They’re there for when the situation is critical. For when time is of the essence. For possibly the most intense moments anyone will ever spend in a hospital, after something unexpected and possibly life-threatening has occurred.

They’re also your neighbors.

That’s why the doctors, nurses, and everyone staffing the emergency room at Lake Cumberland Regional Hospital pour so much of themselves into providing the best, swiftest care they’re able — and take such pride and enjoyment in what they do.

“You deal not only with the patient, you deal with the family,” said Dr. Mel Medroso, a long-time member of the medical community in Somerset — he has been with the hospital since it arrived in the 1970s. “Explaining to them what’s wrong with the patient, especially in a very hard situation, that’s probably the hardest part (of the job). But at the same time, it’s also probably the most rewarding, because you have the family thanking you for what you have done.”

And there’s a lot more to be thankful for these days. Great strides have been made in the last year to improve quality of service in the emergency room. The first phase of the ER project — the new, expanded waiting room, walk-in and ambulance entrances, 24-hour staffed greeting station, three nurses stations, triage rooms and a private consultation room, all new construction — was completed in December 2004, while the remainder was ready by January 2006. The total cost of the project: $2.5 million

In addition to a makeover both aesthetic and practical in nature — a boost from 12 rooms to 23, a bed-tracking system to check availability, helicopter service, and going from four quick-care beds to having all beds emergency-room-ready, key among those changes, as well as limited security clearance for visitors of patients so too many people aren’t in the way — that old nemesis time has been taken on as well. As a result, LCRH has offered a 30-minute guarantee as of April of 2006 — either you see a physician or treatment begins in a half hour’s time, or the hospital will give you something in return, such as a gift card to an area business or movie tickets.

It’s not just a gimmick — it’s worked. According to LCRH, the average wait time to see a patient in the emergency room in 2006 was just over 27 minutes — down significantly from 56 minutes the previous year and 53 minutes in 2004. At the same time, the number of patients seen has gone up.

“Our patient satisfaction survey is way up from what it was last year,” said Roslyn Allison, R.N., the ER director. “Our times have been cut way down from what they were before.”

But just as in any effective business, the most important dimension involves the people. Thanks to the formation in early 2006 of the Elite Health Group, doctors and nurses alike have formed a cooperative symbiosis that allows for more efficient care of patients. Utilizing nine full-time doctors in a local core with the medical staff there in the LCRH emergency room, the Elite Health Group holds monthly meetings, to allow for regular discussion and quick resolution of problems — and a sense of teamwork.

“We have a president, we make our own schedule, we do our own billing, (and) any complaints have always been taken care of because we have a monthly meeting,” said Medroso.

“When we get into a (hectic) situation, if I can see that my patients are stacking up, I can feel free to call any of these physicians and say ‘Hey, come in’ and they’re right here within 10 to 15 minutes, and we’ll have the situation under control,” added Allison. “They come in because they care about the community. That makes a major difference. We’ve seen 1,400 patients in two weeks, so you know they’re busy.”

For Medroso and fellow Dr. Bernard Williams, that last point cannot be overstated.

“One of the things that we set out to do with the new group was to get a sense of ownership — the fact that we are part of the community,” said Williams. “We live here. We always want a good outcome for our patients because we have to look at people in the grocery store. We have to stand in line with people at Wal-Mart. Some of the previous regimes where people didn’t live in the community, they didn’t seem to care as much as the doctors that we currently have working here.”

“For many years, we were managed by groups from outside of Kentucky,” Medroso chimed in.

“This is the first time really that we have a local group where everyone lives around the city here, everyone is proud about the ER and everyone works hard.”

The unique aspect of working in the emergency room is the wide spectrum of ailments those medical professionals have to treat.

“You see all types of patients — you see pediatrics, you see geriatrics, you see trauma, you see general medicine. It’s just a wide variety,” observed Williams. “This hospital probably has as wide a variety of illnesses as you would see in any big city hospital. There’s quite a pathology around the county — we get to see it all. It’s rarely boring around here.”

And all these problems have to be treated as quickly as possible. Medroso pointed to technological advancements such as faster, more efficient lab instruments eliminating the need to walk specimens to and from the laboratory and x-ray machines that forego film for digital imaging right on the computer as just part of the process for speeding up service

In fact, x-rays have their own new room with state-of-the-art Proteus equipment, focusing on patients with emergency needs. The table is equipped to hold patients up to 400 pounds in weight.

If the patient’s conditon is not severe enough to warrant immediate attention, he or she will see a triage nurse who determines the priority of patient conditions and the order to be seen by the physician – based on the severity of each patient’s condition. Standing orders for X-Rays and blood work are implemented for some patients, based on their probable diagnosis, prior to taking them back to ER to help eliminate wait time. After triage and/or standing order implementation patients are taken back to the emergency room and are seen by physician in order of severity of condition.

Want high-tech care? You’ve got it. The Patient Tracker is a system that assigns a time format to each test ordered by the physician from ancillary departments such as Lab, Radiology, and Respiratory Therapy, utilizing color to denote status. A red light means time for the test is up, helping things run smoother. And the PACS (Picture Archive and Communication System) provides for the electronic exchange of images from the imaging equipment to the radiologist and to the referring physician. In other words, what Dr. Medroso mentioned — seeing the x-rays images immediately.

The exciting new features don’t stop there. Among the 23 treatment rooms, four apiece serve cardiac and trauma concerns, one each for obstetrics and behavioral health, and 13 are assessment and treatment rooms — two being isolation rooms with provate baths.

As always, however, it comes back to one very important x-factor — the human factor.

“I think we’re all adrenaline junkies here,” said Allison. “It takes a special type of person to be an ER physician or an ER nurse. You either want to be or you don’t want to be, because there’s definitely disappointment, lives that are lost. However, there are also great outcomes that make you very happy to see that person a year down the road and see how they’re doing. That’s part of being a caregiver and that’s why we chose to be medical people.”

And why more people are choosing Lake Cumberland Regional Hospital’s emergency room. n

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