News Release
"MMC Working to Cut Time in Emergency Room"
By Karen Van Splawn
Las Cruces Sun-News
Memorial Medical Center officials say they are working to reduce waiting time inside the hospital's emergency room. The challenge, they say, is to take care of patients in a timely fashion.
"We really want to be responsive to the community's needs, " said William Einig, head of Memorial's emergency services.
Memorial officials invited a Las Cruces Sun-News photographer and reporter to tour the emergency room on Tuesday afternoon. According to Einig and other officials, Memorial's emergency room saw 30,000 people, while its PromptCare facility treated 35,000 patients.
"Since the opening of PromptCare (an urgent medical treatment center located next to MMC), we've taken the less critical patients out of the ER," Einig said.
"Memorial's emergency room improvements are making a difference," said Renee S. Frank, vice president for strategic planning, marketing and business development.
The hospital credits PromptCare and the seasonal Pediatric Urgent Care Center with helping Memorial "avoid the excessive and dangerous levels of emergency department overcrowding being reported everywhere from Boston to Los Angeles," according to a hospital news release.
News reports occasionally surface about overcrowding and long waits in America's hospital emergency rooms.
A recent Washington Post story cites a number, courtesy of the National Center for Health Statistics, of 100.4 million visits to U.S. emergency rooms in 1998. Ten years before that, the number of visits was 81 million. According to the Center, in that same 10-year time period, the number of hospital emergency departments has fallen, from 5,200 to just over 4,000.
In El Paso, people have been turned away from hospital emergency rooms - or must wait for hours until a doctor or bed is available.
Susie Kimble, MMC's marketing manager, said the average wait in Memorial's emergency room is 3.5 hours.
"Patients coming into ER need blood tests, X-rays and other diagnostic tests, and therefore the time they're in there takes longer," Kimble said. "Their care is more acute."
Einig said Memorial has started a "rapid triage" system to cut down on waiting. For example, the triage nurse can quickly check a computer to see if there's a free bed in the emergency room.
"If there's an empty bed, you see the nurse, and someone will come and register you at your bedside," he added.
Another way to speed up things is computerizing the records charting system, and that is what MMC has done.
"We can pull up a chart instantly," Einig said. "It shows the medical information on a patient."
To prove his point, he pulls out a computer laptop terminal in an emergency pediatrics room and clicks on the name of a fictional patient, a 28-year-old with abdominal pain.
With CodoniX, a doctor can order tests or medication, while a nurse is able to document patient care. An encrypted Intranet system keeps information secure.
"It means no paper charts," Einig said. "You go to the triage nurse, and she enters your name into the computer."
Kimble said there is not a shortage of doctors at Memorial's emergency room.
"We're staffed to the capacity of what we can do," she said. "We could double the (emergency doctor) size, but we'd have empty rooms half the time."
Nine doctors work on Memorial's emergency staff, Einig said.
"Generally, we'd like to have 10, or actually 12 or 13," he said. "People ask, 'Why don't you have more doctors?' I ask, 'Do you know any? Tell them to come over'."
"Like any specialty, we have a problem recruiting," Einig said.
One reason, he said, is a low reimbursement rate for Medicaid, the federal-state program that pays health-care costs for low-income families with children, the disabled and others, and Medicare, a federal health-care insurance program for those 65 or older.
In Missouri, a doctor may receive a $100 reimbursement from Medicaid or Medicare for performing a certain procedure.
"Here in New Mexico, it could be $30," Einig said. "We are the second or third lowest (state) for reimbursement." New Mexico also is less attractive to physicians because of the personal income tax and the state gross receipts taxes on earnings, he added.
Emergency room doctors are paid a fee for their services. "You could sit here all day long and get paid nothing," Einig said, "if no patient walks into the emergency room."
Memorial has a full emergency nursing staff, with six to seven nurses on a shift at any time between 11 a.m. and 3 a.m., hospital officials said.
"Last winter, the emergency room was down between five and eight nurses," said Lee Golden, a registered nurse who is director of emergency/cardiovascular services.
"At 12:20 p.m., Tuesday, Memorial's ER waiting room was pretty much empty, and that's the way it should be," Einig said.
From 3 p.m. until midnight is usually the busiest time. Around that time period, people have a greater tendency to be injured or realize they need to seek medical attention for their illness.
Einig called the emergency room "the barometer of illness in a community."
"Because of cost-cutting health management plans, or no insurance at all, a person may not be able to get to a doctor early enough for preventative care," he added. Then something serious happens, and the person ends up in the Memorial emergency room - which by law must treat everyone who walks through its doors.
"This is the place of last resort," said Einig, who added that many coming into his ER are indeed suffering from a life-threatening condition, be it a heart attack or gunshot wound.
Patients come in three categories, with the most urgent classified at Level 1. Level 2 patients may be sick with the stomach flu, but in no immediate danger. People with lesser problems - such as a severe cold or sprained ankle - fall into Level 3.
"If the ER waiting room is full, and the person is not in dire need of care, he may have to wait several hours," Golden said.
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