“The doctor will see you now…”
Parma Hospital’s Emergency Department
puts doctors on the front line of care

The potentially stressful experience of going to an Emergency Department is eased at Parma Community General Hospital by the advent of Doc at the Door, where a physician assessment occurs within approximately 30 minutes of the patient’s arrival.

Under a new process known as Doc at the Door, the physician makes a preliminary diagnosis and can order testing before the patient is even brought back into an ED patient room. The physician heads a team, including a nurse, paramedic and technician, that can perform EKGs, draw blood and start IVs. Parma Hospital is the first hospital in the Cleveland area to handle ED patients – including those that arrive by ambulance – with this efficient new approach, says Jesse DiRando, MD, chairman, Department of Emergency Medicine.

“Doc at the Door speeds the completion of diagnostic studies,” says Dr. DiRando. “In less urgent cases, patients are discharged directly home by the triage physician, eliminating the need to be placed in a patient bed.”

Hospitals from as far away as Connecticut, Oklahoma, North Carolina and Hawaii have traveled to Parma Hospital to study and learn from the success of Parma Hospital’s program that puts physicians on the front line of care. Physician in Triage was introduced in the Hospital’s ED nearly two years ago and expanded recently to be available from noon to 10 p.m. everyday, including weekends. The ED recently completed renovation to remove registration areas off the waiting room and replace them with more private triage rooms. Since patients are registered at the bedside, separate registration suites are no longer needed.

“We put the whole team at the front door to support patient needs, making the delivery of care quicker and more efficient,” says Dawn Beljin RN, director of Emergency Services.

The success of Physician in Triage is evident in the Hospital’s recent Press Ganey patient satisfaction scores, which are in the 90th percentile for the past three months. In that same period, compared to other hospitals across the nation with more than 40,000 patient visits per year, Parma Hospital has averaged:

• Approximately 30 minutes from the time the patient walks in the door (or arrives by ambulance) and is evaluated by an ED doctor. The national average is over 60 minutes.
• A dramatically reduced length of stay, much less than the national average.

“We beat all national benchmarks,” says Dr. DiRando. “These are key indicators of patient satisfaction, department efficiency and patient safety with risk management. I’ve had patients tell me that they pass by other hospitals just to come here for our services.”

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