Chief Executive Officer
Sutter Medical Center
Sacramento, CA-based Sutter Medical Center uses a rapid medical exam to speed patient flow in its busy emergency room. Tom Gagen explains the process, implemented a year ago, and how it helped Sutter improve patient safety and satisfaction during peak times in the ER.
Gagen: Between two sites, we see about 80,000 emergency room patients annually. We've seen our daily census go from about 100 patients a day to 135 over a couple of years at Sutter General Hospital. We were having some throughput problems in taking too long to see patients and having low-acuity patients tie up beds.
Say I'm a typical patient, and I come in. The first thing I usually see is a triage desk with a nurse. During the hours of rapid medical exam, at that triage desk is a nurse and physician. That nurse is getting my vital signs, my symptoms, my history. The physician's doing a very quick medical exam: listening to my symptoms, seeing what my causes are. Basically he's making a decision whether I need to be seen as a regular ED patient or if I'm a lower-acuity patient. I'm not tying up an ED bed waiting for the process—I've been seen and screened. I'm back out waiting for things to come back for a definitive diagnosis.
It's let us see more patients, turn those beds over, decrease the number of left-without-being-seen, and decrease diversion hours. From the patient safety side, it helps us get more acute patients to the ER quicker. It puts the patient at the right level of care.