VCU news

By Malorie Burkett

Emergency departments across the country are bursting at the seams as demand for emergency care continues to increase while hospital closures have resulted in decreased capacity. Diversions, crowded conditions and long wait times further contribute to the limitations placed on ED services.

But the Virginia Commonwealth University Health System’s Department of Emergency Medicine is maintaining its critical position in the community as the gateway point to care for underserved populations, while reaching and often exceeding state and national benchmarks for quality care.

Emergency departments must remain open and accessible to all patients, because of the Emergency and Medical Treatment and Labor Act. Passed in 1986, the law requires hospitals and ambulance services to provide care to anyone needing emergency health treatment regardless of citizenship, legal status or ability to pay.

“Millions of Americans have either no health insurance or inadequate coverage to meet their needs when catastrophic illness or injury occurs,” said Joseph Ornato, M.D., chair of the Department of Emergency Medicine. “Large, urban emergency departments function as the ultimate ‘safety net’ for such individuals.

“Unfortunately, with economic turmoil and unemployment soaring, already overcrowded and overburdened emergency departments have been challenged like never before,” he said. “On top of all this, the recent H1N1 epidemic pushed ED volumes to record highs.”

Recognized in the 2009 Commonwealth Fund report as one of five top safety-net hospitals in the United States, the VCU Health System has been using a combination of changes to curb common strains often faced by a safety net hospital, which provides a significant level of care to low-income, uninsured and vulnerable populations.

Some of these interventions include reconfiguring the ED to maximize efficiency; devising a pre-diversion system to alert staff of ED crowding; installing an electronic tracking system; designating staff members to be responsible for tracking patients; and developing meaningful performance metrics.

“The VCU Health System physicians and staff have been working to enhance the quality of services provided in an effort to become the safest hospital in the country,” said Sheryl Garland, vice president of community outreach for the VCU Health System. “This is a priority of our health system's leadership and has contributed to the VCU Medical Center being a premier institution that is focused on providing quality care to all patients, regardless of their ability to pay.”

The VCU Health System and four other hospitals — Boston Medical Center in Boston; Denver Health in Denver; Memorial Regional Hospital in Hollywood, Fla.; and Memorial Hospital West in Pembroke Pines, Fla. — are currently recognized in the Commonwealth Fund report as top safety-net hospitals because of their long-standing commitment to providing quality care for vulnerable patients as well as their performance on nationally recognized measures of care.

According to the report, the hospitals have seen improvements in a number of measures, including greater patient satisfaction, better patient care, reduced waiting times, decreased costs/increased revenues, and less time spent on ambulance diversion.

“Like many other academic medical centers, the VCU Health System is committed to fulfilling its mission to provide clinical services, promote the development of research and support the education of health care professionals of the future,” said Garland. “As a part of its role as an urban medical center, caring for the uninsured is an important part of the services provided by the VCUHS and our ongoing commitment to the communities we serve.”

VCU’s Department of Emergency Medicine provides treatment for approximately 85,000 patients per year and is nationally recognized for innovative management of chest pain, innovations in resuscitation of cardiac arrest patients, and medical direction leadership of the Richmond Ambulance Authority — an award winning EMS system.