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J A N U A R Y
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SPOTLIGHT
SPECIAL EDITION:
ED Transformation Page
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4 IT’S BETTER ALREADY Change is in the air
6 MAKING IT HAPPEN
ED Transformation team leaders
A new era began on Jan. 2 as Zach Tebb, M.D., Charles Lewis, R.N., Stephanie Austermann, R.N., and Eric Appelgren, M.D., officially opened the newly renovated Emergency Department.
8 FIRST PERSON
A grateful wife says, “Thank you!”
Terrific
TOTALS from our Emergency Department
*
44
69,947
Patient visits
Percent
(Combined adult and pediatric)
of ED patients were admitted
“DOOR TO DOC” TIME
25
(Average ED wait time to see a physician)
2
20 9 9 26 32 6 4 4 70 12
NUMBER OF PHYSICIANS
Minutes
(As compared to 120 minutes in 2012)
ST. ANTHONY’S HAS MEDICAL CONTROL IN
EMS DISTRICTS
Adult
Pediatric
ED Rooms
TREATMENT:
TRIAGE:
FAST TRACK:
EMS DISTRICTS SERVED
NUMBER OF NURSES
TOP
DIAGNOSES OF
Adult
SPOTLIGHT SPOTLIGHT
Pediatric
* Data from Fiscal Year 2013
ED PATIENTS
Chest pain
Stomach pain
Dehydration
Urinary Tract Infection
THREE things every employee and volunteer needs to know about our new Emergency Department:
Transformed ED is more efficient, patient-friendly F
ERGEN
PA
Y C
DE
or the past seven years, when people would ask Jenn Potts, R.N., what she did for a living, she would say “I’m an ER nurse.” Now, she tells people who ask that question, “I’m an ER nurse at St. Anthony’s.” “It was tough working the ED,” said Potts from her new triage desk, just a few feet from the revolving door that leads patients from the parking lot to the Emergency Department. “We would constantly hear patients complain about the four- to five-hour waits to see a doctor. They would yell at us, and I understood their frustration. People come here when they are sick. They already feel miserable and we, unconsciously, were making them feel worse.” But things have changed. Dramatically. Over the last seven months, the Emergency Department at St. Anthony’s has undergone a transformation (see the sidebar on this page). “There’s no other service line that affects more of our patients than the Emergency Department,” said Eric Appelgren, M.D., Vice President of Clinical Services, at the ribbon cutting Jan. 2. “It’s about caring, compassionate service. It’s about the community we serve.” “There’s not a ‘Mission Accomplished’ sign up,” said Zachary Tebb, M.D., Medical Director of the Emergency Department. “We are always looking for ways to improve. The real goal is to get the patient to a nurse or doctor as quickly as possible.”
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We’ve done all of this while still maintaining our exceptionally high level of capabilities, including our Level II Trauma Center, Accredited Stroke Center and Chest Pain Center. This means you can take comfort in knowing St. Anthony’s staff and physicians have the highest level of capabilities to care for you, no matter what brings you to the Emergency Department.
T
Employees and members of the community toured the newly renovated Emergency Department following the Jan. 2 ribbon-cutting ceremony. The new work environment includes six flexible triage rooms and an EMS and Patient Flow Communications Center.
N
2
The patient experience has improved. We’ve hired additional staff, including new patient advocates who work with the patients and their families to ensure they receive the best care. We’ve also improved our methods of communication with our patients’ physicians.
EM
1
Our wait times have dramatically improved, and are now better than industry best practice. We’ve accomplished this through physical remodeling and improved patient flow processes.
RT ME
Continued on page 4
JANUARY 2014
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Continued from page 3
Jerry Power, R.N., is a new nurse and St. Anthony’s is his first job in the healthcare field. When he told family members and friends about his new job, they told him things like “I would never go to St. Anthony’s,” and “I’ve only heard bad things about St. Anthony’s.” Now, he says, “the negative talk has stopped. I can sense the change in their attitudes about the care we give here. I can also see a change in the attitudes of the patients we treat here. The patients are happier; those who are happier feel better.” The clinicians are also feeling better about the work they are doing, and the reason behind why they do it. “A healthy emergency services department is important for our community,” said Dr. Tebb. “When we speak of our ED, we speak about social justice. We treat all people, at all times, from every circumstance. The work we do is very special and it’s something we can all be proud of.” “We’re all excited!” said Potts of her co-workers’ reactions to the transformation. “We see patients as soon as they walk in, and you can sense their relief. They notice it, they comment on it, and they appreciate the changes we’re making.”
FAST TRACK, SCRIBES, PATIENT ADVOCATES, AND MORE
In the ED, change is in the air • Patients have seen a dramatic decrease in the time it takes to see a doctor – now five times faster than it was one year ago.
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“I can see a change in the attitudes of the patients we treat here.” – Jenn Potts, R.N.
• The Emergency Department has changed physically, allowing for six flexible triage rooms and an EMS and Patient Flow Communications Center. • When patients come with non-life-threatening conditions, they are moved to a four-room suite in the Emergency Department known as Fast Track, where they are seen by nurses and a physician assistant dedicated solely to that area. • The Emergency Department has hired additional nurses, physician assistants and other employees to help improve processes, increase the quality of care and allow doctors to spend more time with patients. • The use of technology is improving communications between the Emergency Department and the patient’s primary care physician. • Specially trained scribes are shadowing physicians as the physicians provide care in the Emergency Department. The scribes enable the doctors to spend more quality time with the patients and their families at the bedside. • Emergency Department Patient Advocates are helping provide better communications between physicians and the patients and their families.
120
Nov. 2012
25
Nov. 2013 0
20
40
60
80
100
120
Average ED wait time to see a physician (minutes)
SPOTLIGHT SPOTLIGHT
Start
SPREADING the word Ad campaign announces St. Anthony’s improved ED
Jerry Power, R.N., enters one of the new Emergency Department triage rooms to evaluate a patient.
5000
The negative talk has
stopped.
4,545
– Jerry Power, R.N.
4000
3000
2000
1,595
1,742
1,927
1,726 1,270
1000
0
2008
2009
2010
2011
2012
2013
Patients who left the ED before receiving treatment
Jan. 2 marked the kickoff of an advertising campaign touting the new features of our Emergency Department through radio, print, outdoor and online advertising. The campaign runs through June 2. To learn more, visit southcountyemergency.com. “This is a tremendous opportunity to reintroduce our transformed Emergency Department to the community and to build their trust in our care,” said Mary Sherfy, Director of Marketing, Communications and Community Outreach. Listen for sixty-second radio spots on KEZK-FM, KYKY – FM, WARH – FM, KLOU – FM, KIHT – FM, WIL – FM, KMOX – AM and Pandora digital radio. Watch for full-page color print ads (shown above) in the South County Times, WebsterKirkwood Times, Jefferson County Leader, Arnold-Imperial Leader, St. Louis Review, St. Louis Medical News and St. Louis Metropolitan Medicine. In February, outdoor boards will begin running along I-55, I-255 by the Jefferson Barracks Bridge, I-44, and Highway 141. Online ads will run on stltoday.com and other websites. To hear the radio commercials and see the print ads, visit SAMCare.
JANUARY 2014
5
ED TRANSFORMATION
team leaders 6
SPOTLIGHT
Eric Appelgren, M.D. Vice President of Clinical Services
E
ric Appelgren, M.D., is an anesthesiologist by education, was trained as a flight surgeon in the United States Air Force and is a romantic at heart. That’s what led him to the military. “It’s what I am most proud of … being associated with amazing people who have served, some fatally, for a belief in freedom and democracy. It was an honor to serve with them.” He feels a different kind of honor and responsibility to those who work at St. Anthony’s. “We have such a great and talented staff here, and I feel called to help them do their jobs better by finding them resources, helping them navigate
Zachary Tebb, M.D.
Medical Director of the Emergency Department
Z
achary Tebb, M.D., is a new doctor who is always looking for new challenges, both personally and professionally. After graduating from Pepperdine University with a degree in sports medicine, he was looking for a career that would allow him to apply his love of math and science, but keep him out of a cubicle. He chose medicine and attended University of Missouri – Columbia School of Medicine. Dr. Tebb pursued emergency room work after enjoying that part of his rotation. He then completed his residency at the University of Colorado and the Denver Health Medical Center.
Charles Lewis, R.N. Director of Emergency Services
A
few years ago, Charles Lewis left his job as Chief Nursing Officer at BJC’s Progress West Hospital to help St. Anthony’s turn around its Emergency Department. It would be the third such project in his career. “What makes St. Anthony’s different is that the staff was hungry for change,” said Lewis. “I’ve never worked with an ED staff that was so eager to make things better for the patient. The reputation that St. Anthony’s had in the community betrayed the employees, and the staff wanted to change that.”
through administrative roadblocks and supporting them in their work.” Appelgren completed his undergraduate work at Augustana College in Rock Island, Il., and went to Loyola University for medical school. From there, he went into the military. He was deployed in Southwest Asia in support of Operation South Watch, which enforced the no-fly zones in southern Iraq. Additionally, he provided support after the U.S. Embassy bombings in Kenya and Tanzania. As Vice President of Clinical Services, he oversees Emergency, Cancer Care, Pharmacy, Lab, Imaging, Surgical, and
Therapy Services. He is also responsible for Hospice, Pulmonary and Neurodiagnostics, Urgent Cares, and Occupational Health. “As an anesthesiologist, I can take care of one patient at a time,” said Dr. Appelgren. “The work we do together at St. Anthony’s now impacts an entire community every single day.” He and his wife, Rebecca, who also is an anesthesiologist at St. Anthony’s, have an 8-year-old daughter, Ellie. Dr. Appelgren enjoys doing anything outdoors, including hiking, fishing, hunting, farming and golfing.
“I love the problem-solving part of ED care,” said Dr. Tebb. “I like to determine the diagnosis and get patients to the next stage in their care.” As medical director of the Emergency Department, Dr. Tebb oversees the medical protocols and treatment of patients and assists with creating policies to improve patient throughput. Dr. Tebb is a member of the Emergency Physicians of St. Louis, PC, an organization of emergency physicians that staff the Emergency Department. Dr. Tebb hopes community members will realize the resources and care provided by
the staff at St. Anthony’s and will seek it out when they need health care. “A healthy Emergency Services department is important to the community. The stronger and more efficient the ED, the healthier the community.” He and his wife, Emily, have two children: Torch, 4, and Bea, 11 months. They live in Webster Groves. Dr. Tebb recently completed the Triple Bypass Ride, 120 miles at above 10,000 feet of challenging elevation over three mountain passes in Colorado. He’s also completed several marathons and triathlons.
Lewis’s career didn’t begin in health care. It began in music. He was a professional guitar player for years but, when he realized he would never be on the cover of Rolling Stone magazine, he started thinking about his next professional move. “A friend was going into nursing and suggested I consider it. I’m creative and analytical, so I thought it might be a good fit for me.” After earning his R.N., and then a graduate nursing degree in Executive Leadership from the University of South Alabama, Lewis began working in different healthcare settings in various operational leadership roles. He eventually focused on Emergency Department transformations.
“I like the challenges in an Emergency Department. While employees focus on the patients, I am motivated by focusing on the employees and physicians, and how to provide the resources they need and the environment necessary to deliver safe, highquality healthcare. A better experience for an employee means a better experience for the patient.” Lewis has three daughters: Sara, Chloe, and Mia. Two of them still live at home. He and his wife, Heather, live in Arnold. When not at the hospital, Lewis likes to entertain his artistic side through music, writing and art.
“St. Anthony’s is my community hospital. We had our daughter here. It’s where we come when we are sick. My wife and I work here, and live a mile from here. St. Anthony’s success is important to me, professionally and personally.”
“A healthy Emergency Services department is important to the community. The stronger and more efficient the ED, the healthier the community.”
“This is my hospital. This is my community. My grandparents utilize St. Anthony’s. My primary care physician is with SAPO. I believe in the care we give, and I believe in the people who give it.”
JANUARY 2014
7
F I R S T
P E R S O N
A grateful wife says, “Thank You!”
Patients are
feeling
better about their
Pete and Marett Lombardo
experiences in the ED October 15, 2013
8
Dear Dr. Appelgren:
Please take a moment to read Marett Lombardo’s letter (shared with her permission) regarding her husband’s care after he suffered a heart attack and was brought to St. Anthony’s Emergency Department. In it, she expresses her appreciation for the care and concern the staff gave to her, her husband and their family.
Thank you for personally taking me to my husband when he was having his first heart attack. Thank you for checking on me and my family during his procedure. Thank you for taking the time to talk to me after his second heart attack. Thank you for visiting my husband afterwards. Thank you soooooo much for everything. Your sincere concern was very much appreciated and heartfelt. Unfortunately, St. Anthony’s has a bad reputation, but if you need a spokesperson for the changes you’ve made, we are it. I have had nothing but wonderful things to say about the treatment and care that my husband received. I saw the ambulance speeding down Telegraph Road at 8:35 a.m., and pictures were taken of my husband’s heart by 9:10 a.m. Your response time was amazing.
If we provide this kind of care and concern to every patient, every day, we will change the story of St. Anthony’s in our community.
My mother-in-law and father-in-law were both at St. Anthony’s for heart issues, and they too received excellent care. Your entire team at St. Anthony’s was wonderful. Everyone treated my husband as if he was their only patient. They took the time to listen to our questions, explain what happened, what changes he needs to make and how they can help. And Dr. Allen – well, that’s a whole ‘nother letter. WE LOVE HIM! I can’t say enough good things about you and your staff. Fondly,
Marett Lombardo
Spotlight is published quarterly by the Marketing Department of St. Anthony’s Medical Center.
Writer: Anne Steffens, ext. 4947 Photography: Christy Siebert, ext. 4934 Graphic design: Stephen Walker, ext. 4767