Most Walk-In Patients See a Doctor Who Starts Their Treatment Within 30 Minutes

As a patient you arrive at the emergency department wanting answers: Is it broken? Why am I so sick? You want to talk to a doctor, but more often than not the first person you see is a triage nurse, unless you’re at Missouri Baptist Medical Center.

From 8 a.m.-midnight, seven days a week, emergency department patients are initially seen by a physician. It’s a first for the St. Louis area.

“No one else in the region is doing this,” said Leonard Winer, M.D., F.A.C.E.P. regarding Missouri Baptist’s decision to have a full-time physician working side-by-side with a triage nurse to make initial assessments of a patient’s condition and provide more rapid care. The decision to add a triage physician was made when Missouri Baptist opened its new emergency department in the hospital’s all new East Pavilion in January 2007.

“In about 10 percent of cases, the triage physician may be the only physician the patient needs to see,” said Dr. Winer. “He or she can conduct the initial evaluation, order tests, make a diagnosis, recommend a treatment and discharge the patient.”

With its new system, Missouri Baptist also has cut the initial waiting time for non-critical patients. “Our goal is to have 85 percent of walk-in patients see a physician who can start treatment (order tests, etc.) within 30 minutes,” says Dr. Winer. “Obviously there are days when the emergency department is very busy and the wait will be longer, but most days we hit the goal.”

Length of overall visit now averages less than 3.5 hours for discharged patients.  Obviously, sicker patients and patients arriving on a really busy day will experience a longer stay.

Considering that patients can wait 5 to 7 hours just to be seen in many hospital ERs, the new system improves the patient experience.

The new emergency department also takes a high-tech approach, with wall-mounted computers in every room and throughout the department’s common areas. The computers allow the physicians to enter critical data regarding a patient’s condition and treatment, order tests and medications, and send alerts to the nursing staff. It’s extras like these that make Missouri Baptist unique in its high level of emergency patient care.

That goes for the exceptional care that can be found right down the hall in the newly opened St. Louis Children’s Hospital pediatric emergency room staffed by specially trained pediatric nurses and Washington University physicians. Children who require emergency care are quickly ushered into a world of their own with brightly decorated waiting areas, tropical fish tank and play areas with a nautical theme.

“We want to keep the children comfortable and calm,” said Doug Carlson, M.D., “and to reduce trauma on the family.” The new Children’s Hospital pediatric unit houses nine emergency beds and six in-patient beds. With summer rapidly approaching, Dr. Carlson said the most common reasons for a child to need emergency care are lacerations and broken bones. He stresses the need for helmets and pads, when riding bikes, skateboards, roller skates and scooters. “Parents need to make certain that their children are using the proper safety equipment and using it correctly,” he said. “Everyone, at every age, should wear a bicycle helmet.”