Recently, we sat down with Cleaveland and Dr. Stephanie
Dabulis, MD, FACEP, medical director of the emergency
department (ED), to learn more about how the emergency
department works and how the ED staff work diligently to
ensure a good patient experience.
Our Life-Saving Role
The purpose of the emergency department, Dr. Dabulis
explained, is to rule out and/or treat any life-threatening
issues.
“The emergency department is truly here to assess and
treat your current emergency problem. It can be frustrating
for patients who are looking for us to diagnose or help
manage chronic medical conditions, but that is simply not our
role,” Dabulis added.
For example, if a patient comes to the emergency
department with a generalized complaint about falling down,
tests will be done to rule out a heart attack, stroke or other
emergent symptoms right away. “Every patient encounter gets looked at through a life-saving
lens. We are going to immediately
rule out those life-threatening issues
and focus on what may have caused
the fall in the first place,” said
Dabulis. Discharge instructions will
not always provide a diagnosis, but
instead, are the gateway to the next
step in the process – receiving followup
care.
The goal of the ED is to treat
the most critical or severe patients
first, in order to save their lives. It’s
important to understand behind
every moment in the waiting room,
there could be someone else receiving
critical life-saving care on the other
side of the door.
Reasons Behind The Wait
The needs in the emergency
department can literally change
in seconds. According to Dr.
Dabulis, the ED is staffed for a
predictable number of people and
inevitably, that number will become
unpredictable. An ambulance could
come in requiring a large amount of
emergency department resources,
putting the patients in the waiting
room on hold.
“When I come to work my hope
for my patients that day is that none
of them have to wait. I want them to
have clear communication and a good
experience,” said Dr. Dabulis.
Because of patient privacy and
safety, emergency department staff
aren’t able to tell the full waiting
room there is a combative patient
or perhaps there was an accident
and multiple patients are being
transported to the ED by ambulance
for life-saving care. All of these
situations can require additional
resources and do equate to longer
wait times for those patients who
are not experiencing life-threatening
illness or injury.
Even the more routine cases can take
up a lot of time, Cleveland said. Results
for routine tests such as blood work and
X-rays can take up to 90 minutes. And
based on the results of those tests, a
provider may make recommendations for
further testing or medication. A typical
visit to the emergency department is four
to six hours long.
Being Informed Is Key
Whenever possible, patients should
seek the right care, at the right time,
at the right place. For concerns
that are not of a severe nature, a visit to
your primary care provider or an urgent
care center may be a better alternative.
Dr. Dabulis noted that seeking nonemergent
care through a primary
care provider or urgent care center is
not always feasible after hours or on
the weekends. She added, “We also
understand that ‘the right place’ can
be subjective. And that’s what we are
here for..”
It’s also crucial to keep up with
preventative care visits to detect health issues before they become
emergent problems. Cleveland said
that in recent months, the emergency
department has seen increased
cases of severe issues that are
likely linked to patients delaying
preventative care during COVID-19.
Another critical step to
expediting care at the emergency
department is ensuring that medical
records are accurate and accessible.
Dr. Dabulis said, “It’s important to
bring pertinent records, know your
medications, allergies and surgical
history. Every patient who comes to
this emergency department deserves
to have me look at their records,
and that takes time,” Dr. Dabulis
continued.
“We may ask the same question
several times,” said Cleveland. “This
is because what may trigger a triage
nurse to action is different than
what a doctor may respond to. Their
jobs are different, and they may be
looking for slightly different things.”
For example, if a patient complains
of abdominal pain and vomiting, a
nurse may work to get the patient
started with labs, an IV and nausea
medication. The doctor may ask
what the pain feels like in order to
diagnose and fix.
“If you have a true emergency,
it doesn’t matter what the wait time
is – you will be seen immediately.
Although our primary role is to treat
life- or limb-threatening illness or
injury, we are committed to serving
every single patient who comes
through our doors,” Dr. Dabulis said.