Q: What are common challenges facing emergency care?
A: The traditional challenge of emergency medicine has been — and continues to be — having to make medical decisions based on sometimes incomplete information in a fast-paced setting where minutes can determine the patient’s ultimate clinical outcome. We spend three years of residency learning how to operate in this environment and then spend our careers honing this skill.
Each setting has its own challenges, and depending on volume the through-put model of each ED is slightly different. At Centennial, we’re a tertiary care referral center, with almost every specialty available. Our ED population skews more complex, with more comorbidities and a high volume of behavioral health patients because we have a psychiatric hospital.
Q: How are you and your team able to address those challenges?
A: Prior to the pandemic, it was fairly uncommon for us to have a lot of admitted patients holding in our ED. We had a high number of nurses, so even if all beds were full upstairs, the hospital would creatively pull patients into a surgical waiting area or similar area to begin inpatient care.
Now, with fewer nursing resources, we’re changing how we operate, such as placing admits on hospital beds in the ED when we know they’ll be with us overnight, or working with the dietary department to make sure that everyone gets a meal. We have been flexible in making sure that our patients get what they need.
Q: What are some of your proudest moments in the ED?
A: We’ve always had the opportunity to care for a lot of people experiencing behavioral health emergencies, and the pandemic has increased this. Centennial has implemented enhanced care for our behavioral health patients. Measures include opening a behavioral health area separate from our ED, where it’s calmer and quieter and offers patients dignity and privacy.
Q: What stands out to you about the team you’re working with?
A: The physicians, PAs (physician assistants) and NPs (nurse practitioners) who work with me are excellent clinically. They’re resilient through difficult times and dedicated to improving patient care. When we start a new process that will make the flow of the department better or help us take better care of people, they buy in. If they have concerns or questions, we all discuss them and make sure we agree. We trust each other, and all of us provide great care. We support each other in caring for patients and each other. The team is able to keep patient care our focus. Centennial is lucky to have such a great team of providers.