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November
28, 2006,
RCRMC
was awarded
the California
State
Association
of Counties
(CSAC) Challenge
Award for
2006,
for implementation
of the
Rapid
Medical
Evaluation
(RME)
program.
The RME
program
was initiated
to reduce
emergency
department
wait times
by creating
an integrated
team approach
and incorporating
current
technology,
to move
patients
from the
waiting
room to
the treatment
area more
efficiently.
RCRMC—much
like every
other
hospital
in the
nation—is
trying
to address
the issue
of long
wait times
in its
Emergency
Department
(ED).
Physical
limitations,
increased
patient
population,
and nationwide
healthcare
worker
shortages
are just
a few
of the
issues
that impact
emergency
department
overcrowding
and wait
times.
RCRMC
has been
concerned
about
this issue
for quite
a while.
In January
2004,
RCRMC
embarked
upon an
initiative
aimed
at reducing
those
wait times.
This initiative
required
input
from a
multidisciplinary
task force
composed
of administration,
physicians,
nursing,
and admitting
staff.
The task
force
compiled
protocols
and policies
and procedures
for the
RME program.
RCRMC’s
RME program
was implemented
in three
phases:
planning
and coordination,
implementation
of a quick
registration
utilizing
mobile/wireless
PC systems,
and finally,
implementation
of physician
and nurse
team assessments.
Full implementation
of the
RME program
was achieved
in August
2004.
The goals
of the
RME program
were to
decrease
the patients’
wait time
to seeing
the provider,
increase
patient
satisfaction,
decrease
the number
of walkway
patients
(patients
who leave
the ED
before
they’re
seen by
a healthcare
provider),
and improve
employee
morale.
The RME
program
changed
both the
registration
and clinical
assessment
processes
so that
the two
are now
performed
almost
simultaneously,
rather
than sequentially.
RCRMC
obtained
approval
from the
County’s
Information
Technology
Department
to allow
use of
wireless
personal
computer
systems.
Wireless
laptop
computers
were purchased
and mounted
on mobile
carts
in the
ED, allowing
registration
and admission
staff
to move
from one
area to
another,
patient
to patient,
completing
the registration
process
quickly.
Simultaneously,
a physician
and nurse
team performs
clinical
assessments
on the
patient
in the
RME treatment
area.
The quick
registration
allows
the treatment
process
to begin
immediately,
by ordering
laboratory
work and
necessary
x-rays.
To date,
the average
wait time
in RCRMC’s
ED has decreased
from over
two hours,
to 30 minutes.
The percentage
of walkway
patients
has decreased
from 5.3%
to 2.4%.
Patients
express
amazement
and gratitude
at the quick
process,
and hospital
staff are
very excited
to be involved
in a program
that increases
patient
satisfaction
and improves
utilization
of scarce
resources.
— 06-1203a |
