Brian Gallagher builds a second Emergency Department

The pandemic has hit facilities hard in Native American communities, including those we serve. Our Chief Clinical Officer, Brian Gallagher, serves one Arizona hospital that’s been swamped with COVID-19 patients. While other hospitals typically deal with high demand by transferring patients to another facility, this reservation is the size of Connecticut – and transporting patients can take hours. Another factor are the crowded local residences. One household might have 14 members, which means diagnosing and controlling infection is critical.

Brian and his team came up with several solutions. One was converting a local community center into a ward for COVID-19 patients, helping contain household infections. Next they developed a second emergency department. Launching April 1, 2020, the new emergency department was designated “the Red Unit” for COVID-19 and other infectious patients. The new ER had 8 beds, with 1 negative pressure room.

The old unit was designated as “the Blue Unit” for non-infectious patients. Outside both units, a nurse triaged all patients. Testing occurred in another isolated area.

“Patients who need to get tested may not want to go into the COVID-19 unit so they go into a designated room for swabbing and testing,” explained Brian Gallagher, Chief Clinical Officer.  Another effective infection control: “They put up plexiglass so radiology techs can take x-rays through it without entering the infectious ward, which maximized infection control.”

The benefits were immediate. Providers weren’t traveling between wards, which kept both patients and providers safer. In fact, the concept was so successful that the hospital has designed a mobile ER unit for infectious patients. The trailer unit is equipped with two beds, telemetry, oxygen, computers, and other technology.

Impressively, despite the crush of COVID-19 patients, the facility has managed to drive better efficiencies across the emergency department. In addition to increasing the acuity of the patients being treated, some metric improvements include:

  • Discharge time improved to 100 minutes (National standard of care:120 minutes)
  • Door to Triage Time has been 4 minutes or less (National standard of care: 10 minutes)
    • Door to Provider Time has been shorter than 10 minutes most months (National standard of care: 30 minutes)
    • Left Without Being Seen Time is 0.5% or less since April of 2020 (National standard of care is under 2%)

Also impressive: 0 provider infections despite the high rates of COVID in the community.

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