Pointe Coupee General Hospital Improves Emergency Services

January 2013
National Rural Health Resource Center (The Center)

In 2004, Pointe Coupee General Hospital (PCGH) was designated a critical access hospital (CAH). The hospital has twenty-five inpatient beds for acute and skilled care which includes a six-bed telemetry unit. PCGH provides outpatient (OP) services such as ED, Lab, routine radiology, CT, Ultra Sound, Mobile MRI, Mammography, GI scope, Ophthalmology and other minor OP procedures as well as therapy services (PT, OT, SLP and RT) and OP Infusion Therapy. The ED was last renovated in 1996 and a large percent of the inpatient unit was recently renovated and has a wonderful inviting feel to it.

Chad Olinde, Chief Executive Officer of Pointe Coupee General Hospital in New Roads, LA wanted to further PCGH's success by improving their emergency services. The goal was to work with the director of nursing/assistant administrator, ED nursing manager and all department managers involved in ED processes, from patient registration to billing for the services, to determine opportunities for improvement in patient flow, coding and billing process, staffing, ED utilization, and patient satisfaction survey process.

Olinde shared the following information about their emergency services project with RHPI.

Q: Why did you choose to focus on emergency services for your RHPI project?

A: Administration felt that we could improve on the efficiency of our outpatient and ER operations. We knew that we needed to reduce the average elapsed time from registration to completion of outpatient tests and procedures. In addition, our ER and outpatient areas shared registration areas causing patient confusion. We knew that we needed structural changes to alleviate this and insure full compliance with HIPAA rules. Finally, we wanted to change our use of observation status for ED patients.

Q: What is your hospital's current status with regard to implementing the recommendations made during this project?

A: We have completed most of the initiatives that were identified through the review process. The ER / Outpatient waiting room was divided into separate units allowing for better patient flow. New signage was included to direct patients toward the appropriate area. An automated registration process was initiated providing a more professional experience. Patients can easily be tracked as they progress through the system. We were able to revamp our procedures for use of observation status.

Q: What were the expected outcomes of this project? Has your hospital been able to document any of these outcomes?

A: The flow of outpatients from registration through completion of the outpatient procedure has become much more efficient as we had hoped. Complaints concerning Lab wait times have virtually disappeared. In addition, we have received many compliments on the new networked registration system. It appears that the improvement in efficiency has resulted in a volume increase in the Emergency Department. ED visits in 2012 were 7% higher than in 2011.

Q: What are the expected next steps towards adopting your consultants' recommendations? Is there a sustainability plan?

A: The review identified that chargemaster updates were necessary. We have made many updates in this area and plan to continue to review this area on an ongoing basis.

Q: Is there anything your hospital would do differently if you were able to repeat this experience?

A: I can't think of anything we would do differently. Mary Guyot of Stroudwater Associates, provided excellent leadership through the entire project. She guided us though the process of identifying the areas of concern, brainstorming possible improvements, deciding on the appropriate steps and finally implementing the needed improvements.