Genesis Emergency Efficiency Measures Help Reduce Wait Times

DAVENPORT, Iowa -- Jennifer Cauwels of Rock Island knows something about emergency departments. She has spent enough time in them dealing with degenerative disc disease.

Her condition causes her to sometimes need medical attention when her primary care doctor is not available. When she needs care, she heads for Genesis Medical Center, Davenport, where she hopes to get on the Fast Track back to her home.

Fast Track, which specializes in moving less serious patients through the Genesis emergency department quickly, is one of the several initiatives Genesis has implemented to upgrade efficiency and bring shorter wait times.

“I continually return to Genesis for Fast Track and have been very pleased,” Cauwels said. “Most of the time when I use Fast Track, I’m back home in less than two hours. No one likes to visit the hospital, but the Genesis doctors, nurses and receptionists make my visits as comfortable as possible. There is a continuum of care that I appreciate. When I come to Genesis now, most of the time the doctor or nurse knows me and my medical history. That is comforting.”

Bucking a national trend

While a recent study released by the Harvard Medical School indicates that patient wait times are increasing nationally, Genesis has been able to reduce waits for most patients on most days. And in a recent study, Iowa hospitals had the shortest emergency department wait times in the country.

At Genesis Medical Center, Davenport, 96.4 percent of Level 1 patients (the most seriously ill or injured) are seeing a physician or nurse practitioner within 30 minutes of arrival at the emergency departments. At Genesis Medical Center, Illini Campus in Silvis, 88.6 percent of Level 1 patients see a physician or nurse practitioner within 30 minutes.

Even a majority of Level 5 patients (the least urgent) are seen within 30 minutes, and 75 percent of Level 5 patients are discharged within 90 minutes of arrival.

These times have improved from previous years. The reduced wait times are attributable to technology advancements and efficiency measures, like Fast Track, that have been introduced in recent years. At the same time, patient satisfaction scores have also improved.

“We have patients from other parts of the country who come into our emergency departments while they are traveling or visiting and they are often shocked by how quickly they are able to see a doctor or nurse here,” said Carla Roman, trauma and emergency department director, Genesis Medical Center, Davenport. “We have introduced a lot of measures to make our departments more efficient.”

There still may be lengthier waits for the Level 5, or least urgent, patients, particularly if the department is responding to trauma patients or other patients with more serious conditions. As the only Regional Trauma Center in the Iowa Quad Cities, the most seriously injured patients are transported to Genesis, East Rusholme Street.

Efficiency measures introduced in recent years have included:

• ACT initiative – ACT, a hospital-wide initiative that stands for Access, Convenience and Throughput, moves patients through all hospital services as quickly and safely as possible. Regardless of how efficient an emergency department is in triaging and treating  patients, the process slows if a hospital bed is not available when a patient needs to be admitted. The ACT team, made up of representatives of a number of hospital departments, works at keeping all patients flowing through the hospital efficiently.
• Fast Track service – Patients with minor injuries or illnesses are seen more quickly at Genesis in a separate treatment area.
• Five-level triage system – The system helps staff prioritize which patients require the fastest response.
• Short-form triage form – Only a few vital questions are asked of patients as they enter the Emergency Department. The rest of the registration process is conducted after a patient has been moved from the public waiting area to a patient room.
• Computerized Provider Order Entry – Computer software enables physicians and nurses to enter patient orders into a computer at the bedside rather than on paper. It has been proven to reduce medication errors and improve efficiency.
• Bedside charting – Using a notebook computer, nurses and physicians complete charts in real time at the bedside.

“We are continuing to make progress toward the most efficient and safe methods of assessing and treating emergency department patients,” Roman said. “From the response we are receiving from patients, we are moving in the right direction.”

Genesis, East Rusholme Street, is one of five Regional trauma care facilities in Iowa. Only two Iowa hospitals are Resource trauma care facilities, which is the highest level.

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