Baltimore Washington Medical Center has launched an innovative model of care that has changed the face of emergency medicine in the Baltimore Washington corridor. By implementing a new revolutionary care system ? InstaCare ? wait times are minimized and ambulance diversion hours have almost been eliminated. The new system reduces delays and streamlines key ancillary processes to create a system in which providers can consistently see patients within minutes of arrival. The bold step shortens wait times, improves patient satisfaction and opens up beds for the sickest of patients.
Baltimore Washington Medical Center's Emergency Department is the largest ED ever to institute InstaCare and only the third one in the country to do so.
The cornerstone of the InstaCare system is putting the patient in front of the physician or physician assistant immediately upon arriving to the emergency department.
Old system:
Patient Arrival - Triage by nurse - Registration - Lab work/xrays - To Room - Seen by physician
New system:
Patient Arrival - Seen by Physician
This system allows clinical decisions to happen at the beginning of patient care, decreasing wait times, lowering turnaround times and facilitating quicker access to physician care.
If you can be evaluated and treated by the physician at the beginning of the process, we will be able to discharge you immediately with the appropriate medication, care, and follow up. Since implementing this system, that applies to nearly five percent of our patients!
If you need further evaluation or tests, and a room is available, we will move you to that room immediately.
If you need further evaluation or tests but a room is not available, we will begin ordering and carrying out some of the tests such that when a room is available, some of the test results will be back and the physician can make a decision even sooner!
There are many different areas to our emergency department, and based on what your concern is, the physician will move you to the appropriate area.
The main pod is where our patients with serious or life-threatening injuries are seen. Such examples include, but are not limited to, heart attacks, stroke, confusion, loss of consciousness, and the elderly with abdominal pain.
The staging area is where a team of providers will treat, but is not limited to, lacerations, abscesses, broken bones, the young with abdominal pain, and migraine headaches.
A child's health is never something to delay care of. As a result, we have emergency physicians who are trained in caring for children and also have board certified pediatricians in the emergency department 24 hours a day, 7 days a week. If your child requires admission to the hospital, BWMC has an inpatient pediatric floor that will provide the best care for your child.
If you are feeling anxious or depressed, and you feel you need to talk to someone or may need to be admitted to the hospital for your safety, we have Mental Health Clinicians on staff 24 hours a day, 7 days a week. They work hand-in-hand with the physician to determine the best course of action for you or your loved one. They will speak with the patient, family, and a psychiatrist if necessary to make sure you are safe and taken care of.
Regardless of whether you have insurance or not, the goal of our emergency department is to address your medical concerns immediately. That is why we do not obtain your information until after you have been seen and treated. If the registration can be completed while you wait for your tests to come back, we will do so. If you are discharged, we will obtain this information at exit registration.
As you know, patients come to the emergency department for many reasons, some life-threatening, some that can be very painful, and some that are non-emergent. We try to see everyone as soon as possible, and at times we must determine who needs to be seen the fastest as it could be the difference between life and death.
The BWMC emergency department has seen tremendous growth. In 1999, a new ER opened with the ability to treat 60,000 patients. But in a short time, patient numbers were exceeding capacity. By 2004, the department was treating an average of 219 patients a day about 80,000 a year. Inevitably, as the patient numbers grew, so did ED wait times.
However, with the implementation of InstaCare and the addition of 17 additional treatment rooms, the future of your care at BWMC will continue to improve while the wait times continually decrease.
