Nash UNC Aims to Improve Patient Experience in Emergency Department
As emergency departments across the country have been challenged with COVID patient surges and nursing shortages, Nash UNC Health Care leaders announced several improvements being made to enhance the patient experience and quality of care in the emergency department.
Dr. Alex Warren, Nash UNC’s Medical Director for the emergency department, says COVID surges lead to challenges such as crowded lobbies, higher wait times, and visitation restrictions for patients.
“When we experience COVID surges, those are some of the most difficult times to practice emergency medicine across the entire state, not just Nash UNC,” said Warren. “Now that COVID has slowed, Nash UNC’s emergency providers are working with nursing to find a sense of normalcy with a renewed focus on reducing wait times while improving patient quality – both in the care given and the process of how that care is given. Putting these processes in place now will allow us to better manage future COVID surges or increases in patient volume.”
Meredith Denton, Nash UNC’s Emergency Department Director, echoed Dr. Warren’s thoughts.
“When the emergency department faces an influx of patients due to a COVID surge, the sudden increase in patients can lead to crowded lobbies and higher wait times. Because of this, we put precautions in place, such as visitor restrictions, to reduce congestion and to ensure our staff can handle the demand while continuing to provide high quality care,” said Denton. “But we are happy to be in a place currently where our wait times are improving, lobbies are less crowded, and we are able to welcome one undesignated visitor for each patient.”
But Warren highlighted other changes and unique care models that are also helping reduce wait times and improve the patient experience in the emergency department.
“At Nash UNC, we currently utilize a provider-in-triage model that gets patients in front of a provider quickly during the initial evaluation process to facilitate getting patient care started as soon as possible,” said Warren.
Denton explains that this means patients with mild to moderate medical issues can be evaluated by a provider who orders labs, imaging or other tests, and treated in a private care setting without having to wait for a traditional room.
And while Denton explains that care model helps improve the front-end process, Warren noted that Nash UNC uses another program to make things more efficient for patients who need emergency care beyond the provider in triage. Thanks to a new paramedic team nurse model, the emergency department can treat more patients with the assistance of paramedics.
“Our department's ability to hire paramedics to support our nursing staff with patient care right here in the hospital has allowed us to expand our ability to care for our patients throughout the department – from the lobby to patient care rooms,” said Warren. “Paramedics handle critical tasks such as blood draws, IV placement, splints, medication administration, and much more, which allows nurses to care for more patients at a time.”
The new paramedic team nurse model was endorsed by the NC Department of Health and Human Services in 2019 after the NC Board of Nursing and NC Office of EMS released a joint statement outlining the collaboration that allows EMS personnel to work in teams with physicians, nurses, and other healthcare professionals in alternative care settings, such as emergency departments.
“These paramedics have proven instrumental in helping our department provide care to as many patients as possible while working to complement our nursing team and other medical professionals,” said Warren.
Denton added another way paramedics are making an impact on patient care is through the Community Paramedic Program. The program provides at-home care for medium-to-high risk patients to reduce the likelihood of hospital readmission, as it empowers patients to manage their health and minimize unnecessary emergency department visits. The program is made possible by the Nash UNC Health Care Foundation thanks to grants and donations from the community.
According to Denton, a new, robust nurse graduate and residency program is also helping elevate the patient experience in the emergency department.
“We are proud that several nursing school graduates have chosen Nash UNC as their place of employment. We have a great program in place to onboard these new nurses and give them the tools they need to succeed right away,” said Denton. “Our nursing students are brought in during the final year of their program so they can gain valuable hands-on experience prior to graduating.”
Emergency department nurses are also given hands-on training through a partnership with East Carolina University (ECU) and Vidant Medical Center that brings a pediatric trauma simulation lab on-site to Nash UNC via the ECU Brody School of Medicine’s Interprofessional Clinical Simulation Program.
“This partnership allows our nursing teams to receive on-site pediatric trauma training based on various medical scenarios, which prepares our team to better manage these types of emergencies,” said Denton.
Denton says programs like these help develop a strong workforce that makes a big impact on quality of care and patient experience.
“I’m proud of our team for thinking outside of the box and using creative programs to ensure we continue to meet the needs of our patients and families,” said Denton.
“We hope our community will continue to entrust our team with their emergent medical needs. We are here for any patient who comes through our doors and we remain committed to providing high quality care while working to improve the health and wellbeing of our community,” said Warren.