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Healthy ER response times

Three years in, new sorting system in busy BWMC emergency room gets patients in and out


By ALLISON BOURG, Staff Writer

When Takoya Sturgis felt sharp pains through her back and up her sides, there was only one hospital she wanted to go to for treatment.

The Glen Burnie woman headed to Baltimore Washington Medical Center's Emergency Department, where she had been several times before.

"I knew they'd get me back here quick," Sturgis, 24, said from her hospital bed in the emergency room.

At other Baltimore area hospitals, she's waited up to three hours to see a doctor.

"Every time I come here, I've been seen as soon as I come in," Sturgis said. "I know they find the problem and get you out."

The Glen Burnie hospital has the second busiest emergency room in the state, second only to Franklin Square Hospital Center in Baltimore County.

Doctors see about 103,000 patients per year, a volume that continues to grow annually by between 5 and 6 percent, said Dr. Neel Vibhakar, chairman of BWMC's emergency department.

Vibhakar, a Millersville resident at BWMC for six years, said he expects the emergency room to one day be the state's busiest.

"We're determined to do it," he said.

The community hospital is already tops in the state for ambulance traffic. About 20,000 ambulances per year - or 60 per day - drop off patients at the emergency room doors.

But despite the heavy volume of patients, the average waiting time is only wait about 20 minutes to get into a treatment room, Vibhakar said.

Most people, Vibhakar acknowledged, assume that a trip to the emergency room means hours, possibly most of a day, spent waiting to see a doctor or a nurse.

"That presumption, I think, is wrong," he said. "At The Cheesecake Factory, you expect to wait two hours. We want our patients to be seen as soon as possible here."

Three years ago, BWMC eliminated its triage - the process by which patients are ranked according to the severity of their illnesses - for 16 hours a day. During those hours, there's a physician and a physician's assistant out front meeting with patients who come in, getting the treatment process started right away.

That cut down on a lot of red tape and ultimately moved patients along much faster. About 10 percent of patients seeking emergency care - usually the ones with minor ailments - are discharged within an hour, and another third are discharged within two hours.

"It's definitely a trend," Vibhakar said of the new process.

Jim Reiter, a spokesman for the Maryland Hospital Association, said every emergency room has a different way of handling its intake process.

"I do know BWMC has had other hospitals check them out to see how they do it," Reiter said.

Carol Ann Sperry, head of nursing for the department, said the days of 24-7 triage were tense - for patients and for the nurses.

"You couldn't see every patient who arrives right away, so it was a sorting process," Sperry said. "You were making life and death decisions. It was a very stressful job."

She worked for 25 years under that system, but now, can't imagine going back.

"It's made for happier patients back there," Sperry said.

Manic Monday

Monday afternoons are usually the busiest in BWMC's Emergency Department, and this week was no exception.

Sperry said nurses and physicians were busy all day long with heat-related illnesses brought on by the temperatures in the 90s.

"It's a lot of respiratory problems," she said. The story has been the same throughout most of the summer, especially during record-breaking heat waves in July.

But wait five minutes, she called out.

"It could change," she said.

In fact, Mondays are usually so busy that the hospital added a whole extra physician shift to cope with the extra patients.

On Monday, all of the examining rooms were full, but the department's waiting room was relatively quiet. Maybe a dozen people sat waiting, mostly relatives of patients.

"You'd think people would be standing around, but they're not," said Kevin Cservek, BWMC spokesman.

Sandra Diaz of Suitland wound up in the emergency room after a minor car accident on Route 175. She was nearing a traffic light when all of a sudden she felt a car hit her from behind. She was rushed by ambulance to BWMC for slight neck and back injuries.

"Within 15 minutes, I was in the hospital room," the 24-year-old said. "I've been to other hospitals, and it's not as quick."

A $13 million expansion to the emergency department in 2008 may have also made things speedier. Seventeen more beds were added, taking the total number of treatment areas to 69 and making it one of the largest in Maryland.

Vibhakar said contrary to popular belief, Friday and Saturday nights are actually the quietest for BWMC's emergency room personnel. Instead, people who get sick over the weekend and need medical attention tend to put off going to the hospital until Monday.

"It is consistent," he said of the Monday afternoon rush.

Vibhakar said he also sees a spike in ER traffic following holidays or sporting events like Baltimore Ravens games - possibly the result of too much partying.

But he wants to dispel the myth that the emergency room is packed full of patients who don't really need to be there.

"That's untrue," he said. "We can't expect someone to know whether something is an emergency or not. We want people to come here to figure that out."

Sperry agreed.

"Is chest pain a cold or just a heart attack? You're asking lay people to make very important decisions," Sperry said.

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