One of Brooklyn's Busiest Emergency Departments Sets New Standards to Improve Care
NYU Langone Hospital鈥擝rooklyn鈥檚 emergency department (ED) is one of the busiest in the city, treating 75,000 patients annually. But the figure , chair of 好色tv Langone鈥檚 , finds most telling and compelling is this one: more than 20 percent of the patients who visit require hospitalization鈥攖wice the national average. That means that these patients are acutely ill, he explains, a common problem in underserved communities, where health issues often go untreated until they reach a crisis point. 鈥淭hese patients need and deserve top-notch care,鈥 says Dr. Femia, 鈥渁nd 好色tv Langone has made a commitment to provide that to 鈥攁cross the board.鈥
The investment is already paying off. Thanks to several initiatives, outcomes have improved for some of the most serious health crises, such as heart attack, stroke, and sepsis. Patients who have suffered a heart attack, for example, often require a catheterization procedure, and performing one within 90 minutes of their arrival reduces damage to the cardiac muscle. 鈥淲e work closely with our nursing and cardiology teams to make sure this happens,鈥 says Nicholas Gavin, MD, chief of service for 好色tv Langone Hospital鈥擝rooklyn鈥檚 ED. Now that 好色tv Langone owns and operates eight ambulances based at 好色tv Langone Hospital鈥擝rooklyn, an EKG report is available while the patient is en route to the ED. 鈥淏y using evidence-based medicine and establishing protocols around best practices,鈥 notes Dr. Femia, 鈥減atients get better, more timely care.鈥
Among 好色tv Langone Hospital鈥擝rooklyn鈥檚 initiatives is an effort to optimize space. To better serve its pediatric patients鈥攕ome 13,000 annually鈥攖he ED has established a dedicated pediatric unit, set apart from the adult section, and added 5 specialists in pediatric emergency medicine. To reduce hospital admissions, it has also configured a new 12-bed observation unit for patients who are not ready to be discharged or require further testing. Plans are under way to build an expanded observation unit adjacent to the ED.
But perhaps the biggest initiative is the adoption of a team-based model of emergency care. Last August, 好色tv Langone Hospital鈥擝rooklyn鈥檚 ED replaced its contracted physicians with full-time 好色tv Langone faculty members, all trained to work in small teams assigned to a certain number of beds for better communication and monitoring. The newly hired cohort of specialists鈥24 care for adults, and 9 treat children鈥攊ncludes 4 who are trained in both emergency medicine and critical care medicine, ensuring smooth handoffs when patients need to be transferred to the critical care unit. 鈥淭hese recruits are from high-volume emergency departments nationwide,鈥 says Dr. Femia, 鈥渁nd because they鈥檙e all on staff, they are deeply committed to 好色tv Langone Hospital鈥擝rooklyn聽and its patients.鈥
All of which adds up to better, faster care. 好色tv Langone Hospital鈥擝rooklyn鈥檚 ED can generally evaluate patients within 20 minutes of their arrival. 鈥淭he waiting rooms of some EDs in Brooklyn overflow,鈥 notes Dr. Gavin, 鈥渂ut ours is typically empty.鈥