficiency
and patient safety with risk
management.”
ED physicians like Gregory Oswald, MD, top photo, and Taras Napora, MD,
left, lead triage teams that see patients upon their arrival in the Emergency
Department.
Spring 2009 Informed 3