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HOSPITALS San Jacinto Methodist Hospital’s model for emergency service
✚ HANDS-ON MEDICINE
BY DENNY ANGELLE
Welcome to the San Jacinto Methodist Hospital Emergency Department. Ambulances still screech to a halt outside its doors, people drive themselves here for treatment. Inside, doctors and nurses work at a feverish pace to tip the balance between life and death.
But something is different here — some element is missing, something awry that makes this emergency center different from many others, even the ERs you see on TV.
What’s missing are the people waiting, waiting, waiting — to see a doctor, to receive treatment for a minor injury or to be admitted into the hospital, if needed.
The reason why is San Jacinto’s new model for emergency service, designed by the department’s health care team and its lead physicians, Drs. Paul Torre and Amir Rassoli.
When a person comes to the emergency department during peak hours, the first hospital representative that person sees is a doctor-nurse team. A cadre of nurses, physicians and nurse practitioners immediately evaluates patients.
Many of the individual steps that were taking place before a patient was seen by a doctor have now been combined to speed up the treatment process. “If it’s something like an ankle sprain, we can send the patient for X-rays immediately. If it’s a complaint that can be treated with medication, we can write the prescription right there,” said Rassoli, the assistant medical director. “As we get the patient’s information, the nurse and doctor are working simultaneously… getting vital signs, beginning treatment. Everything happens virtually at once.”
Since the new process began in June 2005, the doctors say the department has been able to reduce a patient’s time from door to doctor. There also has been a sharp 75 percent drop in patients who leave the emergency department without treatment due to long waits.
San Jacinto’s emergency department is the busiest of the four hospitals in The Methodist Hospital System. Torre said they treated 57,000 emergency patients at San Jacinto last year. He estimates they will see around 61,000 in 2006. In contrast, the emergency service at The Methodist Hospital in the Texas Medical Center treated 35,000 patients last year.
“We’re busy, and we’re growing,” Torre said. “We have created a center that is able to treat many people effectively, in a reasonable amount of time.”
Which would seem to be one answer to the state of emergency that Houston’s EDs have been in over the past few months. Many of them have encountered overcrowding issues so severe that the Harris County Hospital District created smaller clinics to treat patients who don’t really need emergency care.
“The popular misconception is that people who have minor problems create a logjam in an emergency room, but that’s not true,” Rassoli said. “In many cases, overcrowding and delays are caused by a lack of space and resources. But the main cause for delay is that doctors are treating the patients with true emergencies.”
So, freeing up space in the emergency department to treat patients who really need emergency care is an idea whose time has come. Torre said the San Jacinto system increases doctor-to-patient ratio in addition to slicing the wait time for patients.
The two physicians, who met while working in another hospital a decade ago, have formed a company — Emergency Physicians PA — that manages the emergency department at San Jacinto Methodist.
The company staffs the San Jacinto emergency department with five doctors and three physician assistants or nurse practitioners a day, and Torre and Rassoli place themselves in the weekly rotation to treat patients.
“Emergency medicine is handson,” said Rassoli, “which is why it makes sense to put the doctor at the front of the line.”
San Jacinto Methodist Hospital’s emergency department recently received a 2006 Press Ganey Compass Award. The company, Press Ganey Associates, tracks satisfied patients and scores hospital departments on the number of patients who respond favorably to the service they received. The Compass Award is given to institutions that have improved their patient satisfaction scores over the past two years.
“This concept of emergency care will continue to improve patient care and customer service,” Torre said. “We put patients where they need to be, much quicker than before.”
