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Bon Secours Memorial Regional Medical Center 1

  • Part of Bon Secours
  • 255 Bed, Community Hospital
  • 74,000 Annual Visit ED
  • 49 Bed ED (main side, fast track, hallway)
    • 33 private, monitored, Main Side rooms
    • 8 private, monitored, Fast Track rooms
    • 8, monitoring capable, Hallway beds
    • ED last renovated in 2003.
  • APPs work both on the Main Side and Fast Track
  • 100% Scribe coverage for both EMPs and APPs
  • 8% of ED population is PEDs
  • 15% admission rate (combined true hospital admits and observation admits)
  • Hospitalists admit 85% of the admitted patients in the hospital.
  • EPIC EMR System
  • VCU EM Residents rotate through the ED as part of their community ED rotation
  • ED Director sits on the Medical Executive Committee
  • US Machines in the ED
    • Currently doing procedural and screening diagnostic scans – not billing for ED ultrasounds at this point.
    • US Director on staff
  • PACS radiology film reading on site
  • Sedation Agents used: Propofal, Versed, Ketamine, Etomidate
  • RN to Patient Ratio: 4 RNs to 8 beds (peak); 3 RNs to 8 beds (low)
  • Splinting done by EMPs and RNs
  • 3 CT machines located in the ED
  • Plain Film Suite in the ED
  • Designated a Primary Stroke Center
    • TPA given with in-house neurology.
    • Receiving hospital for stroke patients
  • STEMI Center
    • 3 In-House Interventional Cath Labs
    • Receiving hospital for STEMI patients
    • 95% complaint less than 90 minutes
  • RN to Patient Ratio: 1:4
  • Tech to RN Ratio: 1:2
  • Splinting is done by the Physicians (for billing purposes)
  • 24/7 In-House Coverage for the following:
    • Psych Social Workers
      • EMPs medically clear pts, they finalize everything and find placement
      • No in-house psych beds
    • Radiology – 24/7 in-house real-time reads for all scans
    • CT
    • Ultrasound
    • MRI
    • Hospitalist
    • Anesthesiology
    • ICU
      • 45 bed ICU
    • NICU
    • OB-GYN
    • Neurosurgery
    • Neurology
    • Opthomology
    • Ortho
    • Oncology
    • Laparoscopic Surg.
    • General Surgery
    • Urology
    • Hand Surgery
    • Spine Surgery
    • Thoracic Surgery
    • Gastro
    • Vascular Surgery
    • Pulmonology
    • Nephrology
    • Colon-Rectal Surgery
  • On-Call only:
    • Opthomology (24/7)
    • Plastics (8a-5p)
    • Cardiology (24/7)
    • Oral/Facial Surgery (24/7)
    • Cardiothoracic Surgery (24/7)
    • ENT (24/7)
  • Currently Lacking:
    • Pediatrics (no in-house PEDs unit)
      • PED admits are sent to St. Mary’s
    • PICU
    • Trauma
  • Good Lab Turnaround times
  • Point-of-Care Labs in the ED:
    • Chem Eight
    • Creatinine
    • Lactate
    • BNP
    • Hemocult
    • Gastrocult
  • Glidescope in the ED
  • Booje in the ED
  • RN Protocals used in Triage
  • Provider in Triage (APP)
    • Enables door to provider times of less than 1 minute

Also have direct-to-bed policy, which bypasses Triage if beds are available (10a-10p)

Patient Population:

  • English spoken by 99.9% of patients
  • Suburban Richmond patient population
  • 50/50 white/black patient population
  • Middle and upper middle class