How does the emergency department determine when patients are seen?

An emergency department can be a scary place. There’s something wrong with you and you may or may not know what’s going on. Things may seem chaotic, but emergency department professionals are following a well-tested plan.

Unfortunately, a trip to the emergency room isn’t always a quick process. And most importantly, an ED does not work on a first come, first serve basis.

At St. Joseph’s/Candler, more than 100,000 people visit the two hospitals’ emergency departments in a year, with a daily average between 100 to 170 visitors, says Chris Fortin, St. Joseph’s Hospital Emergency Department staff nurse. St. Joseph’s/Candler never refuses treatment for a patient, and it is the goal of both emergency departments to see patients in a timely manner, Fortin says.

“We have a wonderful staff that wants to take care of everybody that comes in as quickly as we can,” Fortin says. “It frustrates us just as much as it frustrates them to have to wait. We don’t want people to wait for their care but sometimes it is something that can’t be controlled. It’s something we work hard at on a daily basis to prevent.”

What is triage?

St. Joseph’s/Candler’s emergency departments follow a triage process. Triage is the process of determining the priority of a patient’s treatment based on the severity of his or her condition. Specially trained nurses sort emergencies based on their condition, Fortin explains. Patients are sorted by an acuity system of rankings 1 to 5 with 1 being someone who isn’t breathing or doesn’t have a heart rate to 5 being someone who just came in for a prescription.

A number is assigned based on the patient’s symptoms, vital signs, and medical history. Those three sources of information paint a picture for the nurse to assign a level 1 through 5; however, Fortin says 1s and 5s are easy to determine, it’s figuring out other acuity levels that sometimes can be difficult. He encourages all visitors to the emergency department to be honest about all their symptoms and medical history, even if a question seems silly.

Patients are then seen as beds become available based on their number. If all acuities are the same, Fortin says the emergency department takes the patient that’s been waiting the longest.

 “We definitely try to sympathize with their frustration,” Fortin says. “We’ve all been there. We’ve all had times we’ve had to wait when we felt it wasn’t fair. But we realize that as a visitor, we don’t know what is going on in the treatment area in the back and how many patients are being seen that are in much worse shape than we are. Ultimately, we want to get patients in and out as quickly as possible. So we try to reassure all our patients that they are in the right place, and we are doing our best to get them home and comfortable as soon as possible.”

While there’s no true way to speed up your time spent in an emergency department, it is important to come to the ED for emergencies and be upfront about all your symptoms and medical history. Not sure if you should go to the emergency department or urgent care? Fortin offers advice on that. 

Did you know?

Currently, the Candler Emergency Department has 39 beds, divided into three separate areas. The first area is split into two parts – ED 1 and ED 2. ED 1 is 11 beds and ED 2 is 10 beds and serve the majority of ED visitors from the very severe to the common cold. The second area is the treatment area, which includes 7 beds. This area is for primary care type of complaints. The final area is the disposition unit, which is 11 beds. This unit serves as an internal waiting room. For example, if someone is waiting for a test result or fluids to finish infusing before going home, they will typically wait in the disposition unit before being discharged.

The newly renovated St. Joseph’s Emergency Department opened in January. The new construction expanded the ED by 14,815 square feet. When the second phase of renovations are complete this summer, there will be 32 ED rooms, including six fast-track treatment rooms for lower acuity patients.  There’s also an operational CT scan and X-Ray room inside the ED.