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Hospitals try to speed up their ER care

Reacting to a rise in emergency patients, two companies in Hernando County create programs to treat people in one or two hours.


© St. Petersburg Times, published May 14, 2001

Local emergency rooms, it seems, are in a rush themselves these days -- to get patients in and out the door.

The two hospital companies in Hernando County both have recently implemented programs to speed and improve services in their emergency rooms.

The moves come about as hospitals nationwide are awakening to the idea that emergency rooms, with their growing number of visitors, are the "front door" of the health-care system, according to the American Hospital Association.

ERs are no longer just a place for dire, traumatic cases. They have become the stopping place for people, particularly the uninsured, suffering from common colds, sore throats or persistent headaches.

And for anyone who has had to sit for four hours waiting to be seen for a sprained ankle, ERs and their crucial role in health care are a key to customer satisfaction.

In a competitive and growing market such as Hernando County, hospital officials hope to win over patients by getting healthy bodies out the door as fast as possible.

"Our goal was to be able to see every patient after triage and Quick Care, door to door, within an hour," said Jaime Wesolowski, chief executive officer of Oak Hill Hospital in Spring Hill, which is owned by HCA -- The Healthcare Co.

"They have been successfully doing that every month since we started."

Oak Hill started the Quick Care program in October. The hospital carved out a separate unit and shuffled hospital employees so the unit is always staffed with a physician, nurse, technician or assistant.

The unit is open from 10 a.m. to 10 p.m. seven days a week. It is separated from the emergency room and has seven stations to handle patients whose symptoms aren't the most traumatic or serious: broken bones, lacerations, swollen throats.

"We focused on the ER patient that would sit and wait forever," Wesolowski said. "They are the ones that get most upset."

About a third of Oak Hill Hospital's ER visitors now pass through Quick Care.

Last year, about 26,000 people passed through the emergency department. That was a 12 percent increase from the year before, said Dean Alexander, the hospital's chief operating officer. Before that, numbers of visitors grew at about 3 percent a year.

The growth, Alexander said, stems from the increased use of the emergency room by the uninsured.

"We do have a crisis in health care," he said, "and emergency departments are taking more of the brunt in delivering health care."

According to the American Hospital Association, hospitals are required by law to screen all patients seeking emergency services, and, if needed, stabilize them. Many patients obtain further services, such as in-patient care or consultations.

From 1990 to 1999, the number of emergency-department visits nationwide rose by 15 percent from about 87-million to about 100-million. But the AHA attributes part of the rise in volume at existing emergency rooms to closures of other hospitals, which puts pressure on those that remain.

Health Management Associates, which runs Brooksville Regional and Spring Hill Regional hospitals, is also making plans for the pressure expected from a growing population in Hernando County. At one of the two hospitals it runs, Spring Hill Regional, it expects to start construction of a new emergency room by the end of the year.

It calls for a $6-million emergency room expansion, which will add 14,000 square feet to the existing 7,000-square-foot unit. The number of beds will go from seven to 22.

At both local HMA hospitals, a new program was implemented last fall to guarantee a consultation with triage staff within 15 minutes, or the hospital would waive emergency room expenses.

"We want to reassure them that they are going to get in right away if they are in a serious situation or give them some idea when they'll be seen," said Tom Barb, local chief executive officer for HMA.

"Most people come in very anxious."

A consultation with a triage staff member does not mean treatment is close behind, Barb admitted. But he said that at both hospitals, which see a combined 38,000 emergency room visitors a year, the average wait is less than two hours.

Officials with both companies say they realize that customer satisfaction with an entire hospital can hang on the service provided in the emergency room.

"I think that health care has become very competitive, and I think this is where competition works," Barb said, referring to the different ER programs at the local hospitals.

At Oak Hill Hospital on Friday, Barbara Rogers and her 19-year-old daughter, Tonya, were satisfied that they wait 10 minutes before they were ushered into Quick Care to treat Tonya's sore throat.

About an hour and a half later, armed with a prescription for an antibiotic, the Rogerses were headed home.

Barbara Rogers said that long delays of the past, when she sat in Oak Hill's waiting room with painful, arthritic legs, appeared to be gone.

"You sat there forever," she said. "You had to wait behind everyone back then."

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