With the huge increase in volume due to the consolidation, which was completed in November 2009, sometimes the ED still gets backed up, but it's rare, says Jarvis.
"The biggest challenge has been keeping it up," she admits. "The system works, but it's a big change from the way people are used to working."
Though the changes put the patient at the center of the process, it causes patients to be moved a lot, making the transition a little more chaotic for staffers at first, she says.
"It's easy for staff and docs to slide back into the old habits, so we really have to stay on them," she says. "We have to make this the new normal. The doctors are working as hard or harder than ever, and they like being busy, but they agree things work better."