Exploring ED Solutions

John Commins, October 23, 2014

In our May Intelligence Report, leaders listed their greatest challenges regarding their ED. HealthLeaders Media Council members discuss the biggest challenge they are facing and what approaches they are taking to address that.

This article first appeared in the November 2014 issue of HealthLeaders magazine.

Julie Dunlop, RN
BSN, MRO-A
Director of Emergency Preparedness
East Liverpool
(Ohio) City Hospital

Julie Dunlop, RN
Julie Dunlop, RN

One of our major problems is patient flow. We get a lot of patients who are underinsured or uninsured. We have a lot come because there are only two hospitals in the county. We sit where West Virginia, Pennsylvania, and Ohio meet. We get a lot of patients from all three states. We are a tiny ER. We have probably only 22 beds. Of those, only 10 are urgent care beds. The rest are fast-track. So we can get overwhelmed fast.

For workflow we use a lot more physician assistants. They see probably 60% of our patients. Right now we are going through a lot of restructuring, closing floors down because of the financial status of the community. We fly a lot of our patients out who need critical care because we just don't have the doctors available.

We also redesigned the whole system to make it faster. Our time to discharge is usually less than an hour unless it is an urgent patient, but we usually have them out of here in less than four hours or admitted upstairs. Once they are admitted we have a nurse assistant who will take patients up to the floor, if they don't need a cardiac monitor, while the nurse is giving a report.

John Commins

John Commins is a senior editor at HealthLeaders Media.

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