Building a Better ER

Care centers that circumvent long, painful ER waits.

ByJOHN McKENZIE<br>ABC News Medical Correspondent

Jan. 15, 2008&#151; -- It's bad enough to get sick or injured, but even the most stoic of patients can end up moaning in frustration when stuck in an emergency room for five or six hours.

Click here for guidance on when you should seek emergency care.

Click here for valuable resources, including how to tell if your insurance covers emergency room visits or how to contact your state representative about long ER wait times.

"Delays are avoidable and hospitals need to be able to step up and make changes in how we staff and [make] changes in our processes," said Gordon Docking of St. Joseph's Medical Center in Kansas City.

Click here for tips on what to bring with you to the ER and what you can expect once you get there.

how to tell if your insurance covers emergency visits, how to tell if you have a medical emergency, contact your congress person about long ER wait times, etc.)

St. Joseph's is now promoting its rapid ER service, one of several new initiatives from hospitals looking to improve the speed at which its patients receive care.

In this case, the Kansas City hospital hired more doctors and nurses and streamlined its lab techniques so that it can now advertise a 30-minute guarantee to its patients who are seen within a half-hour of their arrival.

When patients arrive at San Jacinto Methodist Hospital in Houston they can often bypass the waiting room and go directly to an exam room where triage is completed so treatment can begin more quickly.

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New York City's busiest emergency department, at Montefiore Medical Center, spent $40 million over four years to improve its facility. They've added a fast-track program 24 hours a day to treat those with minor aches and pains, and 30 percent of the ER patients no longer need to see a doctor.

They've also hired 50 more doctors who are board certified in emergency medicine. Some staff members say these improvements offer a definite boost to the care they offer to patients.

Dr. Michelle Davitt recalls her own experience of waiting in the emergency room in the past, and believes the speedier service equates to better health care as "time is very much related to quality."

"If you're getting treated quickly, if you're being evaluated, if you're getting medication in a timely fashion, you're getting better care," she said.

And that is appreciated by the patients -- when Santos Vargas had a sore throat and fever a nurse practitioner collected a throat culture, ordered the lab test and wrote a prescription for the necessary medication.

Vargas said he was "in and out" in an hour and five minutes.

"Very impressive," he said.

Montefiore also opened around-the-clock radiology suites inside the ER for faster X-rays and CT scans. And it tracks patients using new clinical information software that displays each patient's progress through the ER on screens throughout the department.

"We know exactly where they are. We can track how long they've been here, make sure they haven't been waiting too long for the results," explained Dr. Doug Finefrock of Montefiore Medical Center. "Blood tests, labs, we know instantaneously if they're back."

And reducing ER wait times is not only good medicine -- it turns out it's good business. At Montefiore the number of money-making hospital admissions coming through the ER is up 26 percent in the past three years.

"The number of patients who want to come here goes up," said Dr. Joseph Braverman, an emergency care physician at Montefiore. "EMS wants to bring patients here because they're confident of the care -- we get more admissions."

For a comprehensive listing of Medicine on the Cutting Edge reports with John McKenzie, click here.

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