By Mr. David M White (Army Medicine)September 4, 2018
David M. White
Public Affairs Office
Eisenhower Army Medical Center
The Emergency Department at Eisenhower Army Medical Center is open 24 hours a day, seven days a week, 365 days a year. And they are busy.
"We see 38,000 to 39,000 patients per year," Lt. Col. David Vollbrecht, EAMC's ED officer in charge, said. "Our average daily census is 105 to 110 patients."
People seeking treatment in the ED are triaged -- assessed to decide the order of treatment based on need using a nationwide standard from emergency, for example, CPR in progress -- to non-urgent, according to the Agency for Healthcare Research and Quality.
In short, if you require CPR, you're in the right place in the ED. If you have a non-urgent problem, like a prescription refill, maybe there's a better place to receive the care you need.
"A medical emergency is an acute illness or injury that poses an immediate risk to a person's life or long-term health," Vollbrecht said.
According to records of visits to the ED, approximately 6 to 8 percent of its patients are triaged as emergent, about 35 to 40 percent are urgent and 50 to 60 percent are categorized as non-urgent.
When a patient enters the ED, the clock is running: from presentation to triage to treatment to discharge or, in some cases, admission to the inpatient side of the hospital or another facility.
The time to triage (being seen by a nurse) is less than 10 minutes for more than 90 percent of the patients. The average time from a patient's initial presentation to triage is 4 to 7 minutes. The time to be seen by a doctor for emergent patients, according to statistics provided by Vollbrecht, is less than 15 minutes from time of arrival. For urgent patients, it's 30-40 minutes and for non-urgent patients, it is usually 30-60 minutes.
EAMC's numbers compare favorably with the National Hospital Ambulatory Medical Care Survey 2010-2011, published by the CDC. According to the survey results, the "median wait time to be treated in the ED was about 30 minutes. … the shortest median wait time was 12 minutes for patients who had an immediate need to be seen."
"The ED in any hospital," Vollbrecht said, "is not intended to be a convenient place to receive care. We do not provide primary care medical services, but we are a part of the spectrum of care."
"We see patients on a daily basis with sepsis, congestive heart failure, diabetic emergencies, acute intoxication, toxic ingestions, lacerations, broken bones, heart attacks, strokes and a myriad of other medical emergencies," he said.
All departments and clinics at EAMC strive to be good stewards of the resources they have. That means being medically efficient in providing high-quality care while keeping an eye on the best business model with the least amount of waste. Often, this means that patients with less urgent problems have longer wait times.
"The ED has taken strides to work on plans that meet our patients' needs," Vollbrecht said. "We want to provide great service while eliminating waste and maximizing resources, efficiently getting patients the care they need."
"Organizationally, we have started with two changes," he said. "The ED partnered with Central Appointments, placing an appointment clerk in the ED to find last-minute cancelations and available appointments for patients without life-threating illness. Additionally, the Troop Clinics have opened sick call in the morning giving troops the opportunity to see a doctor early in the morning before work begins." EAMC's ED is dedicated to its mission of providing 5-star health care to America's Soldiers, sailors, airmen, Marines, their families and retirees.
"At Fort Gordon, we are America's best and we are honored to serve with you," Vollbrecht said. "We want to see patients requiring emergency intervention, we encourage all patients to use their best judgement as to whether or not they have an actual medical emergency."
Editor's note: Patients needing medical advice can contact TRICARE advice line at 800-847-2273. Appointments can be booked through TRICARE On-Line at tricareonline.com, or through the EAMC's Central Appointment line, 706-787-7300. Messages can also be sent directly to your Primary Care Provider through relayhealth.com for routine concerns or advice.