Everyone made one thing clear to Lance Porter when he arrived in mid-2014 as the new CEO of Payson (Ariz.) Regional Medical Center: The hospital's emergency department had to be “fixed.”
Patients routinely complained they had to wait more than 40 minutes to see an emergency clinician, and the staff was frustrated, too.
The level of discontent was a big concern for the 44-bed hospital. It offered the small town of Payson and the surrounding communities a wide array of services, including cardiology, orthopedics and obstetrics, but was facing serious competition from the Mayo Clinic 60 miles away in Scottsdale. That's “close enough for people to seek care there if they don't feel we provide good enough care here,” Porter said.
Last August, Banner Health acquired the hospital from Community Health Systems. Banner brought in a new physician group that worked to improve staff communication. The initiative revealed poor communication was a key factor in problems at the hospital, which was renamed Banner Payson Medical Center.
By December, waits had dropped by almost half.
“Emergency and wait are two words that shouldn't go together—it's oxymoronic,” said Dr. Jay Kaplan, president of the American College of Emergency Physicians. ED patients are distressed about acute health problems, and long waits can mean worse outcomes. In 2008, the ACEP said too many EDs were critically overcrowded, which Kaplan says remains the case.
Recommended solutions, such as registering patients at the bedside and adding personnel to “fast-track” low-acuity patients, have not been widely adopted.
That's true even as hospitals face tangible consequences for frustrating their patients. What patients relay about their experience on the HCAHPS survey figures into whether hospitals win or lose under Medicare's Value-Based Purchasing Program. And ED wait times are posted on the federal Hospital Compare website intended to help consumers choose where to seek care.