When Southwest Mississippi Regional Medical Center scrapped immediate plans for an emergency room addition because complete funding wasn’t available, it didn’t end plans to find a way to lessen the burden on the the hospital’s emergency room.
After a couple of test runs last week, the hospital’s fast-track emergency room area officially opened on Thursday. Patients who have non-emergency ailments now have the option of being seen in the newly designated sixth-floor ER by an emergency room-trained nurse practitioner.
The newest ER is open seven days a week from 2 to 10 p.m., which hospital officials determined is the busiest time for patient use.
“We went in and studied the admission patterns in the ER and discovered peak time for non ER cases was from 2 to 10,” said Norman Price, CEO of Southwest Health System and administrator at the hospital.
The sixth-floor space being used is part of the now-defunct in-patient rehabilitation unit, which Southwest closed because of low reimbursement dollars. Costs for converting the space was fairly low because the hospital is using equipment and rooms already on hand.
The former therapy room is now the fast-track ER waiting room, and there are three exam rooms in use, with all equipment available that would be in an after-hours urgent care clinic.
And if it’s necessary for a patient to be sent for diagnostics, the lab and X-ray departments are available.
Price said 50 percent of the patients at the Southwest ER are non-emergent cases — patients complaining of ear aches, sore throats, coughs, achy joints, nausea, etc.
“But there are levels of those symptoms — with flu and pneumonia — that will be considered emergent,” he said.
All patients who enter the emergency room are assessed, just as they always have been, by a triage nurse, who determines the seriousness of a patient’s illness.
“That’s the triage nurse’s job, to distinguish emergent or non-emergent. It’s the same triage that’s been in place, but they can see you much quicker upstairs,” Price said.
“They’ll triage downstairs first in ER, and if patients are determined to be non-emergent, they’ll be given the option of going upstairs and being seen. Or they can sit downstairs and wait. Of course, true emergent cases come in by ambulance.”
The average emergency room wait nationally is five hours, he said. Southwest’s average isn’t quite that long, but it’s still significant when the emergency room is busy.
“It will cut the wait time significantly by going up to fast track,” Price said. “We’re already seeing about 20 a night. We expect that number to go up as patients become familiar with it.”
And even though a patient opts to go to the fast-track ER, they still have the right to return to the regular emergency room, he said.
Price said the emergency room physician staff was consulted about the new process.
“We got their blessing before we did it, and they were for it,” he said. “It will lighten the load in the ER.”
The Southwest board of trustees also unanimously approved the change. The board had already OK’d a fast-track ER in its plans to add on to the existing emergency room in an $8 million expansion project. The hospital had a $5 million grant, awarded after Hurricane Katrina, but didn’t have the necessary $3 million to complete the project.
“We expect the fast-track ER to make a big difference in the wait. I expect it to decrease the waiting time, downstairs and upstairs,” Price said.
All patients who choose the fast-track option will be escorted upstairs by a triage technician, and the department’s staff will take over from there.
“The patient is in a less resource-intensive environment, which frees the resource-intensive environment up,” Price said.
Those resources include physicians, ER-trained nurses, trauma equipment and more.
“We’re trying to not encumber the trauma side; we’re trying to ease the burden on that end,” he said.
Not all patients will be fast-tracked, however. No children under 3 will be seen upstairs. Other walk-ins will be evaluated for medical necessity.
“If patients present (in the ER) with symptoms that would ordinarily be treated at a walk-in clinic, they’re diverted upstairs,” Price said.
And those patients will get a price break, too. The cost of the fast-track ER won’t include a doctor’s fee, for example.
The new ER area is an example of how many hospitals nationwide — and regionally — are dealing with the problem of overpacked emergency rooms, and ever-toughening Medicaid reimbursement funds.
In Brookhaven, King’s Daughters Medical Center has changed its ER assessment process. As of July 15, the hospital’s nurse practitioners and physicians began assessing patients to separate those who don’t appear to have a serious medical problem. Patients who aren’t high risk or have no urgent need have the option of choosing other facilities, such as the hospital’s quick care medical clinic. If those patients still choose to be treated in the ER, they will be required to pay a $200 deposit or the applicable insurance deductible or co-pay.
