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Frequently Asked Questions About Your Emergency Department Visit

To help you understand what to expect during an emergency department visit, we have provided answers to some commonly asked questions.

 

What is TCMC doing to address waiting times?

Waiting in an emergency room is a national problem that has dramatically worsened in the last decade. However, we at TCMC understand how difficult it is to wait when you or your loved one are ill. That is why we are constantly monitoring our times and setting goals that exceed national and community standards. Recent improvements include:

Converting 11 beds into a high acuity area to accommodate seriously injured or ill patients

Adding a 6 bed Fast Track to quickly treat less acute illnesses in a separate area

Creating a second triage station during peak hours.

Initiating standing orders in triage to begin tests that are routinely ordered for specific complaints. We value your time and don’t want any time you spend in the waiting room to be “wasted.”



Why do I have to wait for treatment in the emergency department?

People wait in the emergency department for many reasons.  Some of these include:

Waiting while the sickest patients are seen first(except when triaged to the Fast Track).

Overcrowding due to epidemics such as the flu or ambulance diversions from neighboring hospitals.

Unlike a doctor’s office where appointments are scheduled, many emergency patients may arrive at once.

Waiting for radiology and laboratory results. Some of the most modern studies require more time than prior tests did.

Tri-City serves a large number of elderly patients, who often have complex illnesses requiring more tests and frequent admissions.

Waiting for consultations from specialist physicians.

Shortages of inpatient beds in the hospital, resulting in patients remaining longer than expected in the emergency department. This practice is known as “boarding” and has been identified by a national task force as the number one reason for overcrowding in emergency rooms.

Tri-City is the second busiest Emergency Department in San Diego county.  We treat approximately 70,000 patients each year.

 

How long can I expect to be in the emergency department?

The very best care takes time.  A triage nurse will grade your condition by severity.  Patients with life-threatening conditions such as a stroke or heart attack are seen first.

Once in the treatment area, your total stay may depend on your symptoms, illness and whether you have to be admitted to the hospital. Also, if the emergency physician consults with a specialist or you have special tests ordered, your stay may be longer.

The time of day and the day of the week may also determine how busy the emergency department is.  Typically, the emergency department is busiest between 3pm and 11 pm.  Weekends and Mondays are usually the busiest days of the week.

 

Why do some patients get seen before others?

We must care for critical patients with life-threatening conditions first.  If you have a less severe illness or injury, you may have to wait while sicker or more severely injured patients are seen first. However, we recently opened a new Fast Track area designed to accommodate only minor illnesses and injuries. Patients triaged to the Fast Track are the exception to the rule of sicker patients being seen first.

 

What is triage?

You may hear the word triage (pronounced “tree-ahj) when you enter the emergency department.  The triage process determines who needs to be seen first.  A triage nurse will determine the severity of a patient’s condition, based on symptoms.  In addition, when a patient first comes to the emergency department, personal and medical history information will be obtained, and vital signs will be checked, including temperature, heart rate and blood pressure. Just because someone else is seen first doesn’t mean you aren’t ill, it just means that they may have a condition that may be more life threatening.

 

Do prolonged waiting times affect treatment outcomes?

Our emergency staff works very hard to make sure no one waits so long it will affect the severity of illness or injury. We don’t want our patients to wait for one minute, but at times, patients wait longer than we would like. We are committed to ensuring that seriously ill patients are seen immediately and that all patients are treated as quickly as possible.

 

Why am I waiting when the waiting room doesn’t seem crowded?

An empty waiting room doesn’t mean that the emergency department is not busy assisting patients. TCMC serves some of the oldest and most acutely ill patients in the county, and most of those patients arrive by ambulance. They enter the emergency department through a different entrance.  Also, because our emergency department is a designated stroke and heart attack center, we often are taking care of patients that draw upon extensive resources in order to maximize their care.

 

How long does it take to get laboratory and radiology results?

To accurately diagnose your condition, we need time to review any lab and radiology tests.  Most laboratory tests take 1-2 hours. CT scans and MRI’s take a few hours, while routine xrays generally take less than an hour, depending on the specific circumstance.

 

Why shouldn’t I eat or drink before being seen by a doctor?

Some tests and procedures require that you have an empty stomach. Eating or drinking something prior to being seen by a doctor may limit your doctor’s ability to perform that test or procedure safely.

 

Who will be caring for me?

As a patient in the emergency department, you will be cared for by a team of highly skilled professionals.  These include the following:

A Board Certified Emergency Physician(M.D. or D.O.) has overall responsibility for your care.  Our doctors are all specialists in the field of emergency medicine. Based on their assessment, they will order the appropriate studies and treatments. They may at times obtain consultations from subspecialists necessary to complete your care. An Emergency Medicine Resident or physician assistant(P.A.) may also evaluate you under the direct supervision of one of our Board Certified physicians.

A registered nurse (R.N.) will assess and monitor your physical condition, give you your medication, and keep you and your family informed of any tests and procedures.  Your nurse will also provide you with important discharge information before you go home.  Each nurse is responsible for several patients and works very closely with your doctor to provide the best care possible for you.

A scribe will accompany your doctor and enter your history and examination into your electronic medical record. This maximizes efficiency, improves accuracy, but most importantly, allows your doctor to devote more time to you.

Other department technicians may work with you, your nurse, and doctor.  They include emergency medical technicians, EKG,  radiology, laboratory, and respiratory technicians, all trained to perform specialized functions.

 

Can my family visit me in the treatment area?

Two family members are allowed to wait with you in your treatment room.  They must stay at your bedside.  If the emergency department becomes full, or if a caregiver feels that you need privacy, your family members may be asked to return to the waiting area.

 

Our goal is to provide each patient with emergency medical care of the highest quality.  If you are dissatisfied with the care you receive at any time during your stay, please inform your nurse, doctor, or shift supervisor before you leave so that we can address those concerns immediately.

We also encourage you to recognize any of our staff members who may have gone above and beyond in delivering your care. Please ask a staff member for a comment card.

Additionally, you may be chosen to participate in a phone survey about your emergency department experience. This information is very helpful to continuously improve the health of those we are privileged to care for and serve.

 

Tri-City Medical Center Emergency Department

41 bed emergency department


Team Triage Area to treat minor problems efficiently

Joint Commission Designated Primary Stroke Center(Gold Seal)

San Diego County Designated STEMI Receiving center (advanced heart attack center)

High resolution 64 slice CT scanner

2 state of the art, fully digitalized cardiac catheterization laboratories for heart attack care

Only emergency physicians certified by the American Board of Emergency Medicine with specialized training in adult and pediatric emergency medicine

Fully integrated electronic medical record

Computerized Physician Order Entry to help eliminate  medication order errors

Order Caresets create efficiency, eliminate errors, and ensure that your care is based on nationally recognized best practices

Bedside registration

Digital imaging technology

If you should have any questions about our emergency department capabilities, please ask. We’ll be more than happy to answer your questions.