2/15/2012 – New

William Adams, MD

ED Department Chair William Adams, MD, sat down with Progress Notes' managing editor Roxanne Bolinger on February 2 to discuss goals and challenges for the Emergency Dept. at LGH.

What is your practice location, work history?

I came to LG Health in 1992 straight from my residency at Geisinger Medical Center.

Why are you interested in assuming the Department Chair role?

Moving to Department Chair was a natural evolution from my role as medical director for the last five years. The structure will not be much different from what we had in the past, since we had an established dyad of medical director and administrator.  In my situation Carla Leed, Administrative Director Trauma and Emergency Services, has been my administrative partner and she is an excellent resource and driving force for improvement.

Do you envision establishing any divisions in your department?

There are opportunities to look at different divisions or subspecialties of emergency medicine but I am not sure if there would be formal divisions in pediatric and geriatrics, for instance. We now have an associate medical director over EMS, which is in sense a division by itself.

What are your goals for the department over the next one to three years?

One of our most important department goals is reducing length of stay (LOS). To do this as a department we want to make sure we have good throughput, from the time of arrival to time of departure from the department both for discharge and admitted patients.

One of the limitations we have is the physical space we are in now. During the last renovation in April 2004 we designed space to handle 90,000 visits a year but this has now ballooned to 108,000 visits.  The reason for the growth is twofold—we have captured more market share and there has been a nationwide trend of increased ED visits.

With the restricted space and without good LOS rates it is difficult to meet the needs of customers.  That has led to ambulance diversions in the past, which is not acceptable for our patients. We are working at refining our efficiencies so we can meet an internal goal of no diversion. The last time we diverted was over a year ago.  We have partnered with radiology and laboratory services in an effort to reduce the turn around time for results which has a direct impact on our ability to reduce the length of stay for many of our patients. Our department appreciates the hard work of these departments.

Another key goal is to increase our patient's "likelihood to recommend" score in Press Ganey from 62.2% to 63.2%.  We just renamed the Press Ganey Committee as "Customer Care Committee."  The dedicated committee, working with physician liaison John Leisey, MD, came up with improved scripting to use with patients. We are changing the focus back to customers, who deserve an experience you would want your family to have.

Falls reduction is another goal.  We have "falls champions," mostly nursing and patient care assistants, who are trying to increase staff education.  The goal is to reduce falls 5% from 53 to 50 falls a year.

A new initiative that physicians will be involved directly with is a new No Pass Policy. Kicking off on Valentine's Day with the slogan "Love your Patient," the No Pass Policy urges anyone – including physicians -- who passes a patient's room that has a bell going off to address the call bell. We don't expect everyone will be able to resolve every issue, but at least the patient's needs will be promptly addressed.

What opportunity do you see for medical staff with regards to restructuring and the increased responsibilities for the Department Chairs?

The biggest opportunity is dedicated time to permit collaboration among others.  Department Chairs will have dedicated time available time to do administrative functions.  Once all the Department Chairs are fully in place, we will then arrange for a schedule of available open times.

What challenges do you foresee in your dept. area?

The biggest challenges are space, patient volume and delays in patients going to admitted beds. That makes all the goals harder to achieve.

What is the best way for dept. members to reach you?

Email me at WHAdams@lghealth.org or contact my secretary Maritza Dagen at MADagen@lghealth.org or 544-4978.

Anything else you would like to add?

I am excited with the opportunity to work with other Department Chairs to improve patient care and throughput throughout the institution.