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CRMC emergency room using new system

Visitors are shown at the emergency room entrance to Cortland Regional Medical Center on Wednesday. The facility, operating under a fast-track system since July, has reduced patients’ waiting times to see a doctor and to be discharged, said Bonny Griffith, director of marketing and communications for CRMC.

Bob Ellis/staff photographer

Visitors are shown at the emergency room entrance to Cortland Regional Medical Center on Wednesday. The facility, operating under a fast-track system since July, has reduced patients’ waiting times to see a doctor and to be discharged, said Bonny Griffith, director of marketing and communications for CRMC.

Since the urgent care clinic closed at Cortland Regional Medical Center in August, shifting patients to its emergency room, the competing Convenient Care at Cortland clinic on Route 281 has seen a sharp increase in the number of patients.

Officials with Cortland Regional Medical Center and Cayuga Medical Center — which runs Convenient Care at Cortland — said they have procedures in place to handle the shifts in patient care, and patients do not have to wait longer for service at either the clinic or the hospital.

In August, CRMC closed its urgent care, which provided non-critical care to patients, and services originally handled by the urgent care now fall to the new emergency room system.

So far the system has been handling the influx well, according to hospital officials. A new system that ensures faster service and shorter wait times for patients, known as the fast-track triage system, was established July 1 and has helped CRMC handle the change.

This system has cut wait times about in half, for both the time it takes a patient to see a doctor and to be discharged, said Bonny Griffith, director of marketing and communications for CRMC.

Urgent care visits at CRMC totaled 11,008 in 2007, according to a spokesman for the hospital at the time. Cortland Regional Medical Center would not disclose more recent figures for patients treated by prompt care.

At Convenient Care at Cortland on Route 281, the absorption of additional patients has been going on for some time, an official said.

“Our numbers are up and we have the capacity to handle those numbers,” said John Turner, vice president of public relations at Cayuga Medical Center.

The average number of patients seen at Convenient Care at Cortland is around 60 a day, Turner said. On Monday, Convenient Care hit a record high of 95 patients, which is not too far above normal as of late, Turner said. This has roughly coincided with the closure of CRMC’s urgent care, but there is no way to be sure if that is the cause, he said.

Patient wait time, even with more patients, has not changed, Turner said. Before the increase, the average time between a patient walking into the clinic and leaving was around 91 minutes, Turner said. That number has remained the same, he noted.

At CRMC, the triage system was started to help ensure that emergency department physicians see quickly and efficiently those patients with non-life threatening issues who may have otherwise experienced longer wait times, Griffith said.

Patients can expect to have the same emergency room doctors, nurses and registration process just with faster treatment, Griffith said. All patients are met by a registered nurse who assesses the patient’s needs based on the severity of the injury or complaint and then assigns a degree of urgency, depending on the injury or complaint.

“Emergency room patients need many different levels of care at any given time,” Griffith said.

Before launching the system, the average door to discharge time for emergency room patients was 200 minutes — now that number is down to 90 minutes, Griffith said.

“The time that a patient now waits to see a doctor has been cut from 45 minutes to 15 minutes or less now,” said Tammy Aiken, director of emergency services at CRMC.

The new system helps even when the emergency room is busy with critical patients.

“This (the emergency room) is now a one-stop shop,” said Aiken. If a patient comes through the triage system but then the injury or illness ends up being more extensive, all the resources of a full emergency department are available.

However, for people who are privately insured, emergency room co-pays are generally much higher than urgent care co-pays.

But for patients who head to the emergency room, CRMC officials say doctors and nurses will work efficiently.

“We flex doctors and nurses as needed in the emergency room to make sure that patients are treated as soon as possible,” Griffith said. Sometimes doctors can even multi-task by treating a fast-track patient while waiting for results for a more seriously ill or injured patient, she said.

The new system required no additional emergency room staff, but the two physicians and nurses who worked in the urgent care were added to the staff of the emergency room, Aiken said.

“This is a respected model of care that exists in emergency rooms throughout the country,” Griffith said.

Other hospitals that have a fast track system in the area include Lourdes Hospital in Binghamton, St. Joseph’s Hospital Health Center in Syracuse and University Hospital in Syracuse, Griffith said.

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