EARLY 150 MILLION PATIENTS are being treated in Emergency Rooms (ERs) in U.S. hospitals each year. An increase in patients 85 years old and older is requiring ERs to administer more complex care than in the past, and patient volume is increasing among women and in cities, according to a five-year study between 2006 and 2011 by the Agency for Healthcare Research and Quality. The following New Jersey hospitals are rising to the challenge and caring for patients with modern, state-ofthe-art ERs: Englewood Hospital and Medical Center; HackensackUMC Palisades; HackensackUMC; Holy Name Medical Center; Jersey Shore University Medical Center; Morristown Medical Center; Robert Wood Johnson University Hospital; Saint Peter’s University Hospital; The Valley Hospital; Trinitas Regional Medical Center; and University Medical Center of Princeton
Englewood Hospital and Medical Center
By Hillary Cohen, M.D., Chief of Emergency Medicine
Our success relies on a thoroughly coordinated care response system starting with a pre-hospital ambulance response and extending into every area of care at the hospital, in addition to evidence-based protocols for time-sensitive emergencies such as stroke, myocardial infarctions and sepsis. We’re proud to be designated as a Primary Stroke Center by the Joint Commission. Our Emergency Care Center is designed with safety, comfort and convenience, including 40 private rooms designed around a central work station and an in-house imaging suite. This allows staff and physicians to immediately evaluate, diagnose and treat patients, all while affording a higher level of privacy. But medical care is only one part of a successful outcome. We’re committed to the highest-quality patience experience, which includes free front door valet parking at The Kaplen Pavilion to help ease the stress of arrival for families, and physician scribes who help document important health information, which allows the physician to spend more time focusing on the patient.
HackensackUMC Palisades, Hackensack Meridian Health
By Dominic Ruocco, M.D., Chairman, Emergency Medicine
During the last several years, we have experienced a dramatic increase in the demand for emergency services for our community. To meet the needs of our patients, we have enhanced our Emergency Department (ED) capabilities by implementing new technologies, adding a waiting room sorter nurse and creating our Rapid Evaluation Unit (REU). Some of the new technologies include a stateof-the-art patient tracking and documentation system, as well as digital radiology and cardiology viewing capabilities at all our ED computer terminals. Our waiting room sorter nurse facilitates a split flow system where lower acuity patients are triaged to our REU for fast track care and higher acuity patients are immediately identified for urgent intervention in our main ED. We utilize an immediate bedding policy, which means all our patients are expeditiously brought in to the main ED or REU after intake in the waiting room. Once the patient arrives to an exam room, we utilize parallel processing for bedside registration, practitioner evaluation and nursing care. All of these improvements have provided a better patient environment, increased capacity, improved patient throughput, enhanced patient safety and quality of healthcare delivery.
HackensackUMC, Hackensack Meridian Health
By Joseph Feldman, M.D., Chair, Dept. of Emergency Medicine
HackensackUMC is one of only 10 state-designated trauma centers and the only Level-II Trauma Center in Bergen County. Every year, HackensackUMC treats more than 111,000 patients in its Emergency and Trauma Center, one of the busiest in New Jersey. HackensackUMC’s worldclass emergency staff, coupled with the recent expansion and renovation of our ETC, enables our medical center to be fully prepared to handle all medical and emergency needs. In May 2012, HackensackUMC began construction on its multi-phase ETC expansion and renovation project, which was recently completed. This project created a state-of-the-art facility to provide patients and their families with world-class care, comfort and privacy. The expansion, which increased the ETC’s footprint by nearly 20,000 square feet, features 78 private patient rooms—complete with storage and sliding glass doors— and five state-of-the-art trauma bays. In addition, the project created a front door presence for the Pediatric Emergency Department, a larger decontamination shower to better handle a major event, should one occur, and a CT scan now located within the Shock Trauma area. The new ETC also provides specialty treatment areas for cardiac, cancer, geriatric, trauma and pediatric patients.
Holy Name Medical Center
By Randy Tartacoff, M.D., Co-Medical Director, George P. Pitkin, M.D., Emergency Care Center
The patient-centered George P. Pitkin, M.D., Emergency Care Center at Holy Name Medical Center features state-ofthe-art technology and resources that are utilized by our board-certified emergency medicine physicians, nurses, physician assistants and staff to treat lifethreatening emergencies and less serious injuries and illnesses within a compassionate, respectful environment. The ED staff focuses on getting patients promptly to medical providers through the triage process and bedside registration. Our customized electronic medical records system ensures continuity of care, from the ED to primary care providers and/or specialists. A designated Primary Stroke Center, the ED also encompasses a pediatrics area staffed by board-certified pediatricians and a FastTrack suite, where patients with minor injuries and illnesses are evaluated and treated within 90 minutes. Holy Name’s interventional Institute provides nonsurgical procedures for many acute illnesses that need immediate treatment. Because people are living longer, we treat a large number of adults over age 85, many of whom have complex medical conditions. Our geriatric-friendly accommodations include low-glare lighting, thicker stretcher mattresses and body-warming devices. Holy Name’s culturally and linguistically sensitive care extends to welcoming family members to wait with patients in the ED as they are examined and treated. Bilingual staff and patient navigators are available, as is a video-interpreting service featuring more than 200 languages.
Jersey Shore University Medical Center, Hackensack Meridian Health
By Robert Sweeney, D.O., Chair, Department of Emergency Medicine
One of the most important changes in emergency departments (EDs) throughout the state is the move to electronic medical records through a health information exchange. With all EDs capable of sharing information about a patient who may have visited multiple facilities, records such as lab and diagnostic tests that have been done at one facility can be shared with another hospital, reducing duplication of testing and costs associated with such. As Hackensack Meridian Health prepares to implement Epic systems for full interoperability throughout the continuum of care, the emergency department system will be particularly instrumental in streamlining workflows and improving care delivery in busy ED environments. Digital imaging through a Picture Archiving and Communication System (PACS) is another technological resource that is benefiting EDs. This allows images such as X-rays, MRIs and CT scans to be read by doctors anywhere. Studies that have been done at other institutions can be shared between hospitals, which eliminates the duplication of scans and can serve as a baseline when new images are required. Another significant trend is the use of ultrasound imaging, particularly pertaining to pediatric patients. Following specific protocols that utilize ultrasound imaging as a first line of evaluation can cut down on the amount of imaging that may be necessary, thus reducing the amount of radiation that children may be exposed to. Access to online protocols such as these means better access to decision making, which benefits patient outcomes.
Morristown Medical Center, Atlantic Health System
By Carol Jones, MSN, RN, NE-BC, Chief Nursing Officer
Morristown Medical Center’s Emergency Department is at the forefront of merging innovative technology with rapid diagnosis and treatment. Before a patient with a suspected heart attack reaches the hospital, the ambulance is able to transmit EKG results and other vital information to the ED physician, who then can activate a cardiac team to expedite opening the clogged artery. Suspected stroke patients can have a video consult with a neurologist during transport to the hospital and in the emergency department, shaving valuable minutes off the time it takes to administer a clot-busting drug or use a mechanical clot removal device—saving valuable brain tissue. This “telestroke technology” has been shown to improve patient outcomes. We are one of the first hospitals in the country to have lab work available before a patient with a severe infection arrives, enabling us to intervene with resuscitative efforts more rapidly. We also use newer, non-invasive monitoring devices to help guide treatment in complicated patients. Our sepsis metrics are well above the national average. As a trauma center, we are equipped with a helipad for medevac air transport, allowing us to treat the most critical patients quickly. We are also home to the Gagnon Children’s Emergency Department, which provides access to expert, pediatric, specialized care.
Robert Wood Johnson University Hospital, RWJBarnabas Health
By Robert Eisenstein, M.D., FACEP, Associate Professor, Chairman, Dept. of Emergency Medicine at Rutgers Robert Wood Johnson Medical School, Chief, Ambulatory Service/Div. of Emergency Care
As one of only three Level I Trauma Centers in New Jersey, an academic medical center and a state and regional leader in emergency and trauma care, Robert Wood Johnson University Hospital (RWJUH) regularly addresses the most serious illnesses and accident-related injuries in the state. Patient demand continues to grow for the emergency care, specialty services and destination therapies we offer. Our Emergency Department (ED) serves as the entry point for thousands of patients who seek these services each year. RWJUH—which currently cares for more than 90,000 emergency and trauma patients annually—is currently undergoing an expansion project to increase the ED’s size from 40,000 square feet to 60,000 square feet, allowing us to meet this demand and continue to provide the highest quality care in a more comfortable and private environment. In addition to giving us added capacity, there will be several enhancements made, including 100+ new, private treatment areas for patients; a separate, expanded Pediatric ED dedicated to children; a treatment area dedicated to patients who arrive with less emergent diagnoses; in-department radiology and CT imaging to increase efficiency and reduce wait times for test results; a new walk-in entrance; and a new ambulance bay with capacity for eight ambulances at one time.
Saint Peter’s University Hospital
By Borislav Stoev, M.D., Chair, Emergency Medicine
Saint Peter’s University Hospital completed a two-and-a-halfyear modernization and expansion of its Emergency Department in 2015. The new facility features one of the largest pediatric emergency departments in New Jersey, special treatment bays for women’s health, acute care and rapidtreatment patients, a geriatric-friendly design, and a redesigned entranceway for easier access by ambulances. The facility is 29,000 square feet in size, an increase from its previous 18,000 square feet, and can easily treat 70,000 to 75,000 patients a year. The new ED holds 56 beds, the majority in four-wall private rooms. In describing some of its special features, the acute-care bay is designed to treat emergency situations such as heart attack and stroke. The women’s health pod responds to conditions such as early pregnancy complications and OB/GYN emergencies. The rapid treatment section provides accelerated services such as IV fluids and brief imaging, enabling patients to return home quickly and safely. The facility’s softer lighting, colors, less noise, more comfortable mattresses, easier to use beds and its open layout offer greater comfort and accessibility for older patients. Saint Peter’s also enlists a fulltime child life specialist, who helps children undergo a comfortable, reassuring experience in the emergency room.