Q&A
Interventions and coordination efforts to manage ambulance offload delays
2:05:33
·
4 min
Dr. Birnbaum discusses various interventions and coordination efforts implemented by H+H to manage ambulance offload delays and improve efficiency in emergency departments.
- Language access support is available through interpreter services for commonly spoken languages
- H+H is implementing a provider-in-triage system at some facilities to start patient evaluations earlier
- The hospital liaison officer role is expected to improve efficiency in patient handoffs between EMS and hospital staff
- H+H coordinates with FDNY EMS during peak hours, with the hospital liaison officer expected to enhance communication
- Dr. Birnbaum reports that the provider-in-triage model has led to decreased patients leaving without being seen and improved patient experience scores at one facility, though specific data was not provided
Mercedes Narcisse
2:05:33
Okay.
2:05:34
What type of language access supports does h and h have at their facilities, particularly at the triage triage station for patients who have limited English proficiency.
Adrienne Birnbaum
2:05:47
We have interpreter services available throughout our facilities, including the emergency department for you know, all the languages that we, you know, that we see commonly spoken at our facilities.
Mercedes Narcisse
2:06:02
Okay.
2:06:04
I know you kind of answered that party, but I'm gonna dive into it again.
2:06:08
Are certain h and h emergency department experiencing higher ambulance offload, I mean offload delays and what target intervention are in place at those locations.
Adrienne Birnbaum
2:06:24
All of our facilities have experienced increase in volume, some more than others.
2:06:30
So some of the things that we have put into place are, first of all, we're looking forward to the hospital liaison officer joining us But we also have implemented a number of our facilities, a provider in triage system where there's in addition to a nurse or instead of a nurse, there may be a provider actually stationed in triage, and that person can actually start the evaluation going for some of the, I mean, the highest acuity patients would be pulled in and treated and addressed immediately.
2:07:06
But for those that are less urgent, the provider in triage can provide the start up of some of the treatment and the studies that need to be done in order to to get to the disposition of that patient.
Mercedes Narcisse
2:07:25
What protocols are in place when ambulance wait times exceed, I mean, acceptable limits and how our patients needs managed during the extended of load periods?
Adrienne Birnbaum
2:07:39
Well, we always see the patients as they come to us based on their priority and their needs.
2:07:49
As I said before, we continuously reevaluate our staffing needs and we are able to staff up as, you know, as we need to.
2:07:58
And when if patients are boarding in the emergency department, We manage those patients so that they get the same care that they would get if they were admitted upstairs by our teams admitting them and caring for them while they're in the emergency department.
Mercedes Narcisse
2:08:17
How does h and h coordinate with FDNY EMS during peak hours to manage patient transfers?
2:08:25
And are there any joint initiatives to improve communication and reduce the wait times?
Adrienne Birnbaum
2:08:33
Well, we're very much looking forward to the implementation of the hospital liaison officer.
2:08:39
I think that will be a really positive thing for us in terms of being able to increase the efficiency of that handoff that occurs between the EMS crew and our staff.
2:08:52
And we'll be able to get the unit out ready to take care of the next call even more efficiently.
2:09:00
Okay.
2:09:01
And also allow us to communicate on an ongoing basis.
Mercedes Narcisse
2:09:06
Okay, triage model.
2:09:08
Can you share how much wait times at H and H emergency department have decreased since implementing provider in triage models?
2:09:19
I mean, specifically at the highest volume locations.
Adrienne Birnbaum
2:09:25
I don't have data on that to provide right now, but I can get it for you.
2:09:29
But I can tell you from my personal experience when we implemented it at 1 of facilities, we saw significant decreases in the number of patients that we're leaving without being seen, as well as increases in the patient experience scores.
