'One Patient at a Time'
Tulare
- Doctors for Emergeant Medical Associates (EMA) said their company is
confident it will increase public confidence in the Tulare District Hospital's
emergency room and two doctors who sit on the hospital's board of directors
say that already is starting to happen.
“In the six weeks you've been here, I've not heard a single complaint about your care,” Dr. Prem Kamboj told Drs. Val Warhaft and Marco Hernandez of the newly formed Tulare District Emergency Medical Associates, an affiliate of EMA.
Kamboj and fellow board member Dr. Lonnie Smith were highly critical of ER services when they ran for the board in 2006, saying they believed the reason more of their patients were asking to be sent to other hospitals for inpatient care was because of the bad experiences their family members, friends and acquaintances had reported in the ER.
Like Kamboj, hospital board Chairman Dr. Parmod Kumar said the new group is a welcome addition to the hospital and lived up to its excellent reputation when one of his patients went to the ER and was quickly diagnosed with massive blood clots in his lungs and sent to the intensive care unit in less than 30 minutes.
'One Patient at a Time’
During the board's regularly scheduled meeting, Walhaft told the board EMA is committed to gaining public confidence. “We'll win that one patient at a time.” He is the chief medical officer for EMA.
While the ER has averaged 75 to 80 patients a day, he projected that within six months the number will increase to 100 patients per day as Tulare District becomes the ER of choice for district residents.
EMA has a track record of proven success, he said. “We've grown by request, not by design.”
Tulare District ended its previous contract with Team Health West in September after its new Chief Executive Officer Shawn Bolouki expressed concerns about patient safety and quality of care in the emergency room. Team Health officials strongly disagreed with his assessment.
EMA has a goal at each hospital it serves to have no more
than a two-hour lapse from the time the patient arrives and to the point
a decision is made about his or her care, Walhaft said, adding the national
average is between 350 to 400 minutes.
Two programs have been initiated in the TDH emergency room to improve
efficiency and reduce wait time, according to comments Walhaft made at
the board meeting and in a hospital press release about the change.
'Fast Track Gone'
The first eliminates “fast track” beds, which were introduced a few years ago to try to lessen waiting times for patients with less serious problems, in favor of putting patients in any available bed in the ER.
“Fast track” would sit idle 12 hours a day, while patients waited in the lobby to be seen, he said. Now patients are put in any available bed and “all of the space in the ER has all the necessary resources to treat patients.”
The second program sets up a treatment area where medical personnel can “evaluate, treat and discharge those who have come to the emergency room with less demanding emergencies such as ear infections, fevers, minor cuts and sprains,” Walhaft said.
EMA also is creating profiles for each physician in the community, so ER doctors know how they prefer their patients be treated.
Steps also have been taken to increase communication between
doctors and nurses, Walhaft said. “The nursing staff needs to have
a firm and clear voice in what we do.”
Chief Nursing Officer Pat Mathewson said “it's been very healthful
for our nurses to work in an environment in which physicians treat nurses
as colleagues.” She added steps are under way to provide more education
for critical care nurses.
Hernandez, associate director of medical services, said Tulare District has given EMA “one of the warmest receptions we've had.”
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