Sunday, January 21, 2018
Health

Florida Hospital Zephyrhills unveils streamlined ER

ZEPHYRHILLS — Christopher Atkins jumped on the trampoline two weeks ago and fell on his arm. It didn't hurt then. But it hurt now.

The 8-year-old Lacoochee boy's mother took him to the emergency department at Florida Hospital Zephyrhills on Wednesday morning to have the arm X-rayed and make sure it wasn't broken.

"He said it hurts when he sleeps," Ramona Atkins said.

The Atkinses got to experience a new emergency room concept being employed at the hospital. A $200,000 remodel of the department added four exam rooms dedicated to patients with non-life-threatening illnesses. A covered drop-off area was added to the front, so staffers could see patients and offer assistance before they enter the building. The registration desk was moved to the front of the department so nurses can assess patients faster. Those with life-threatening conditions are sent immediately to the main emergency area. The others are sent to one of the exam rooms in what is known as "the fast track" area. There they are evaluated, taken for tests if needed and treated.

"Triage used to take a long time," said Ruth Hemphill, the hospital's chief nursing officer. "About 20 minutes. Now it takes less than two minutes."

Rooms are separated by cubicle-like walls instead of curtains to offer more privacy. One of the rooms, called a "procedure room," has a door and can be used for patients who have cuts that need to be stitched.

"We had to do this within the existing footprint," said Seta Ruiz, director of the emergency department. The remodel took several months to complete. In the meantime, "we had to stay open," hospital spokeswoman Michelle Oswald-Bianchet said.

The old ER had a traditional large waiting room. That area is much smaller now that the space has been dedicated to exam rooms.

"We don't need a large waiting room because we won't have many people waiting," Hemphill said.

Emergency rooms are critical places for hospitals. Often it offers a first impression. It also serves as a social safety net for the uninsured and for rural residents who might not be able to find a primary care physician.

"We don't turn anybody away," Ruiz said.

Florida Hospital Zephyrhills typically gets about 2,500 ER visitors a month. In December, that number climbed to 3,044. The goal is to get those with less serious illnesses in and out in less than two hours.

A year ago, Pasco Regional Medical Center unveiled its own $7 million emergency department expansion, designed to take patients from the front door to discharge in two hours or less. The expansion nearly doubled the number of exam rooms and added a dedicated CT scanner suite as well as other specialty suites. The Dade City hospital also boosted its staffing. Officials then said they had seen a 12 percent increase in ER patients over the previous year.

Increasing ER use across the country has hospitals working to streamline their processes, with several hospitals' stories being detailed on the American Hospital Association's website.

Several cite the "lean" process, which began with Japanese automakers after World War II. It means eliminating waste and streamlining processes, leaving only those that add value. It has been used throughout hospitals in the Adventist Health System, which is the nonprofit, faith-based parent company for Florida Hospital Zephyrhills as well as Florida Hospital Wesley Chapel.

Thomas Jefferson University Hospital in Philadelphia, a 957-bed facility, used the process to improve its ER efficiency. It ended up dedicating a team to handle "fast track" patients.

"Use of the lean process was an important facilitator to the improvement of the fast track. Previously, performance improvement initiatives within the department were led by committees of staff. The committees often made useful suggestions, but rarely did the suggestions lead to sustained improvement," the hospital's report said.

Christopher Atkins and his mom know nothing of the lean concept. But they were happy to be out of the emergency department in about 45 minutes. His arm wasn't broken, physician assistant Alberto Nunez told Ramona.

"Just give him Motrin," he said.

     
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