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Visiting an emergency room in the event of a serious accident, toothache
or some other nagging pain can be a trying experience for almost anyone,
and waiting endless hours to be seen by a physician for a minor injury
can be just as upsetting. Most people want their aches and pains addressed
right away—without waiting and wasting time.
At Grady Hospital, such concerns are being addressed, thanks to PACE (Patient
Ambulatory Care Express), a 24-hour “fast-track” emergency department
of sorts, supervised by Emory physicians, that aims to treat minor pains
and injuries in a fraction of the normal time. In fact, more than 25 percent
of all patients seen in Grady’s Emergency Care Center are seen in
the PACE area.
“The thing patients care more about is getting seen as quickly as
possible,” said Richard Ismach, PACE medical director and assistant
professor of emergency medicine in the School of Medicine. “People
are seen and treated much more quickly than they
would be if they were going through a regular emergency
department.”
Leon Haley is medical director of the Emergency Care Center, chief of
service for emergency medicine and assistant professor of emergency medicine.
He estimated that the average time from entry to discharge for patients
entering PACE is usually three hours, noting that the wait time to be
seen is actually very short.
After entering triage and registration, patients in the PACE area typically
are treated by a separate staff of physicians, nurses, physician assistants
and nurse practitioners. Having a separate staff, Ismach said, allows
center patients to be seen in a timely, efficient manner.
And while studies suggest a substantial minority of emergency department
patients have “non-urgent” problems, physicians cannot simply
turn them away, said Arthur Kellermann, professor and chair of emergency
medicine.
This is because federal law requires emergency departments to conduct
a “medical screening exam” on every patient to determine that
an emergency condition does not exist—something that cannot be safely
or legally done at the triage desk.
Another reason, Kellermann said, is that approximately
5 percent of patients thought to be non-urgent over the phone or at triage
actually turn out to have a serious problem that requires immediate hospitalization.
“Fortunately, PACE is backed up by the full resources and expertise
of the Grady Emergency Care Center, which is staffed by emergency medicine
specialists 24 hours a day, seven days a week,” Keller-mann said.
“This way, patients get cost-effective care, referral to a primary
care physician or clinic for follow up, and the safety net of the Grady
ECC if their ‘heartburn’ turns out to be a heart attack.”
According to Ismach, fast-track medicine has become a fairly popular idea
in urban hospital emergency departments over the past decade. He said
what makes PACE so effective is that it is part of Emory’s emergency
medicine department, which has well-trained physicians.
“Our physicians are more intimate with state-of-the-art emergency
medicine, and we are providing high quality, world-class care,” Ismach
said.
Ismach hopes PACE will soon begin attracting even more patients—namely
business professionals in downtown Atlanta who, if injured, will come
to PACE for prompt,
efficient medical care.
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