Recently, we sat down with Cleaveland and Dr. StephanieDabulis, MD, FACEP, medical director of the emergencydepartment (ED), to learn more about how the emergencydepartment works and how the ED staff work diligently toensure a good patient experience.
Our Life-Saving Role
The purpose of the emergency department, Dr. Dabulisexplained, is to rule out and/or treat any life-threateningissues.
“The emergency department is truly here to assess andtreat your current emergency problem. It can be frustratingfor patients who are looking for us to diagnose or helpmanage chronic medical conditions, but that is simply not ourrole,” Dabulis added.
For example, if a patient comes to the emergencydepartment with a generalized complaint about falling down,tests will be done to rule out a heart attack, stroke or otheremergent symptoms right away. “Every patient encounter gets looked at through a life-savinglens. We are going to immediatelyrule out those life-threatening issuesand focus on what may have causedthe fall in the first place,” saidDabulis. Discharge instructions willnot always provide a diagnosis, butinstead, are the gateway to the nextstep in the process – receiving followupcare.
The goal of the ED is to treatthe most critical or severe patientsfirst, in order to save their lives. It’simportant to understand behindevery moment in the waiting room,there could be someone else receivingcritical life-saving care on the otherside of the door.
Reasons Behind The Wait
The needs in the emergencydepartment can literally changein seconds. According to Dr.Dabulis, the ED is staffed for apredictable number of people andinevitably, that number will becomeunpredictable. An ambulance couldcome in requiring a large amount ofemergency department resources,putting the patients in the waitingroom on hold.
“When I come to work my hopefor my patients that day is that noneof them have to wait. I want them tohave clear communication and a goodexperience,” said Dr. Dabulis.Because of patient privacy andsafety, emergency department staffaren’t able to tell the full waitingroom there is a combative patientor perhaps there was an accidentand multiple patients are beingtransported to the ED by ambulancefor life-saving care. All of thesesituations can require additionalresources and do equate to longerwait times for those patients whoare not experiencing life-threateningillness or injury.
Even the more routine cases can takeup a lot of time, Cleveland said. Resultsfor routine tests such as blood work andX-rays can take up to 90 minutes. Andbased on the results of those tests, aprovider may make recommendations forfurther testing or medication. A typicalvisit to the emergency department is fourto six hours long.
Being Informed Is Key
Whenever possible, patients shouldseek the right care, at the right time,at the right place. For concernsthat are not of a severe nature, a visit toyour primary care provider or an urgentcare center may be a better alternative.Dr. Dabulis noted that seeking nonemergentcare through a primarycare provider or urgent care center isnot always feasible after hours or onthe weekends. She added, “We alsounderstand that ‘the right place’ canbe subjective. And that’s what we arehere for..”
It’s also crucial to keep up withpreventative care visits to detect health issues before they becomeemergent problems. Cleveland saidthat in recent months, the emergencydepartment has seen increasedcases of severe issues that arelikely linked to patients delayingpreventative care during COVID-19.
Another critical step toexpediting care at the emergencydepartment is ensuring that medicalrecords are accurate and accessible.Dr. Dabulis said, “It’s important tobring pertinent records, know yourmedications, allergies and surgicalhistory. Every patient who comes tothis emergency department deservesto have me look at their records,and that takes time,” Dr. Dabuliscontinued.
“We may ask the same questionseveral times,” said Cleveland. “Thisis because what may trigger a triagenurse to action is different thanwhat a doctor may respond to. Theirjobs are different, and they may belooking for slightly different things.”For example, if a patient complainsof abdominal pain and vomiting, anurse may work to get the patientstarted with labs, an IV and nauseamedication. The doctor may askwhat the pain feels like in order todiagnose and fix.
“If you have a true emergency,it doesn’t matter what the wait timeis – you will be seen immediately.Although our primary role is to treatlife- or limb-threatening illness orinjury, we are committed to servingevery single patient who comesthrough our doors,” Dr. Dabulis said.
