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Streamlining the ER - Natividad Medical Center trims its wait time in the unit
The Salinas Californian, March 29, 2006
Patients in Natividad Medical Center's emergency room used to get so sick of waiting to be seen, many packed up their pain and frustration and hobbled home.
Ten percent of the ER's annual 31,000 patients did just that.
"Some days, it was up to 15 percent," said Dr. Jeffrey Arnold, ER medical director. "The problem was that many of those people who left were really sick."
Studies show 10 percent to 15 percent of those who leave an ER before being checked should have been admitted to the hospital, Arnold said.
Days later, their condition vastly worsened, they would hobble back to the ER. They would require more extensive, and expensive, treatment and longer hospital stays.
On Nov. 1, the Emeryville-based California Emergency Physicians, a medical group of which Arnold is a member, took over the ER. Since then, things have improved, he said.
RICHARD GREEN/THE SALINAS CALIFORNIAN
In the emergency department at Natividad Medical Center
From left: Jeffrey Arnold, MD; Jerry Joseph, PA; Patty Mata, RN
Instead of 10 percent to 15 percent of waiting patients leaving early, the number has dropped to 2 percent. That bests the national average by a percentage point.
Instead of up to 3,100 a year giving up on the wait, the number is down to about 620.
Jerry Joseph, a physician assistant in the ER, witnessed the change.
"It's been a remarkable turn-around," Joseph said.
The pace of any ER is hectic and erratic, of course.
"Hours of routine," Joseph said. "Then moments of sudden terror."
The very nature of emergency care dictates spikes and lulls. Emergency cases do not conform to dates and times in an appointment book.
"You have to be prepared at all times for whatever comes in that door," said Patty Mata, a registered nurse with five years in the unit.
She and Joseph see broken bones, gunshot wounds, mental health patients, babies with fevers and victims of car wrecks.
