GBMC's new ER uses strategy for rapid care

Check-in: Goal is to streamline triage process, getting patients out of waiting area and into care rooms, where paperwork will be done.

May 27, 2004|By Jennifer McMenamin | Jennifer McMenamin,SUN STAFF

Visit a typical emergency room, and you are likely to be greeted by a hospital worker with a tall stack of registration papers and a long waiting list.

The $13.4 million emergency department that opens today at the Greater Baltimore Medical Center seeks to change all that with a single innovation: the "quick-look nurse."

From a desk similar to a hotel concierge's - right down to the oversized vase of flowers - the nurse will ask only patients' name, date of birth and reason for visiting before shepherding them off to a patient-care room for full registration and the medical evaluation.

"We've moved the entire triage process to the patient's room so you're out of here in 90 seconds. That's the goal," Paula Terzigni, clinical director of the emergency department and pediatrics, said this week, standing at the new quick-look desk. The nurse, she added, "will be experienced enough to look at three people at once and know who she needs to talk to first."

The new emergency department at the hospital's campus on North Charles Street in Towson - opening after three years of planning and 16 months of construction - also separates adult patients from children with a new, state-of-the-art pediatric emergency unit.

Calming touches

From purple and green bathroom tiles and whimsical hallway accents to the twinkling stars on the ceiling of the nursing station and the family waiting room, the unit was designed to minimize children's fear of what can be a scary prospect - visiting a hospital emergency room.

Wooden panels above the beds slide to conceal medical equipment that might not be needed for a particular child. And the family waiting room, separated from the regular ER waiting area, features computerized finger-painting screens and make-your-own-movie stations often seen in children's museums.

"They're not looking at scary equipment, they're not looking at people with IVs and all the trauma that goes along with an emergency room," said Valerie Tighe, a pediatric nurse of 27 years and the clinical unit coordinator. "The kids don't have to go through all that `adultland' stuff. They go through something that's more like Wonderland."

Deploying resources

Adultland has plenty of new innovations of its own.

For starters, there's the bank of remote-controlled, flat-screen plasma monitors that list every patient being seen or awaiting treatment in the emergency department as well as the waiting room.

Dr. John Wogan, GBMC's chairman of emergency medicine, says the screens - and the clinical unit coordinator who monitors them - will transform the ER's workflow.

"You can scan the screens and see where to deploy resources," he explained. "Is the waiting room backed up? Do we need to bring another doctor over? Are there not enough radiology technicians running X-rays?"

Allowing the unit coordinator to summon on-call staff to alleviate bottlenecks or to suspend housekeepers' breaks to get rooms cleaned more quickly should make the whole department operate more efficiently, Wogan said.

The new adult department also includes 20 patient-care rooms; a triage area to be used when those rooms are full; an eight-bed Urgent Care Center open from 11 a.m. to 11 p.m. for less-serious injuries and services; a seven-bed Rapid Diagnostic Unit, where patients can be observed while awaiting test results or admission to the hospital; and two resuscitation rooms to handle the most critical and life-threatening conditions.

At nearly double the size of the old emergency department, the new facility increases GBMC's emergency-room capacity by about 48 percent. Doctors expect the renovations will allow the hospital to handle more than the 50,000 emergency room visits a year that GBMC has averaged.

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