PROVO -- Hurry up and wait.
It's a reality of health care, but providers in one local hospital realized a year ago that there was far too much waiting going on in their emergency room and it was affecting the standard of care they wanted to provide.
Officials at Utah Valley Regional Medical Center were ranked last among comparable hospitals in the Intermountain HealthCare system in wait time for patients who came to the emergency room. The average door-to-doctor time was 43 minutes. Of the 120 patients who arrived on an average day, at least two left before they ever received care; sometimes as many as seven a day left with no treatment. They were comparable nationally, but not where they wanted to be.
"We didn't want our quality of care affected by the amount of the wait," Dr. Cameron Symonds, the emergency room medical director, said.
Thus launched a months-long examination of the ER's processes and how to improve them. While there were no glaring errors, what staff found was that they were running into bottlenecks largely as a result of the traditional format of ER care: the patient arrives, checks in, is assessed in the waiting room for triage purposes, then is taken to a room and assessed again, then waits to see a doctor and then is assessed by the doctor.
Now, unless there is a shortage of nurses or beds, the first assessment is largely eliminated. Patients are moved into a room, vitals taken, the typical questions asked and then a doctor comes in. Some of the improvement is perception, ER manager John Resch said: less time in the waiting room makes people happier with their care. However, they're not just waiting in their room instead of waiting in the waiting room; doctors actually get to patients in about 25 minutes now instead of the previous average of 43 minutes. They spend half as much time in the waiting room, and only 0.4 percent of patients leave without receiving treatment.
Patient perception is better, but so is patient care, Resch said. The result is happier, healthier consumers.
"Most people don't understand the difference between quality and customer service," he said.
Other reform aspects included defining roles more accurately, allowing staff to make more decisions and standardizing how tests and lab work are tracked. The results after eight months have been noticeable even to patients, Symonds said. What used to be a full waiting room most of the day is now frequently a largely empty waiting room. And thus far, they've sustained it.
"We haven't lost any gains," he said.
The MountainStar hospitals have erected billboards along I-15 with the ER wait times listed; even though that most likely will not make a difference in choosing an emergency room -- most insurance plans list either MountainStar or Intermountain as in-network providers -- it does give patients an idea of how long they will be sitting in the waiting room. Those hospitals also have made decreasing wait times a priority; the average ER wait times at Timpanogos Regional Hospital decreased from 27 to 21 minutes in the last two years and from 36 to 27 minutes at Mountain View Hospital in Payson.