Hospitals promote ERs to drive patient traffic

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When she thought she was having chest pains, Rebena Tyler didn't think of going anywhere else but University Hospital. Having worked there for 23 years had something to do with it, she admitted, but it was more than that.

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Trinity Hospital promotes its ER by word of mouth.  File/Staff
File/Staff
Trinity Hospital promotes its ER by word of mouth.

"These people are dedicated and they are honest," said Mrs. Tyler, 77, a former supervisor in housekeeping.

She is part of a growing trend as emergency rooms in the Augusta area are seeing more patients, who then are an important driver of hospital business.

In a competitive market such as Augusta-Aiken, hospital ERs seem to have carved out niches for themselves in an effort to attract more patients.

Medical College of Georgia Hospital and Clinics, which has the largest and busiest emergency rooms, is renovating to get even bigger and better to handle different types of patients.

University Hospital, which says it treats more heart patients than all the others combined, is adding a helipad so patients can be brought from farther away.

Doctors Hospital has been stressing its low ER waiting times.

Aiken Regional Medical Centers is embracing its role as a community hospital and focusing on making the services it does provide count.

Trinity Hospital of Augusta relies on community experience and word of mouth that it can quickly get to routine care.

"It is absolutely the front door to the hospital," said Jim Davis, the chief operating officer for University. "An awful lot of folks come through your Emergency Department. It's a busy place."

It is also often a critical first impression most people have of the hospital, said Cathy Robey-Williams, the administrative director of clinical operations for Aiken Regional.

"If people don't have a good experience when they come in for an emergency, they're not going to come back," she said.

It is also an important source of patients. At most Augusta hospitals, half of all patients admitted to the hospital show up first at the ER.

"It's a big chunk of our business," Mr. Davis said.

At MCG Hospital, it is even higher, about 63-64 percent, because the hospital receives so many transfers from other facilities, and they all come through the ER, said Rich Bias, the senior vice president for ambulatory and network services. Its eight rural hospital partners accounted for 1,700 transfers last fiscal year, he said.

Almost everyone is seeing more ER patients: MCG Hospital, Doctors and University are all seeing about a 6 percent increase over previous years, and Aiken is growing at about 5 percent a year, officials said. Some of it might be because of the economy, as unemployment often robs people of health insurance and access to care other than the ER, which has to see them.

"They tend to put off illness until it is to the point that they need to seek emergency care," said Karen Swim, the chief nursing officer for Doctors.

Some of it is the nature of the population itself, MCG's Mr. Bias said.

"We believe between the patient population as well as the changing demographics with the older population that at a minimum we would see a 2 to 3 percent increase every year," he said. MCG Hospital, for instance, saw 77,000 patients last fiscal year but is renovating to handle up to 95,000, Mr. Bias said.

For others, the changes were more focused on the processes for handling patients in order to reduce wait times for getting into a room and seeing a physician. At Aiken Regional, for instance, patients are sent straight to a room if one is available, Mrs. Robey-Williams said.

"If there's a bed in the back, they go straight back," she said, and that has reduced waiting times -- even when busy -- to about 20-30 minutes. Doctors Hospital averaged 26 minutes in December, Mrs. Swim said. The hospital is encouraging patients to text or use smart phone applications to check on its waiting times, she said.

"We know that the public is using the new technology now to find health care providers and to seek fast care," Mrs. Swim said, "So we are trying to take advantage of what methods are used the most."

Trinity's reputation for getting patients through the ER and into a bed if they need it is aided by the fact that the same physician group that staffs the ER also staffs the floors, making quick collaboration easier, CEO James Cruickshank said.

"Our message to the community is come to Trinity and we'll get you in and get you taken care of and get you out as quickly as possible," he said. "I think the patients that have been in the community for a while, they realize that."

In fact, standing out is important for ERs when patients are making that decision, Mr. Cruickshank said.

"When you need an ER, you need an ER," he said. It's like, 'OK, now which one do I go to?' "

Augusta hospitals realize that.

"I would say that it is a fairly competitive market in that the health care consumer has so many choices available, within close proximity," Mrs. Swim said.

In University's case, it comes down to the heart. In addition to the helipad, the hospital will soon be working with ambulance providers to transmit EKGs from the field to the ER so that the catheterization lab can be readied if needed, Mr. Davis said.

The hospital already gets 95 percent of patients from the door to a catheterization in less than 90 minutes but is striving to do better.

And there is a reason for the emphasis: heart and vascular services account for nearly a third -- 32 percent -- of hospital revenue.

"It's a very big piece of our business," he said.

That MCG Hospital and Clinics has the only Level One Trauma Center in the area is well known, and patients come from an hour and a half in all directions, Mr. Bias said.

What is often overlooked, however, is the area's only dedicated pediatric ER at the Children's Medical Center, which also has pediatric subspecialists backing it up, he said.

"From my perspective as a parent, knowing what is available through the only pediatric emergency room in the region, I don't understand why anybody would take their child who is in a true emergency anywhere else," Mr. Bias said. "We are absolutely unique in that respect."

Because it is the premier trauma center, MCG Hospital's adult ER also has ready access to subspecialists when needed, which accounts for a lot of transfers there, he said.

"Basically we're the place where the other hospitals in the region will refer the patients that they aren't able to address," Mr. Bias said.

Aiken Regional has eschewed trying to do everything and focuses on quality services, Mrs. Robey-Williams said.

"Our goal here is to do well at what we do," she said.

The quicker waiting times at Doctors are not just for the patients but aid the rest of the hospital as well, Mrs. Swim said.

"If we can get patients treated and diagnosed faster, we can get their care started quicker and hopefully make the whole process for them go faster," she said.

Reach Tom Corwin at (706) 823-3213 or tom.corwin@augustachronicle.com.

Comments (13) Add comment
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HughDonnet
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HughDonnet 01/10/10 - 05:11 am
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I'm sorry but how do you

I'm sorry but how do you "think you are having chest pains" ? I can understand thinking you might be having a heart attack. But I'm pretty sure most folks could tell if they are experiencing pain or not.

Just My Opinion
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Just My Opinion 01/10/10 - 09:16 am
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The problem with the ED at

The problem with the ED at MCG is the indigents who frequent the place. Ask any of the personnel there and they can point out the "frequent fliers"...the people they see on a regular basis. These type of people come there for food and a place to rest. They know the system, and know that all they have to do is go in and complain about chest pain or some other vague malady, and they HAVE to be seen. THAT is why that ED has such a long wait-time, and that is exactly why they are enlarging the place...so the regulars won't suck up all the beds and all the care-time for the "real" PAYING customers...uh, I mean patients!

soldout
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soldout 01/10/10 - 10:01 am
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It is a big business and our

It is a big business and our goal should be to become so healthy it becomes a small business. Being healthy shouldn't be complex or expensive and God is on your side if you want to live that way.

okletssee
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okletssee 01/10/10 - 02:24 pm
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I would be interested to know

I would be interested to know the quality of care in area hospitals, from the patients perspective. I would also like to know the wait times to be placed in an ER bed, wait time till a physician is seen, wait time until pain meds are given AND pain is controlled, and wait time until placed in an inpatient bed- from a PATIENTS PERSPECTIVE!! BTW, hospitals should NOT judge the frequent flyers just because they do not understand being poor or troubled, but SHOULD treat ALL patients the same! How do patients rate their care in the ER at UNIVERSITY hospital? You would be surprised at this data, and would choose another hospital!

okletssee
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okletssee 01/10/10 - 02:34 pm
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If financial stability and

If financial stability and thus inpatient bed capacity is driven by satisfied ER patients, UNIVERSITY HOSPITAL will not survive unless they greatly improve this area of weakness which brings the rest of the hospital ( which is excellent) down!!!

SIGHER
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SIGHER 01/10/10 - 02:34 pm
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ok, University is the only

ok, University is the only hospital interested in the "patients perspective" that I know of. They give each and every patient a customer survey form and follow up with phone calls. ER personnel also make visits to admitted patients. You would be surprised at this data and only choose University!!!
Did you not get the pain meds you were seeking?

okletssee
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okletssee 01/10/10 - 02:39 pm
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Why do you think the patients

Why do you think the patients perspective IS considered at University right now? That's right- because they know they do HAVE a problem and a big one. If you work there, you know this is true.

SIGHER
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SIGHER 01/10/10 - 02:45 pm
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ok, I see the cards! And I

ok, I see the cards! And I wouldn't work anywhere else!

SIGHER
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SIGHER 01/10/10 - 02:47 pm
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OR go anywhere else!

OR go anywhere else!

SIGHER
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SIGHER 01/10/10 - 02:52 pm
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ok, sorry you had a bad

ok, sorry you had a bad experience!

okletssee
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okletssee 01/10/10 - 03:43 pm
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No, I did not have a bad

No, I did not have a bad experience. AND this is not one isolated case. There are many excellent nurses in the ER but some of them need people skills and compassion. They also need some experience being a patient. I had 1 experience and it was fairly good but I know many others who have had very bad experiences- for the most part it is the mentality that the nurses don't have to be kind because they are there to save your life. Most of the ER patients are not life or death so some of the nurses get bored and resent the "clinic" type patients (the frequent flyer patients)All I am saying is show some kindness and understanding and realize you may be one paycheck away from being indigent yourself! And, please do t make ALL patients wait to actually see a doctor before addressing their pain needs- go to the Doctor and tell him how bad the patient is hurting. Patients have a right to be comfortable- understanding that a few situations do limit the administration of these meds like head injury, ect, but most often you CAN give some pain meds if the patient cannot take it anymore !!!!!!!

Just My Opinion
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Just My Opinion 01/10/10 - 04:28 pm
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ok, as far as the nurses

ok, as far as the nurses being able to give pain meds without the patient having first being seen by a doctor, that just isn't going to happen. Legally, and ethically, the nurse cannot do that. It may sound like a great idea, but they can't...otherwise their licenses are at stake if something detrimental were to happen to the patient related to the pain medicine. Like I said before, the ERs that have a long wait time are ones that have either several indigents there who are there for a free meal, people there who are basically needing a "Doc in a Box" (PromptCare), or those who are truly in need of emergency care. The first 2 are the ones who are consuming time, space, and labor. If I were you, I'd be more upset at those folks than the staff. Another thing, sigher, all hospitals and ERs in this area, that I know of, give patients surveys to fill out, and make follow-up calls. That is been going on for a few years now. The sad thing is that sometimes TOO MUCH emphasis is given to this info, because the patients give feedback that is not true. Then the hospital staff have to do ridiculous things to avert those false complaints.

okletssee
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okletssee 01/11/10 - 07:35 am
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Ok, are you a nurse? Have or

Ok, are you a nurse? Have or do you work in the UH emergency room. If you answered yes to both questions then maybe you think you are informed. I can say yes to both and that's bull about holding pain meds to protect your license. Yes you consider the problem and the facts surrounding the diagnosis and in a few cases it's better to wait on pain meds. But their doctors have said to just let them know and they will give you an order for pain meds- it's a patients right to be comfortable. Problem is there is too much judging and not making sure your patient is comfortable. No I am not mad at those who have to use the ER for their care because they for some reason can't afford to see their MD. Live a few more years and see how life can knock your plans to h@@@ and back. Life happens so quit punishing everyone for what a few may abuse. Get those patient satisfaction scores up above 70% by being a real caring nurse and quit complaining!!

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