St. Rose Dominican Hospital - Siena

St. Rose Dominican Hospitals' Siena Campus is a level 3 trauma center and community hospital with a dedicated pediatric emergency department (ED) that combined, treats almost 60,000 patients per year. Not only is such volume demanding with 24 adult and six pediatric ED beds, but the hospital is faced with the same challenges as so many U.S. hospitals- hospital overcrowding. ED "boarding" of admitted patients is a daily occurrence, and the EPMG physicians realized that something had to change to improve throughput and patient satisfaction as well as decrease the number of patients who left without being seen (LWBS).

In January 2009, "PhysicianFirst" was born at St. Rose Siena.

Upon arrival to St. Rose Siena ED, patients are immediately directed to the triage nurse. As the nurse begins the triage assessment, the emergency physician is notified by radio that a new patient has arrived. The emergency physician introduces himself/herself in triage, moments after the patient's arrival, and obtains a focused history, performs a brief physical exam, and orders appropriate diagnostic tests and medications. During this process, the patient is only placed in a main ED treatment bed if it is deemed necessary
(i.e., IV fluids, procedures, or immediate treatment).

More thorough physical exams and detailed histories are performed for those patients who require ED treatment, while urgent care and simple problems are treated expeditiously and those patients released home.

Due to the support of the ED staff and hospital, the EPMG PhysicianFirst model has yielded extraordinary results dropping our LWBS from over 12% a year ago to under 2% and decreasing our average door-to-doc time to under 15 minutes. While we are proud of our improved throughput times and patient satisfaction scores, overhearing comments such as, "The doctor saw me as soon as I arrived!" makes the EPMG PhysicianFirst model even more rewarding.