Building a unified communications centre to improve the distribution of EMS patients to a large multi-hospital health system
Abstract
In 2023, hospital care-based models are faced with increasing patient volumes, limited physical space and limited resources. These constraints, felt in almost all acute-based care models, is leading to a crucial crossroads in acute care delivery. Balancing capacity and availability of hospital and system resources is almost impossible in this environment, as need greatly exceeds access to resources and patient care delivery can be significantly hindered. Historically, emergency medical services (EMS) brought patients to the nearest available emergency department (ED), and load balancing could only be accomplished after arrival in the ED. Intervening earlier in patient’s care by providing EMS with destination recommendations based on available resources optimises patient outcomes and decreases the burden on any individual hospital. This change can also greatly affect EMS processes to improve transport times and decrease wall time, the time that EMS crews spend at the hospital waiting to offload their patients into a hospital bed. Wall times can exceed several hours depending on location, time of day and patient resource needs. Reduction of this waiting time has the potential to profoundly improve throughput and patient-centred metrics like patient satisfaction, length of stay and admission rates, as well as reduce overall risk. This also allows health systems to maintain community resources by decreasing EMS crews’ idle time at the hospital. Through the creation of a unified communication centre (UCC), we sought to create a structure that appropriately stratified patients to the most appropriate system hospitals while still in the care of EMS. Our team’s goal was to optimise patient treatment, decrease wall time with EMS, and route patients to the most appropriate facility based on the patient’s medical complaints, hospital capacity and hospital capability in the community.
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Author's Biography
Joshua Gray Joshua D. Gray, MD, FAAEM, is a board-certified emergency medicine physician, who currently serves as the Associate Medical Director of the Greenville Memorial Hospital Emergency Department. He was the founding Medical Director of the Unified Communications Center. Dr Gray has held several other leadership positions in Point of Care Ultrasound and operational leadership in the Department of Emergency Medicine. Additionally, he serves as a clinical assistant professor for the University of South Carolina School of Medicine — Greenville campus. Dr Gray received his bachelor’s degree from the College of Charleston before receiving his medical degree from the Medical University of South Carolina. He completed his residency in Emergency Medicine at Geisinger Health System, where he also served as chief resident.
Cassie Mueller , MSN, RN, PCCN, CNML, SANE-A, TCRN, SANE-P, is a master’s-prepared nurse and is currently serving as the Director of Nursing of Greenville Memorial Hospital’s emergency department. This emergency department is a fast-paced level one trauma centre that sees over 126,000 patients annually. She has the privilege of supporting leaders and clinical nurses to improve the patient experience, quality outcomes and team member engagement. Cassie maintains multiple certifications in her speciality. In addition to her leadership role, she continues to provide care to patients as a sexual assault nurse examiner (SANE).
Jessica Hobbs Jessica E. Hobbs, DO, MBA, FACEP, is a board-certified Emergency Medicine Physician, who practises clinical emergency medicine and serves as the Medical Director of Adult and Pediatric Emergency Medicine at Greenville Memorial Hospital in Greenville, South Carolina, a level one trauma and tertiary care centre. She holds an appointment as Assistant Professor of Emergency Medicine at the University of South Carolina, School of Medicine — Greenville and works as clinical faculty with the Greenville Emergency Medicine Residency Program, which she helped establish as founding faculty in 2017. Dr Hobbs completed medical school at Nova Southeastern University College of Osteopathic Medicine in Fort Lauderdale, Florida, and Emergency Medicine Residency at Ohio University/Kettering Hospital in Dayton, Ohio, where she served as chief resident. She completed the Master of Business Administration in Entrepreneurship and Innovation programme from Clemson University in 2022 with a special focus on healthcare innovation and digital transformation.
Citation
Gray, Joshua, Mueller, Cassie and Hobbs, Jessica (2024, March 1). Building a unified communications centre to improve the distribution of EMS patients to a large multi-hospital health system. In the Management in Healthcare: A Peer-Reviewed Journal, Volume 8, Issue 3. https://doi.org/10.69554/RUBI7155.
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