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Emergency Department Advances with New Technology/Initiatives 
Mary Simmons, RN, makes a follow-up phone call to a discharged emergency patient.The latest technology and innovative approaches to improve the service provided through the Emergency Department are two reasons St. Francis Hospital & Health Services had the highest patient satisfaction score in the SSM Health Care system for the month of September.

In addition to 24-hour physician coverage and highly-trained nursing and medical staff, emergency services at St. Francis continue to evolve with new equipment and programs that are designed to benefit patient safety, quality of care and patient satisfaction. “The changes we’ve made to our Emergency Department are proven to positively impact the patient experience,” said Pat Giffin, RN, ED Nurse Manager. “We’re always striving to do what’s best for our patients.”

The addition of the LIFEPAK 20e defibrillator provides immediate emergency response technology in a compact, portable unit. The LIFEPAK 20e defibrillator and monitor was created specifically for hospitals and clinics for use on "crash carts" as well as for portable emergency response throughout a hospital. It offers both manual and AED modes for ED and non-emergency settings.  The LIFEPAK 20e is biphasic which provides the most updated technology available to restart a normal heartbeat.  “This defibrillator uses less energy so there is less damage to the heart,” explained Giffin. “It is smaller than our old ones and can be picked up and taken to another location such as the parking lot if necessary.”

According to Giffin, the unit is utilized, on average, 2 to 5 times a month. “Our goal is not to use it because we hope to get to the patients and provide treatment before they get to the point of needing a defibrillator,” she clarified. “With rapid identification of medical issues, we can prevent the need for more serious interventions. But if we need to defibrillate, the machine is here.”

“Our Emergency physicians all have to take advanced cardiac life support (ACLS) and advanced trauma life support (ATLS) training.  Our Emergency nurses are also all trained in ACLS,” said Giffin. “We are prepared to handle any emergency such as those that require the LIFEPAK 20e.”

Two new programs to enhance the patient experience have given the ED staff tools to use for improving quality of care as well as patient satisfaction. “Pull to full” and discharge phone calls have been implemented to shorten wait times and improve outcomes.

Discharge phone calls after an ED visit are a means to improve quality by assuring the patient is following discharge instructions and improve patient satisfaction by offering an opportunity to ask questions or voice concerns.

“The staff attempts to call every patient discharged home from the ED to find out how he or she is doing and if there are any comments about the treatment provided,” Giffin said. “Their responses help us find areas where we can improve care.”

An advanced patient intervention, “pull to full” allows staff in the ED to fill every empty bed, even for patients with minor issues, rather than holding a bed for a potential emergent or acute case.

Giffin noted that for St. Francis’ ED nurses, it means “pull to full . . . and beyond”.  “If a bed is open in the ED, we ‘pull’ the patient back to the empty room but, depending on the case, we may also ‘pull’ the patient to a wheelchair in the Emergency Department hallway.  This helps to speed up the process for the patient,” she said. “We want the time from arrival to seeing a physician to be as short as possible.”

The current average wait time to see a physician in the Emergency Department at St. Francis is 16 minutes; that is the time from ringing the bell or checking in with registration to seeing the physician.

“We want to begin treatment to get improvement started as quick as possible,” said Giffin. “People come to the ED to see the doctor, and we try to get the doctor to the bedside as fast as we can.”

“Overall, the technology and initiatives we’ve put into place have had a positive impact on the care that we provide in terms of ensuring patient care quality, reducing risk and increasing patient satisfaction,” Giffin stated. “They assist us in providing the care our patients need and in a manner that makes them pleased that they came to us for their care.”

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