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St. Joseph's Hospital Health Center

Advancing Excellence

Feb 11 2013
Access to Care
6

In Sunday morning's Post-Standard is a story about our emergency room. It illustrates two ends of the spectrum -- one patient with an emergency received timely emergency care, a good outcome and was thankful. The other patient, with a sick child, did what most parents would do when they can't get access to primary care, she went to an emergency room.  It happened on a holiday in the midst of a flu outbreak. She received care for her child after a long wait, and was not happy with the experience.  I am sure the overwhelmed providers that evening did not want her to have that experience any more than she did.

How and where do we access care is really the story. Emergency rooms are just that, designed for emergencies. Yet with a severe primary care shortage and some practices without after hours and/or weekend care, people are forced to seek care that is available. Are they right or wrong? Are the providers right or wrong for taking emergencies first? It's really a system issue. How do we make sure patients get access to the right care at the right time in the right location?

First, it's having enough primary care physicians and clinicians in the right places with the ability to see sick patients after hours and on weekends. Urgent care and specialty access in pharmacies and stores, while not continuity of care, may play a limited role in providing certain access. The recent flu outbreak proved that with the Health Commissioner allowing vaccines for children in these settings.

Second, it's establishing policies and procedures that help patients have a great experience when they choose an emergency department.  Our new emergency room was built with private rooms and quiet natural lighting design to improve the patient experience. What we didn't anticipate was such a large increase in patients! We are grateful and working hard to hire additional staff and decrease wait times. The data for the article included some time in our old ED when space was constrained, and didn't clearly indicate the volume increases we have faced. Dr. Tucker and Dr. Sulik tell me our average wait  time over the last four months is now down to 57 minutes.

But,  just around the corner, millions of Americans are about to have health coverage. Where will they seek care if we have not expanded access to primary care?  In the emergency room.

Thank you to all the staff in the ED who handled the recent flu outbreak, and gave great care under difficult circumstances. We will learn from all these challenges and prepare for a better future.

We want every patient, every encounter, every time to have a great experience, and when they don't we learn from it and improve. That's the St. Joseph's way.


  Comments

6 Comments so far | Skip to comment form


Donald Colon February 11, 2013 at 08:54 am

Kathy, Have you looked into opening urgent care centers strategically located around the county as Sarasota Memorial has done in Florida. We particularly could use one or two more in the northern part of the county. I don't know how many people use North Medical urgent care, but is hard to get to from most parts north. Sarasota has theirs located on main throughfares with high visibility. I know that property on Route 31 or other high traffic areas is expensive but it doesn't seem to be a problem down here. Chestnut Ridge was supposed to be the solution, but that didn't work out and likewise the North Hospital which was going to be near route 81.

Kathy Ruscitto February 11, 2013 at 09:52 am

Thanks Don, all great ideas!

TERRI STEVENS February 11, 2013 at 01:20 pm

I THINK ANOTHER CONSIDERATION IS THE AREA IN WHICH THE HOSPITAL IS LOCATED. THERE ARE ALOT OF PEOPLE WHO DO NOT HAVE TRANSPORTATION AVAILALBE TO THEM TO BRING THEIR SICK FAMILY MEMBERS TO AN URGENT CARE OR AFTER HOURS FACILITY SO OUR ER IS THEIR ONLY OPTION.

Kathy Ruscitto February 12, 2013 at 08:33 am

I agree there are many issues that bring people to our emergency room and transportation can prevent access to care. We are looking at a variety of ways to improve access both in the city and rural communities. Our Westside Family Health center and Family Medicine Centers are expanding, along with our Baldwinsville and Cazenovia practices.

Shirley Pease February 13, 2013 at 07:41 am

I brought my husband into our ED Monday afternoon--he had fallen off our roof. While I admit that the wait time was long (of course, anything over 5 minutes will seem to be long when a loved one is in pain), Ron had tremendous care from the nurses, registration staff,the PA, and the transporter who took him twice for X-rays. The staff seemed very appreciative for the words of praise we gave them for their great care in the midst of their high patient volume. He is now an inpatient on 4-2, and his extremely positive experience is continuing here at St. Joseph's.

Mischel Satunas February 14, 2013 at 01:57 pm

http://www.lvhn.org/facilities_directions/emergency_room_at_lehigh_valley_hospital_muhlenberg Please read this article on my local hospital and ER wait time! PLEASE consider implementing the same thing at St. Joes. The wait time that you currently have is unacceptable!



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