A Physicians’ Leadership Institute project is addressing an urgent need in Dallas – getting emergency care to residents closer to home, especially when the emergency department at Salem Hospital is crowded.
Under project leader Corey Goldberg, MD, the Keeping Our Community Close to Home project evolved through the following SBAR. His team included Steve Yao, MD; Michele Polander, RN; and Melinda Seibert, West Valley Hospital medical staff supervisor. The team implemented changes on March 4.
Situation: Dallas EMS routinely transport most of their patients to Salem Hospital, bypassing WVH. A new “surge” plan was enacted (February 2019) by Dallas EMS to take patients to WVH Emergency Department when wait times at Salem Hospital were high. Rather than waiting until census at Salem is high, the plan is to transport all medically appropriate patients to WVH instead of Salem to initiate work-up and treatment.
Background: Dallas EMS crews often bring patients complaining of abdominal pain to Salem Hospital, feeling that they are surgical candidates. Often, patients are transported to Salem Hospital because it is thought that West Valley Hospital does not have adequate resources to manage these patients.
Assessment: Currently, transport to Salem Hospital takes resources (ambulance, crews, etc.) out of service for up to two hours depending on wait times. Medically appropriate treatment for the patient is also delayed.
Recommendation: 100% of the medically appropriate Dallas patients using the local EMS system will be transported to West Valley Hospital’s ED by May 20, 2019. This excludes STEMI, trauma, OB active labor/high risk, and psychiatric hold patients.