Before heading to the ER, residents can now access the hospital’s website homepage and check out the average door-to-bed wait time. Door-to-bed wait time is the average time a patient waits to be escorted to a bed from the time they arrive in the ER. The time is tracked using a statistical tracker system that transfers data to an RSS (Really Simple Syndication) feed. The feed automatically displays and updates the time online. Wait times reflect a rolling two-hour average and are updated every five minutes. Patients are seen in priority order based on the type and severity of their medical complaint.

“We know that every minute matters when you are ill or have a minor injury,” says Kathleen Waeckerle, RN, interim director of emergency medicine at Des Peres Hospital. “Our teams work hard to ensure that patients receive prompt attention and now our community will know just how long the average wait time to a room is before they ever leave the house.”

The technology is designed for patients with relatively minor medical conditions. Patients with potentially life-threatening health problems should call 9-1-1 so they can receive life-saving measures in the ambulance on the way to the hospital. Patients with medical emergencies, such as heart attack, stroke or traumatic injuries, are always seen immediately.

Marcus Teng, D.O., emergency medicine director at Des Peres Hospital says the technology helps patients and the hospital address one of the most common complaints about emergency departments – long wait times. “A trip to the ER is something most people never want to have to face,” says Dr. Teng. “But for patients with non-life-threatening conditions, knowing what they can expect in terms of wait time in the ER before they leave for the hospital can make their visit less stressful.”

Under the Get With The Guidelines –CAD program, patients are started on aggressive risk reduction therapies such as cholesterol-lowering drugs, aspirin, ACE inhibitors and beta-blockers in the hospital and receive smoking cessation/weight management counseling as well as referrals for cardiac rehabilitation before they are discharged. Hospitals that receive the Get With The Guidelines -CAD Gold Performance Achievement Award have demonstrated for 24 consecutive months that at least 85 percent of its eligible coronary patients (without contraindications) are discharged following the American Heart Association’s recommended treatment guidelines.

 “The American Heart Association applauds Des Peres Hospital for its success in implementing the appropriate evidence-based care and protocols to reduce the number of recurrent events and deaths in cardiovascular disease patients,” said Gregg C Fonarow, M.D., National Chairman of the Get With The Guidelines Steering Committee and Director of Ahmanson-UCLA Cardiomyopathy Center. “Des Peres Hospital has achieved a high level of performance in terms of implementing these life-prolonging treatments.”

“Des Peres Hospital is dedicated to making our cardiac unit among the best in the country.  The American Heart Association’s Get With The Guidelines program helps us improve the long-term outcomes of our cardiac patients,” said Michele Meyer, chief executive officer of Des Peres Hospital. “We are pleased to be recognized for our dedication and achievements in cardiac care.”

The American Heart Association’s Get With The Guidelines –CAD program helps hospitals increase the use of and adherence to the association’s secondary prevention guidelines for coronary artery disease. Developed to assist healthcare professionals follow proven standards and procedures before patients are discharged, Get With The Guidelines –CAD can help Des Peres Hospital reduce the risk of recurrent heart attacks and death in treated patients. The program, which works by mobilizing teams in acute care hospitals to implement American Heart Association/American College of Cardiology secondary prevention guidelines.

According to the American Heart Association, approximately 610,000 people suffer a new heart attack and 325,000 experience a recurrent heart attack each year. Statistics also show 1.26 million individuals are affected by CAD* each year.  Additionally, one in five deaths in the United States is caused by CAD.

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*CAD data was taken from 2009 AHA CHD Statistical Update

Get With The Guidelines is a quality improvement initiative that provides hospital staff with tools that follow proven evidence-based guidelines and procedures in caring for heart failure patients to prevent future hospitalizations.

Under Get With The Guidelines–Heart Failure, heart failure patients are started on aggressive risk reduction therapies such as cholesterol-lowering drugs, beta-blockers, ACE inhibitors, aspirin, diuretics, and anticoagulants in the hospital. They also receive alcohol/drug use and thyroid management counseling as well as referrals for cardiac rehabilitation before being discharged. Des Peres Hospital has successfully implemented these quality measures for (Hospital inserts number of quarters/months or days).

“The full implementation of national heart failure guideline recommended care is a critical step in preventing recurrent hospitalizations and prolonging the lives of heart failure patients,” said Gregg C Fonarow, M.D., National Chairman of the Get With The Guidelines Steering Committee and Director of Ahmanson-UCLA Cardiomyopathy Center. “The goal of the American Heart Association’s Get With The Guidelines program is to help hospitals like Des Peres Hospital implement appropriate evidence-based care and protocols that will reduce disability and the number of deaths in these patients.”

According to the American Heart Association, about 5.7 million people suffer from heart failure. Statistics also show each year more than 292,200 people will die of heart failure.

“Des Peres Hospital is dedicated to making our care for heart failure patients among the best in the country.  Implementing the American Heart Association’s Get With The Guidelines–Heart Failure program makes it easier for our professionals to improve the long-term outcome for our patients,” said Michele Meyer, chief executive officer of Des Peres Hospital.

Get With The Guidelines–Heart Failure helps Des Peres Hospital’s staff develop and implement acute and secondary prevention guideline processes. The program includes quality-improvement measures such as care maps, discharge protocols, standing orders and measurement tools. This quick and efficient use of guideline tools will enable Des Peres Hospital to improve the quality of care it provides heart failure patients, save lives and ultimately, reduce healthcare costs by lowering the recurrence of heart attacks. 

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For patients and family members, it can be confusing to try to identify the many caregivers in a hospital when everyone, including members of the general public, might be dressed in scrubs.   A study published last year in Nursing Management Magazine mentioned that patients and families want to be able to easily identify caregivers so they know who to approach with questions about their care.  Family members reported feeling embarrassed when they approached the wrong person with their questions.

To help patients quickly identify their nursing staff, the nurses of Des Peres Hospital have gotten a uniform make-over: Des Peres Hospital’s registered nurses and licensed nurse practitioners wear navy blue tops and bottoms and white or navy jackets.  Nursing support staff, including patient care technicians, monitor technicians and unit secretaries wear wine tops and bottoms and wine jackets.

“A professional appearance is essential to patient safety, hospital operation, and customer service,” said Rita Hess, chief nursing officer.  “With the new uniforms, our nursing staff will be easily identifiable by their function within the hospital.”

All inpatient nursing unit employees began wearing their new uniforms on March 1, 2010.

According to the American Academy of Otolaryngology – Head and Neck Surgery, more than 37 million Americans suffer from at least one episode of acute sinusitis each year, making it one of the most common health conditions in America.  The prevalence of sinusitis has soared in the last decade possibly due to increased pollution, urban sprawl, and increased resistance to antibiotics.

Sinuses are hollow air spaces within the bones surrounding the nose.  Sinusitis is an inflammation or infection of the membrane lining of any sinus.  Acute sinusitis, which often starts as a cold, is a short-term condition that is typically treated with antibiotics and decongestants.  When a person has frequent sinusitis, or the infection lasts three months or more, it could be chronic sinusitis.

People who suffer from chronic sinusitis may have the following symptoms for 12 weeks or more: facial pain or pressure, headache, fatigue, thick nasal discharge or discolored post-nasal drainage, loss of sense of smell or taste, difficulty breathing through the nose, bad breath, pus in the nasal cavity, and at times, fever.

When medical therapy such doesn’t provide adequate relief, surgery may be an option.  Conventional sinus surgery requires bone and tissue removal in order to open up blocked sinus passageways.  With this new minimally invasive balloon sinuplasty procedure, otolaryngologists (ear, nose and throat specialists) at Des Peres Hospital place a small, flexible balloon catheter through a nostril into the blocked sinus passageway.  The balloon is then inflated to gently restructure and open the sinus passageway, which is then irrigated, restoring normal sinus drainage and function.

Dr. Paul Burke is one of four otolaryngologists on staff at Des Peres Hospital to use this technique and has performed the procedure on more than 45 patients.

“This is a true advance in sinus care because in many cases it can be done without removing any tissue or bone,” said Dr. Burke.  “That means potentially faster recovery times and less post-procedure discomfort.  In fact, several of my patients have been able to return to normal activities within 24 hours and have had significant improvement in their symptoms.”

For a referral to an otolaryngologist at Des Peres Hospital who performs balloon sinuplasty, call toll free 1-866-334-2492.

Des Peres Hospital announced today that it has expanded its wound care services for patients with chronic or non-healing wounds associated with, among other things, infection, diabetes, pressure ulcers, trauma and peripheral vascular disease.  Any patient with a wound that has not shown significant improvement in four weeks or complete healing in eight weeks is eligible to be seen.

The Wound and Vascular Center at Des Peres Hospital provides patient access to a team of physicians in a wide range of specialties, including internal medicine, endocrinology, infectious disease, general surgery and vascular surgery.  All have a passion for and are dedicated to achieving success in wound healing for patients with chronic, non-healing wounds.  Many have been working together for 15 years.

“We promote optimum care through a team approach,” said Dr. James Knight, one of the physicians on staff.  “We treat difficult wounds, those that aren’t showing signs of healing after four weeks.  We’ve found that the earlier we begin treating, the better -- comprehensive wound care can result in earlier recovery, reduced hospitalization and prevention of prolonged or permanent disability.”

The hospital has also added several experienced nursing staff to the Wound Center, another key component of the newly expanded service.  All have specialized training and years of experience in comprehensive wound care. 

The Wound and Vascular Center is located on the third floor of Des Peres Hospital and is open Monday through Friday from 8 a.m. – 4:30 p.m.  The telephone number is 314-966-9358.

For a free brochure on the Center’s services, please call 1-888-457-5203.

Only children under age six go to the emergency department (ED) as often as adults over age 65, according to the Centers for Disease Control’s National Center for Health Statisitics (1).  In fact, nearly one in four adults 65 years and older visits the emergency department one or more times in a 12 month period (2).

 
For years, many hospitals have had separate emergency departments for kids. Now, based on some of the newer thinking in geriatric medicine (3), Des Peres Hospital is the first in the St. Louis area with special emergency rooms for the older adult patient.

“Older adults can have complicated health histories, may take multiple medications and may have functional and cognitive impairments that add a layer of complexity to the ED situation,” said Raana Ponstingl, MD, Des Peres Hospital’s emergency department medical director. 

 
Indeed, according to a study in the Journal of the American Geriatrics Society (3), the rapid triage and diagnosis model and physical set up of most emergency departments may not meet the needs of the older patient – for example, stretchers with thin mattresses increase the risk of pressure ulcers, and noise from monitors, clinical staff and other patients might contribute to communication difficulties for those with hearing impairments.

Des Peres Hospital’s geriatric emergency rooms are designed for the comfort and safety of the older patient – pressure reduction mattresses, foam heel pressure pads and elbow protection may be used for wound prevention; lighting can be adjusted when appropriate; designated rooms are located in lower traffic areas to keep noise to a minimum and create a more calming atmosphere, and warm blankets are provided as a way to make the patient comfortable.

“Our goal is to minimize the anxiety that our older patients might feel while being particularly attentive to the special care considerations that come with age,” said Deborah Wilke, RN, emergency department director.

All Des Peres Hospital emergency department nurses have been certified in geriatric emergency nursing education to ensure that they understand the normal physical and psychological effects of aging and the impact these can make on their clinical assessment of the patient. 
For example, older patients may be reluctant to report pain or may not experience pain in the same way as younger adults, so the nurses assess for changes in behavior, changes in activity level, sleeping problems or agitation.  Another example, older adult bodies metabolize medications differently than younger adults, so the ED team pays particular attention to dosages of certain medications.

  
If family caregivers accompany the patient, they are embraced and included in care as much as possible.  “Family members often are great resources for the health history of the patient,” said Wilke. “They can tell us if behaviors or issues are new or ongoing and that can help us with our assessment.”

The holistic approach to care goes beyond the ED stay:  24 – 48 hours after discharge, Des Peres Hospital emergency department nurses follow up with the patient’s physician, nursing home and/or the patient directly to determine how they are feeling and if there are any questions about their follow-up care.

The geriatric emergency rooms build on the expertise developed in Des Peres Hospital’s Acute Care for the Elderly (ACE) Unit, which opened in 2003.  The goal of the ACE unit is to minimize the adverse consequences of procedures, tests and medications on older patients, and to maintain patient function levels so that they can return home or to the same level of care as they were before they got sick.

In the ACE unit, older patients are cared for by a multidisciplinary team of nurses, physicians, including geriatricians, physical therapists, occupational therapists, pharmacists, case managers, dietitians and pastoral care staff.  Together, they conduct daily medical, behavioral, cognitive and emotional reviews of each patient to help avoid complications and assist the patient in regaining and maintaining good function.
       

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1. Health, United States 2008, tables 91 and 92 (updates)
2. Health, United States 2008, table 92 (update)
3. “The Geriatric Emergency Department,” Ula Hwang, MD, MPH; R. Sean Morrison, MD, Journal of the American Geriatrics Society, 12/4/2007.

“I did not experience any of the common signs of a heart attack,” she said.  “I had no chest pain, no arm pain and no indigestion.  I was loading my dishwasher and I bent over and just started perspiring profusely and grew very weak.  I knew something was very wrong so I called 9-1-1.” 

That call to 9-1-1 set off a chain of events that would take her from phone call to a lifesaving stent in 52 minutes, saving her heart muscle and her life.

“EMS did a wonderful job,” said Sister Lampton.

After assessing her, they transmitted her field EKG (electrocardiogram) from the ambulance directly to Des Peres Hospital’s Emergency Department for review.  As an Accredited Chest Pain Center, Des Peres Hospital has all the systems and procedures in place to assess patients and reduce time to treatment during the critical early stages of a heart attack, when treatments are most effective.  The Cardiac Cath Lab Team was alerted immediately and was waiting for Sister Lampton when the ambulance pulled up.

“As a Chest Pain Center, we know that by tightly integrating the efforts of the community, emergency responders, our emergency department and our cardiac catheterization lab, we strengthen the ‘chain of survival’ for heart attack patients and maximize their chances for recovery,” said Dr. Gary Vlahovich, the interventional cardiologist who oversaw Sister Lampton’s care.

A month after her heart attack, Sister Lampton was reunited with some of the staff who took care of her.  She was absolutely delighted to be able to thank each of them.  She is healthy and strong -- back to exercising and has really only eliminated salt from her diet.  The message she wants to get out to everyone is to call 911 as soon as you start experiencing symptoms.

According to the American Heart Association, a person experiencing a heart attack may not even be sure of what is happening.  Heart attack symptoms vary among individuals, and even a person who has had a previous heart attack may have different symptoms in a subsequent heart attack.  Although chest pain or pressure is the most common symptom of a heart attack, heart attack victims may experience a diversity of symptoms that include:

• Pain, fullness, and/or squeezing sensation of the chest
• Jaw pain, toothache, headache
• Shortness of breath
• Nausea, vomiting, and/or general epigastric (upper middle abdomen) discomfort
• Sweating
• Heartburn and/or indigestion
• Arm pain (more commonly the left arm, but may be either arm)
• Upper back pain
• General malaise (vague feeling of illness)
• No symptoms (Approximately one quarter of all heart attacks are silent, without chest pain or new symptoms.  Silent heart attacks are especially common among patients with diabetes mellitus)

 
Learn the signs, but remember this: Even if you're not sure it's a heart attack, have it checked out. Minutes matter!  Fast action can save lives — don’t wait more than five minutes to call 9-1-1.