Changes have been plentiful at Good Samaritan

A lot has changed in the nine months since the new Emergency Department opened at MultiCare Good Samaritan Hospital in Puyallup. Pierce County’s busiest ED now has more space, serves more patients — and there’s a lot less waiting.

Emergency Department Nurse Manager Lucas Hopkins explains the changes that have come with new 50,000-square-foot facility and how they affect Good Samaritan staff and patients.

What are the most significant changes you’ve seen with the opening of the new Emergency Department?

The most obvious change is the new space. It really does complement the work that we do and it’s energized a lot of new processes. But the biggest change has been in the people and the morale boost that came with that space. There’s a strong correlation between staff satisfaction and patient satisfaction. You have to be excited to come to work and deliver an experience versus just health care. In September, we had the highest patient satisfaction rating we’ve ever had. 

Why are the patients so pleased?

I think a lot is tied to length of stay and waiting. You can be the best nurse or doctor possible, but if a person just spent six hours in a waiting room that’s hard to overcome. I can’t say that never happens, but we have dramatically decreased how often it does.

The average stay for ED patients – from when they get here until when they’re discharged – is 168 minutes. In the old ED, it was more than 220 minutes. And we continue to work reducing that time.

How’d you cut down that time?

We’re focusing on streamlining our practices. A few examples: Now every patient room is set up exactly the same – you don’t have to figure out what part of the ED you are working in today. We have our own radiology and imaging so we don’t have to compete with the rest of the hospital. We’re improving the way we bring in patients and discharge them.

We take a lot of pride in what we do, but we have to recognize that there’s another way. We want to make sure we’re working hard at the right things.

How has the extra space made a difference?

Having the capacity to accommodate everyone is definitely important. Our old ED was 27,000 square feet and the new one is more than 50,000 square feet. We’re the biggest ED in Pierce County and one of the biggest in the state. We’ll serve about 65,000 people this year.

Why are you so busy?

We’re the largest medical center in the area and we serve all of east Pierce County. That’s about 320,000 people. Within 10 square miles, there’s not another hospital.

Did you face any hurdles after the new facility opened?

The size of the space was also our challenge. It was a dramatic change to be spread out over such a distance, and it was something we really underappreciated. We had staff wearing pedometers and they were walking seven to 12 miles per day – that’s substantial. Even if you look at the responsibilities of our environmental services, in the old ED they were cleaning four bathrooms and in the new one they’re cleaning 16. 

Has the new ED attracted more patients?

We did see a bump beyond what we thought. We expected a 4 percent increase when we opened our doors last February, but for the first month and half we were closer to 12 percent. Part of that increase comes from population growth and part from perception. People now recognize that we are a state-of-the-art emergency department.

But the increase is also perpetuated by the lack of primary care and what’s happening with the economy. We’re expanding our services to become that regional medical center of choice, and simultaneously the community needs us more than ever.

We hear a lot about people using the ED for primary care. Does that happen often?

Most of the patients who come to the emergency department have conditions or symptoms that require a quick response and a skilled care team. We do have patients who come to us for more routine conditions because they don’t know where else to go. All of MultiCare’s emergency departments are working to educate people about their options and connect them with primary care providers to make sure they get the right care at the right place.

What exactly happens when someone shows up at the ED?

We have a greeter and an ED technician with training in identifying sicker patients. They get your basic information into the computer. Then an intake team of a nurse, an ED technician and a registration person takes you straight to a room.

They’ll do the classic triage to determine your acuity and get more about your story, while simultaneously getting you registered. Within about 10 to 15 minutes you can expect an ED physician to come in and add to the work that’s already been started.

Why’d you choose to work in emergency medicine?

The essence of emergency medicine is indeed the “emergency.” For me, it’s an honor and often a humbling experience to be with patients and their family during a medical emergency. We take pride in our knowledge and understanding of medicine, but nothing compares to simply sharing one of the – if not the – moments of greatest need with someone.

What’s a good day in the ED look like to you?

When you come in and you were able to provide better care today than you did yesterday. Health care is changing rapidly and you can fall behind real quick. If you don’t walk out the door saying we were better today – you’re behind. A good day is when you have a success story that fulfills that obligation.