New Hospital Emergency Department extends Emory's community outreach efforts

For several years, the Emory health care system has been reaching out to metro Atlanta and making its services more accessible to a much broader population than in previous years. New primary care centers of The Emory Clinic as far away as north Fulton and Fayette counties have been perhaps the most visible signs of that outreach effort.

Last summer, Emory took yet another step forward in broadening community access to its medical services with the opening of Emory Hospital's new Emergency Department. Alan Otsuki, former director of Emergency Medicine at the Hospital, oversaw the year-long conversion of the Hospital Treatment Room into a full-fledged Emergency Department, a process that included a $750,000 renovation of a 6,660-square-foot space. Otsuki said the decision to convert the Treatment Room into an Emergency Department was made to enhance Emory's service to the community, and to provide greater access to the Emory health system.

Doug Lowery, the newly appointed director of the Emergency Department, said that access became available on July 1, when the department opened and began providing the services of an attending emergency physician 24 hours a day, seven days a week. Previously, the Treatment Room had offered attending physician coverage 16 hours a day. The 14-bed facility includes two major critical care rooms, an orthopaedics room, triage, radiology reading, an admissions area and a waiting room.

The conversion also means that ambulance service providers now know in advance that their patients may be taken to Emory for any type of emergency care. Previously, ambulance services would deliver patients to Emory only if the patient specifically asked.

The fact that Emory Hospital has opened an Emergency Department during a time when such departments are being scaled back nationally, Lowery said, is a reflection of the high community and regional demand for Emory's health care services. "We are prepared to see whatever volume of patients the Emory University System of Health Care (EUSHC) wants us to see," Lowery said. "I think EUSHC is gearing us up to be able to do that. I think they want us to continue growing to meet the increasing demand for emergency medical care."

The demand Lowery referred to has been steadily increasing at Emory for the past several years. Current patient volume in the Emergency Department is 10 percent higher than last year's Treatment Room numbers. The department currently sees an average of 45-50 emergency patients per day.

Becky Bosselman, the Emergency Department's director of emergency nursing services, said that being able to meet that demand took some shifting of nursing and other personnel. "We haven't increased the number of staff we had before as much as we have adjusted their shifts for the busiest emergency care hours," said Bosselman. "Also there were procedures that were done in the Treatment Room, such as blood transfusions, that had to shift to other places, because as an Emergency Department we just can't handle scheduled patients."

Bosselman also said that even though the total number of nursing staff hasn't been increased, the department has increased the proportion of emergency and critical care nurses experienced in emergency nursing. She also said the department is now requiring Advanced Cardiac Life Support (ACLS) certification of Emergency Department nurses.

Having staff with that type of experience is crucial for any emergency department, but it is especially important at Emory Hospital, where the average patient is more seriously ill than at other facilities and is generally in need of more specialized medical services. In addition to traditional emergency conditions such as broken bones, Emory Hospital does "specialized diagnostic procedures that other Emergency Departments don't, because we do so much specialty care here," Lowery said. "We need to be able to take care of both those types of Emergency Department patients."

Approximately 26 percent of Emory's Emergency Department patients are admitted to the Hospital, and approximately 16 percent of all Hospital patients come through the Emergency Department, according to Bosselman.

Bosselman believes the Emergency Department will be an especially important resource for Emory students in light of a recent restructuring of the University Health Service that eliminated 24-hour medical care for students. She also believes the department will be an invaluable and convenient resource for faculty and staff who need emergency care. "I want the University community to know that we are an Emergency Department that is fully available to them," Bosselman said.

--Dan Treadaway

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