When Minutes Matter

When Minutes Matter

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Dr. Ramon Nunez, the new Medical Director of the Florida Hospital Zephyrhills Emergency Department, tells the story of a woman who presented at the hospital soon after the group he heads from Florida Emergency Physicians (FEP) arrived at the beginning of October.

“An elderly woman came in complaining of abdominal pain. She’d recently had heart surgery but at another hospital, so we had no records on her. We made a quick diagnosis of a perforated bowel, confirmed it with a CAT scan and got her up to surgery within 30 minutes of arrival. Acting quickly saved her life,” Nunez says.

For Emergency Department Director Kim McDermott, RN, MSN, this kind of prompt action is precisely what the hospital’s “No Wait” goal is all about. But McDermott is quick to point out that just as important as speed is the quality of care patients get when they come to the hospital’s Emergency Department.

"Both prompt action and the highest standard of care are exactly what patients coming to the Florida Hospital Zephyrhills Emergency Department can expect under the guidance of Dr. Nunez and the group of FEP physicians that started at the hospital this October," she says.

“We want everyone who comes into the Emergency Department to be greeted immediately and assessed within minutes to determine their medical treatment needs. Conditions that may be critical are seen immediately, but we strive to take care of each patient as quickly as possible. In fact, more than 90% of our patients see a physician within 30 minutes. When they do, they get the best care possible,” says McDermott.

Better Training, Better Outcomes

To make the best care possible a reality for the people of our community, Dr. Nunez, who was formerly at Florida Hospital Kissimmee, has brought with him a group of FEP doctors and support staff. The team includes Asst. Medical Director Dr. Al Brahmbhatt as well as doctors Amabel Cabatu, Marifel Juarbe and Turi Maki.

“The training we give the staff will elevate the standard of care in the community,” Dr. Nunez says. ”Everyone is focused on the same thing, so people who come into the Emergency Department can expect the highest standard of care. That means skill, safety and effectiveness.”

Florida Hospital Zephyrhills selected the FEP group “because of their patient-first focus, national recognition for quality and commitment to Florida Hospital’s mission,” according to Doug Duffield, the Hospital’s president and CEO.

“At any given time, we have three or four people preparing patients to see the doctors, making sure tests are performed and results are in the doctor’s hands quickly,” McDermott explains. “And when we’re busy, nurses can implement triage protocols based on symptoms and order testing with the goal of having the patient ready when the doctor does see them.”

Nationally Recognized for Being Better

All of these are extremely effective protocols that have been developed by FEP over many years and with the experience of treating tens of thousands of patients. The practice, which has been with the Florida Hospital system for more than 40 years, employs more than 140 Emergency Physicians and delivers emergency medical services to more than 400,000 patients a year at nine of the hospitals within the Florida Hospital system of Greater Orlando.

HealthGrades, the nation’s leading independent healthcare ratings organization, has recognized their work by awarding the Florida Hospital Emergency Department system its Emergency Department Excellence Award in 2010. Under FEP’s leadership, it’s an award that places them in the top 5% of emergency departments in the nation.

In fact, protocols developed by the group for patients having heart attacks and strokes have produced some of the nation’s lowest mortality rates.

“The FEP team is bringing that expertise here,” McDermott says. “”And it’s going to make a difference to the community. For example, the national standard of care for getting someone who arrives at the Emergency Room having a heart attack into the cath lab is 90 minutes. Our average is about 60. Because time equals heart muscle, that’s critically important.”

McDermott cites the case of a woman who arrived complaining of chest pains. “She’d just been to her doctor a few days before, had a battery of tests and gotten a clean bill of health. But an EKG showed she was having an active heart attack. Our protocols enabled us to get her into the cath lab within 20 minutes, open her blockage and restore the blood flow to her heart.”

Treating More Than the Emergency

“We realize that everyone that comes into the Emergency Room is stressed and anxious,” McDermott says. That adds to the emergency. Sometimes it’s necessary for us to look after the family just as carefully as we look after the patient.

“I remember an elderly woman bringing in her 40-year-old daughter. She’d fallen and cracked her two front teeth. The mother was understandably hysterical, far more so than her daughter. She was concerned that her daughter might have hit her head and suffered some neurological damage.

“While the daughter was examined, a nurse took the mother into a waiting room, held her and provided comfort. Sometimes all it takes is a hand on a shoulder and a reassuring word. That’s an essential part of what we do.

Happily, all the daughter had done was crack her teeth. She was more embarrassed then hurt. We only had to give her a surgical mask to hide the embarrassment until she could get to a dentist.”