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Hospitals Using 'Quick Look' Strategy To Ease Crowded ERs

Hospitals Using 'Quick Look' Strategy To Ease Crowded ERs

Patient Mary Ann McClintock of Katy, center, with granddaughter Catherine Hatfield, 15, and husband Chester McClintock wait in the continuing care section of the emergency room at Memorial Hermann Memorial City. (MELISSA PHILLIP CHRONICLE)

Cindy George / Houston Chronicle

January 04, 2009

A patient at the Memorial-area emergency department barely warms a seat in the waiting room before a nurse beckons and starts asking questions.

Beyond the desk and behind a thin curtain, the nurse checks the patient’s blood pressure. During a chat, she assesses the medical problem.

To save time, she may process a urine sample instead of sending out for lab results. Minutes later, a chart or a verbal cue from the nurse alerts the emergency physician about the patient’s symptoms.

Such strategies are moving patients more quickly through ERs at Memorial Hermann Memorial City Medical Center and its sister hospitals, a response to a national overcrowding problem that has forced some facilities to divert seriously ill or injured patients elsewhere, sometimes with tragic results.

Memorial Hermann’s program is an attempt to address the overcrowding problem by making the ER more efficient. One national expert said the strategy is being used by perhaps 10 percent of hospitals across the country.

In Houston, the ER overcrowding problem has been the subject of several studies calling for revisions to the emergency system. In 2006, the Harris County Hospital District changed policy to redirect patients who show up at the ERs of Ben Taub or LBJ general hospitals without emergency symptoms to community health clinics or urgent care services.

The goal at Memorial Hermann? To give every patient a “quick look” by a nurse or other health professional within five minutes of arrival, then get the sick or injured person to a doctor within 30 minutes.

So far, the average wait to see a physician at the Memorial City emergency center has been cut by an hour — from 93 minutes last spring to 20 minutes in December, according to Jim Parisi, the system executive who oversees emergency services.

The time frame factors in trauma patients rushed from ambulances to operating rooms as well as those who show up with minor injuries.

The strategy to accelerate ER visits expanded to most of Memorial Hermann’s other eight hospital emergency centers in December.

Adoption of the new procedures followed reports from the National Center for Health Statistics showing an increase nationally in emergency department wait times.

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