Emergency Department Team
August 2020
Emergency
Center
Emergency Department
Sky Ridge Medical Center
Lone Tree
,
CO
United States
Alex Lang, RN; Chayce Lawson; Brett Lippold, RN; Stephany Lipscomb; Taelor Little, RN; Elizabeth Menne, RN; Christopher Moret; Shelly Nelson, RN; Thomas Place, RN; Sammie Plattner, RN; Emily Ponder, RN; Sasha Ranck; Lindsey Rhodes, RN; Marli Rusk, RN; Floyd Russell; Dom Saiz, RN; Kelli Salmon, Amanda Solomon, RN; Wendy Spronk; Jasmine Stamm; Keith Stanford, RN; Michael Webster; Scott Westlake, RN; Alyssa Wilcoxson, RN
This team exemplifies our mission and values in many ways as well as shown great collaboration and teamwork for our patients, families, hospital, and community:
Enhanced community relationships: Our EMS partners have undergone much change in the past 2 years. Additionally, there have been multiple free-standing emergency departments and urgent care opening up around Sky Ridge. Both of these create pressures which could cause a loss of volume. However, because of the relationships the SRMC ED team has built with EMS as well as community physician practices, our volume, as well as the acuity of our patients, has continued to grow.
High-quality patient care with outstanding outcomes: The focus of our ED team is to provide high-quality care to every patient. We support multiple service lines that all have their priorities for excellent patient outcomes. These priorities mean the ED team needs to identify which one is the top priority and that the prioritization needs to be fluid as we get new patients arriving for care. Despite the multiple balancing of priorities, we have demonstrated commitment to ensuring the pursuit of high-quality outcomes is achieved:
Sepsis: We know that the faster we can administer antibiotics, the better the patients' outcomes. From the beginning of 2019, our goal was to administer antibiotics within 30 minutes of the order. The nursing team struggled to achieve 50% compliance in the 1st quarter. They identify some root causes of delays, focused on being more proactive with provider communication, and by 4th quarter achieved a 74% compliance with meeting the goal. This focus directly impacted our patients and potentially contributed to over 60 lives saved.
STEMI: With collaboration from our cardiovascular service line, we have refined ED processes to support the rapid identification of STEMI patients. Our median door-to-cath time for 2019 was 45 minutes, putting us in the 90th percentile for STEMI quality care.
tPA for ischemic stroke: The national standard for administering tPA for ischemic strokes is within 90 minutes of arrival. SRMC ED achieved a median of 37 minutes of arrival-to-tPA as well as ensured 90% of patients received tPA within 60 minutes of arrival, significantly decreasing morbidity and facilitating excellent patient outcomes.
Trauma Level II: SRMC became an American College of Surgeons and Colorado Department of Public Health and Environment verified Trauma Level II facility in 2016. With a lot of collaboration from our trauma service line, the program has grown and our acuity has increased as well. We have received multiple mass casualty incident victims from our EMS partners due to strong collaboration as well as trust in our system. Our recent re-verification results had no deficiencies and 10 strengths, a testament to our focus on ensuring efficient, focused efforts on immediate and appropriate trauma resuscitation.
Patient experience: While we can focus on high-quality patient care and great outcomes, if our patients do not believe we are providing them great care, we are not fully achieving our goal. Over the course of 2019, our patients' perceptions of their care went from 70.6% to 72.7%. Although this might not seem to be a large leap, it took us from the middle of the HCA patient experience rankings to the top quartile and demonstrates the commitment of the SRMC ED team to balancing high-quality care with patient experience.
All of these accomplishments have been driven by the day-to-day nurse leaders and nursing staff. With the team focus on collaborating and focusing on great, this team earned the 2019 HCA Unit of Distinction Honorable Mention. We moved from 20th place in 2018 to 14th place in 2019; additionally, we were the only HealthONE ED team to receive this honor two years in a row.
Enhanced community relationships: Our EMS partners have undergone much change in the past 2 years. Additionally, there have been multiple free-standing emergency departments and urgent care opening up around Sky Ridge. Both of these create pressures which could cause a loss of volume. However, because of the relationships the SRMC ED team has built with EMS as well as community physician practices, our volume, as well as the acuity of our patients, has continued to grow.
High-quality patient care with outstanding outcomes: The focus of our ED team is to provide high-quality care to every patient. We support multiple service lines that all have their priorities for excellent patient outcomes. These priorities mean the ED team needs to identify which one is the top priority and that the prioritization needs to be fluid as we get new patients arriving for care. Despite the multiple balancing of priorities, we have demonstrated commitment to ensuring the pursuit of high-quality outcomes is achieved:
Sepsis: We know that the faster we can administer antibiotics, the better the patients' outcomes. From the beginning of 2019, our goal was to administer antibiotics within 30 minutes of the order. The nursing team struggled to achieve 50% compliance in the 1st quarter. They identify some root causes of delays, focused on being more proactive with provider communication, and by 4th quarter achieved a 74% compliance with meeting the goal. This focus directly impacted our patients and potentially contributed to over 60 lives saved.
STEMI: With collaboration from our cardiovascular service line, we have refined ED processes to support the rapid identification of STEMI patients. Our median door-to-cath time for 2019 was 45 minutes, putting us in the 90th percentile for STEMI quality care.
tPA for ischemic stroke: The national standard for administering tPA for ischemic strokes is within 90 minutes of arrival. SRMC ED achieved a median of 37 minutes of arrival-to-tPA as well as ensured 90% of patients received tPA within 60 minutes of arrival, significantly decreasing morbidity and facilitating excellent patient outcomes.
Trauma Level II: SRMC became an American College of Surgeons and Colorado Department of Public Health and Environment verified Trauma Level II facility in 2016. With a lot of collaboration from our trauma service line, the program has grown and our acuity has increased as well. We have received multiple mass casualty incident victims from our EMS partners due to strong collaboration as well as trust in our system. Our recent re-verification results had no deficiencies and 10 strengths, a testament to our focus on ensuring efficient, focused efforts on immediate and appropriate trauma resuscitation.
Patient experience: While we can focus on high-quality patient care and great outcomes, if our patients do not believe we are providing them great care, we are not fully achieving our goal. Over the course of 2019, our patients' perceptions of their care went from 70.6% to 72.7%. Although this might not seem to be a large leap, it took us from the middle of the HCA patient experience rankings to the top quartile and demonstrates the commitment of the SRMC ED team to balancing high-quality care with patient experience.
All of these accomplishments have been driven by the day-to-day nurse leaders and nursing staff. With the team focus on collaborating and focusing on great, this team earned the 2019 HCA Unit of Distinction Honorable Mention. We moved from 20th place in 2018 to 14th place in 2019; additionally, we were the only HealthONE ED team to receive this honor two years in a row.