More patients are arriving at Sentara by ambulance, and most need immediate help

We stopped by the emergency department at Sentara Northern Virginia Medical Center where we learned that not only is hospital seeing an influx of patients with severe flu, doctors are also seeing sicker patients overall.

Sentara Northern Virginia Medical Center Emergency Department Director Adam Brown:

“I have been here since 2014, and so I’m even in the relatively short time that I’ve been here. I have seen a pretty dramatic change in the way that patients are flowing into the emergency department…

The biggest change that we’re seeing those we are seeing that patients are going to their primary care physicians sometimes urgent care facilities before coming to the emergency departments which from a public health perspective that’s a really good thing and that’s a goal is for those patients to go to the appropriate place.

As a result of that, however, we have seen a sicker population coming into our emergency department. And so both Lake Ridge and here in Northern Virginia, we are seeing the acuity level —
that’s the medical terminology for the level of sickness or illness of the patient coming into the emergency department– a higher number of ambulance visits into our [emergency department].

So big portion of our patients anywhere between 25 and 35 percent on any given day of our patients arrive by ambulance. And unlike years past when sometimes the ambulance ride was used for not the most emergent or urgent type of condition, we rarely have a patient come in by ambulance that does not require some type of immediate treatment.

So the point being here is that over the past two to three years, despite the fact that we may not be seeing a huge rise in the number of volume within the emergency department, we’re seeing a definite sicker patient population that’s coming in.

We called Patient First, a regional provider of urgent care, which told us

“One of Patient First’s primary roles in the healthcare landscape is to diagnose and treat patients who have urgent but non-life-threatening conditions.  This helps reduce unnecessary ER visits, freeing up ERs to focus on true emergencies.  However, if a patient presents with a true emergency or should an emergency occur at Patient First, our role is to identify the need for emergency care and to stabilize the patient for transfer to the hospital.  This is something that does happen, and we prepare for it.  We provide our staff with continuing training for these types of situations, including advanced cardiac life support (ACLS) and pediatric advanced life support (PALS) training. 

Of course, anyone experiencing a life-threatening emergency should immediately call 9-1-1 or go straight to the nearest emergency department. 

We make it a point to work closely and collaboratively with our neighboring healthcare delivery sites.  We keep an open line of communication with health systems and ERs, primary care providers, and specialists as part of the same healthcare delivery landscape.”

This rise in the number of patients who need more urgent care comes as the hospital remodeled its emergency department. Work on the eight-month project to revamp the emergency room has just been completed.

Brown tell us:

“We started about two-and-a-half years ago on this journey of designing a new emergency department to be, really, an opportunity for patients to come and get seen very quickly and be placed in the appropriate location even within the emergency department depending on the severity of their illness.

We did not increase the bed size of the community or the emergency department. We didn’t change the number of beds that we have available. But what we did do is… we changed the design of how we would take patients and where we would place them in the emergency department.

So now we have actual doctor rooms on the front end of the emergency department and you come in the door so that you can see a nurse and a physician or a nurse practitioner or a physician assistant early on if there’s any delay or any wait.

We also have a section of our department to take care of patients that have less urgent or less severe type of illnesses like cuts lacerations ankle sprains etc., even some more severe things like abdominal pain.

We have an area the emergency department for that we also have an area for observation in short stays within our emergency departments. If he were to come in with chest discomfort or chest pain instead of having to be admitted to the hospital, we’re able to place you in the emergency department under the watchful eye of an emergency physician to ensure that everything is fine with your heart.

But the biggest difference that most patients will notice is that we have a brand new nurses station and physicians station right in the middle of the emergency department to be able to address the needs of the patients much more easily and to address the needs of the employees.

Having that area with great eyesight and visual lines of sight with our patients is important for safety reasons. But also it allows us to be much more efficient in our department when we’re working with our patients.”

Sentara Northern Virginia Medical Center recently turned 45 years old. It is the largest outpost of the Sentara organization, which has its most substantial presence in Hampton Roads.