Leaders at Novant New Hanover discuss efforts to improve patient care

WILMINGTON, N.C. (WECT) -Leaders with Novant New Hanover Regional Medical Center say they are working on a few different policies and procedures to make sure that they’re serving patients to the best of their ability.

“Two main things that encapsulate a lot of the corrective action plan for us in the emergency department. One is how long it takes to see a doctor. And another is managing that patient’s experience while they are waiting,” said Christy Spivey, Senior Director of Nursing for Novant Health Coastal region.

When you get to the emergency department, a triage nurse checks you and goes through a checklist to determine the severity of your illness or injury. Leaders say what happens after that initial check-in is what will provide patients care in a timely manner.

One new change, there’s a nurse dedicated to checking a patient’s vitals and re-assessing their condition about every 30 minutes.

“Another process that we’re monitoring, we’ve greatly reduced the amount of time that patients are waiting in the lobby. For those who are waiting in the lobby, who are stable and appropriate to wait, those patients are getting their their rechecks and their vital signs. So, we’ve seen an outstanding improvement in that regard and we hear that from our patients and our staff,” Spivey said.

Physicians are also heading into the waiting room to see patients before they can get back to an open room.

“We have some rooms outfitted for them to see patients in a private setting. They can go out, start the orders out there and our team is able to carry those orders out whether it’s labs, X rays, starting the care that they might need,” Spivey said. “But all in all, what it does is it decreases the amount of time that patients are waiting. What we’ve seen because of those process improvements is that are left without being seen rate has been reduced significantly. Back in June, it was around 11%. But now month to date were 3%, which is really a national best practice to have rates that aren’t in the double digits. So that’s been that’s been a huge win.

While there were no specific numbers provided, officials said wait times in the emergency department have decreased overall, including those coming in by ambulance.

“We provided education to the staff and re-education in some cases for some staff and, we now have a process in place where we’re monitoring application of that triage process, both in real time and retrospectively. We’re looking at that especially around patients who present with more complex cases, those patients who may have underlying problems that are difficult to discern. So, we spent a lot of time focusing in that area for that education and another area that we focused on was the arrival of EMS patients to our ED. Since we put some of these things in place, we’ve reduced our EMS turnaround time significantly. Back in June, we had times that were up to 80 minutes, but now our median time for getting EMS in and back out is 30 minutes or less, so, that’s improved significantly,” Spivey said. “One thing that was very important that we recognized was we needed a very consistent timestamp for when the patient arrives through the door. So, through our registration process, we were able to improve the registration process and collection of a timestamp and information about the patient as they came into us.”

Dr. De Winter, medical director for Novant Health’s 17th Street emergency department, also talked about the positive change that has happened recently.

“I think what what’s key is that we’ve really adopted a team approach that allows patients to get seen and care started no matter where they are, may that be the lobby, or you know, when a patient’s offloaded from EMS, and we’re able to take care of them very soon after they enter the door. So, our goal has always been to get a patient in front of a provider as soon as possible and get that care started. We’ve been able, from the physician perspective, to see a market improvement in that and are continuing to work on that as we go forward.”

Novant Health officials added that more than 100 nurses have been hired in the past few weeks, with nearly 30 of those now working in the emergency department to help implement these changes.

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