Nurses, physicians and other healthcare professionals at Southern Maryland Hospital Center in Clinton, Md., have partnered to implement First Track, a rapid medical model for evaluating and treating patients who come into the ED.
Donald Charlson, RN, MS, MBA, CEN, director of emergency services, said the ED treats 2.5 times more patients a day under the new program.
“Our door-to-doc time has gone from 56 minutes in the beginning of 2011 to between 36 and 39 minutes,” he said in a news release.
For an ambulatory patient, First Track starts at the reception desk.Donald Charlson, RN
Name, date of birth and reason for the visit are recorded, and a triage nurse evaluates the patient on a one-to-five scale under the Emergency Severity Index. Those at level one the most severe, with life-threatening situations are immediately moved to another part of the ED for treatment. “Rapid care is most important once they walk through the door,” Charlson said.
Level five is for patients with problems such as insect bites or a need for medication refills. Charlson said one of the challenges of rapid evaluation is complying with HIPAAs privacy rule. A triage nurse must quietly ask the patient questions in the lobby area and accurately assess their level of illness. The patient is then taken to one of 10 exam areas. A nurse and doctor together see the patient.
“There is nothing more frustrating for the patient than to have to tell their story over and over,” Charlson said.
After being examined, the patient is sent for the appropriate labs, scans or tests.
“First Track is one of the easiest implementations of a new process Ive ever seen,” Charlson said. “This is thanks to the nurses and medical staff. They got it. They understood the benefits.”