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Redesigning EDs for patient experience

In the new health economy, there is cost and quality pressure and also savvy patients who may Google a hospitals ED before coming in

At a time when emergency care is increasingly viewed as inconvenient, overcrowded and overpriced, and possibly losing ground to urgent care clinics, some health systems are trying to make their ERs a place where people actually want to go and spend their time and money.

Aria Health, a three-hospital network in north Philadelphia, has opened a new $37 million emergency department at its Torresdale campus, on the northern city-suburb border. It’s an investment for growth and in a new approach to emergency care trying to put the patient experience front and center.

“We have spent countless hours listening to our community, nursing staff, physicians, EMS teams and most importantly, patients, to design a facility that will meet their needs and exceed expectation,” said Aria’s new chair of emergency medicine, Gerald Wydro, MD, the former emergency services chief at Temple Health, in a media release.

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Wydro said one of the most significant new patient-centered approaches is a pivot nurse, a new position created with the aim to “transform triage.” The nurse will greet all patients, obtain their information and vitals and perform a “rapid assessment” with the goal being to have all patients triaged within 20 minutes of arrival.

The pivot nurse will assign a severity index score to patients to either alert critical care teams in cases of heart attack, strokes or trauma or bring patients that don’t need immediate care to a room to wait for a physician.

Located on a campus with a 258-bed hospital and inpatient and outpatient facilities, Aria’s new Level II trauma ED has 30 percent more beds and will treat an estimated 60,000 patients annually. The health system’s leaders said the design priority was a “more personalized experience,” with shorter wait times being one aspect and the setting being another. Patients with pending test results, for example, will have a separate waiting area.

Built with $3 million from the Pennsylvania Redevelopment Assistance Capital Program, Aria’s new ED is aimed at serving the growing senior population of the northern Philadelphia suburbs and adapting to the new healthcare economy. Not only is there pressure to reduce costs and improve quality but also to attract patients who increasingly have choices between going to urgent care centers or different providers for emergency and hospital care, and access to online consumer reviews and government data to guide them.

In addition to the pivot nurse, other patient-centered innovations focus on the less-direct aspects of emergency care that may be almost as significant to patient experiences. More health systems are starting to offer complimentary services to patients and their guests and families.

For instance, at Stanford Medicine’s Andreessen Emergency Department – named for benefactor Marc Andreessen, the technologist and venture capitalist who famously said “Software is eating the world,” and who sees healthcare as one of the industries most in need of disruption – patients and guests are offered free Internet, iPads, massages, music and spiritual services.

Offering massages and free Internet access to patients is a simple way for hospitals to enhance the patient experience. It is more challenging meet patient experience goals like ensuring that clinicians have immediate access to patient records, especially in emergency care settings.

On that score, Aria – along with Abington Health, Crozer-Keystone Health System and Einstein Healthcare Network – is participating in the Noble Health Alliance – a kind of collaboration as merger alternative approach to clinical and organizational integration that may provide physicians with the appropriate resources to allow for immediate access to patient records.

“We are anticipating and investigating systems of several types that would connect our physicians so they can have a better experience with patient data, and so patients can have a better experience when they’re moving through any health encounter,” said Noble’s president and CEO Lynda Mischel, former chief development officer at Aria Health, in a recent interview.

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