Letter to Editor

October 7, 2007

By Paul Stewart
President and Chief Executive Officer
Sky Lakes Medical Center

A few weeks ago, “Danny” was having fun riding on the back of his buddy’s bike. It was around dusk, they were going fast down a hill in a vacant lot when the two-wheeler smacked a rock bouncing Danny to the dirt. Hard.

The injury didn’t seem too bad at first so the boys continued to enjoy the warm evening. A few hours later, Danny’s mom could see her son’s hand was swollen and she noticed him wince when she examined his elbow. In her judgment, this was something that could not wait for her regular physician. She rushed him to the Sky Lakes Medical Center Emergency Department for examination and treatment.

She knew that the department is staffed 24/7 by caring professionals, and the physicians on duty are specialists in emergency medicine. Danny’s mom knew her son would receive excellent care.

Danny is a fictitious patient although his case is typical. And what happened after Danny and his mom arrived at the medical center is not unusual: They waited.

The triage nurse was quick to assess Danny’s injuries – worrisome to his mom, but compared to other cases already in the department, relatively minor – and get his case in the queue. It’s the assessment process that gets critically ill or injured patients seen before less-severe cases; it’s that prioritization that leads to waits, which can seem very long.

I sympathize with people who have to wait their turn for care in the Emergency Department. When my own children were hurt, nothing was more important to me than quickly getting them the treatment they required.

All our care providers feel the same way: They want to deliver the best care they can as soon as they can; they want to treat everyone as if the patient was family. The reality is, however, not every case can be first. Some illnesses or injuries require more treatment sooner than others.

People with life-threatening conditions, heart attack patients, for instance, not only move higher in priority compared to, say, Danny’s swollen hand and tender elbow, they may also require test results from our Lab, or scans from our Diagnostic Imaging Department. The emergency physician may need to consult with another medical specialist. A complicated case may also mean that more staff is needed to deliver treatment, making fewer nurses available to tend to lower-level injuries, and that leads to waits.

In the old Merle West Medical Center Emergency Department, there were 14 treatment rooms. When we built a new department, opened last March, many presumed that our construction was finished, and anticipated increased capacity and therefore shorter waits. This is not yet the case. While the new department with the remodeled portion will eventually have 22 treatment rooms, it currently has only 12. The remainder are part of the old department’s remodel and soon will be available for patient care. Not having those additional rooms has resulted in patients waiting longer to be taken to a room and seen by a provider. As these new rooms become available, we will be able to treat more patients faster.

Waiting seems to be an inevitability of emergency department visits regardless of where the hospital is located. The average waiting time at an emergency department in an Oregon hospital is 3 hours 2 minutes. The Centers for Disease Control and Prevention ranks Oregon’s wait times in the upper third in the nation. The best in the nation, Iowa, has an average wait time of 2 hours 18 minutes; the worst is Arizona with an average wait of 4 hours 7 minutes.

Despite having only about half of our rooms available for treatment, the current average wait time at our Emergency Department is only slightly higher than the state average. That does not mean that we are satisfied and we’re working hard to find ways to make improvements.

Overall, I believe our Emergency Department physicians, nurses, techs and others do an outstanding job. They are skilled, kind, and dedicated professionals. Many of our patients agree with me.

A recent visit to the Sky Lakes Emergency Department was a “very scary experience for us and our child… but your staff was professional, caring, helpful, and compassionate from the moment we walked in.  Thank you so much!” a mom wrote to us.

An out-of-town family sent this to me: “(W)hile visiting Klamath Falls, my husband was transported to your facility from the (hotel) where we were staying. From the moment he arrived at the Emergency Room, he was treated with kindness and caring…All of the staff involved with his treatment from the ER to the Lab and the X-ray techs were extremely professional and courteous, and although the ER was busy with other patients, staff continued to check in with us to make sure we were comfortable and to keep us advised as to what was happening.

“The community should be proud to have such a great medical facility as Sky Lakes to serve their community. We know we were sure glad you were there.”

I wish I could say that sentiment is universal. The fact is that the department does at times get backed-up as staff deal with a large number of people and the illnesses and injuries that brought them to our Emergency Department. We never compromise patient care or safety in favor of speed.

Our commitment to you, the people in our community, is that our wait times will decrease and we will continue to provide the very best care possible as quickly as we can with safety and respect.

We appreciate your patience and understanding.