By Anne Polta, West Central Tribune, Nov 1, WILLMAR – Changes are coming to the Rice Memorial Hospital emergency department to increase safety for staff, patients and visitors.
The Willmar hospital is responding to a sharp rise over the past three years in the volume of patients with acute needs, especially substance use.
The trend began in 2014, at about the same time the use of synthetic marijuana, spice, K2 and other designer drugs became more widespread, said Dr. Ken Flowe, an emergency physician and chief medical officer at Rice.
The result has been a rising number of patients who are acutely psychotic, agitated, combative and potentially a threat to their own safety as well as the safety of those around them, he said.
A $550,000 renovation of the emergency department will help reduce some of the risk and create a safer space for those who work there, as well as those seeking care.
The changes will take the emergency room “from safe to more safe,” Flowe said. “We want to make it better. We hope it will at least decrease the distraction of worrying about your safety and the safety of others.”
Funding will come from the Rice Health Foundation, which has launched a campaign to raise the money needed for the project. About half, or $270,000, will come from the foundation’s annual gala dinner and silent auction Nov. 10.
Rice is far from alone in experiencing a rising need for safety. “It’s a statewide and nationwide problem,” Flowe said.
Emergency rooms across the U.S. are installing metal detectors, screening for weapons, adding on-site security officers and taking other measures to better manage the situations they’re dealing with.
In Minnesota, hospitals have been required since 2016 to have preparedness and incident response plans in place that address violence.
It’s a new reality for health care organizations, said Shirley Carter, executive director of the Rice Health Foundation.
“Quality care is a primary focus at Rice,” she said. “We need to adapt to the changes that are occurring in our environment.”
Mental illness and substance use made up 13 percent of 13,500 visits last year to the Rice ER, of which the largest share — and the steepest increase — was for acute episodes involving substance use.
These patients usually need immediate medical attention, Flowe said. “When they’re so high and so psychotic, their vital signs are so erratic. You’ve got to calm them down. You’ve got to keep them safe. Time is of the essence.”
If the patient is aggressive or agitated, doctors and nurses can be put in harm’s way while providing care, he said. A safety crisis with a combative patient also diverts staff from other patients in need of care and can put families and visitors at risk as well.
Situations like these “used to be pretty uncommon,” Flowe said. “Now it’s an every week thing. It’s going to be an everyday thing if this rate continues.”
In a video created for the fundraising campaign, a Rice ER nurse relates an encounter with a patient that escalated into a physical attack.
“I was hit in the head. I was hit in the shoulder. I was kicked in the leg,” she said.
Security enhancements to the ER will “help all of us feel a lot safer when we come to work,” she said.
The renovation will address four specific areas:
• Removing some walls and physical barriers to allow staff to more easily observe patients and visitors in the waiting area.
• Redesigning patient flow to reduce or eliminate contact between patients arriving at the ER and patients who are leaving.
• Relocating the hospital’s security office closer to the emergency department.
• Relocating the medication dispensing machine from the waiting area to a safer, more private area.
Construction will start sometime next year, after the Rice Health Foundation’s fundraising campaign reaches its goal.
Emergency staff had major input in identifying the needs. The hospital’s violence prevention task force also was involved, Flowe said. “It was very collaborative.”
The changes are meant to be proactive, Carter said. “By doing this, we can significantly reduce the risk of something happening. It allows us to keep our services on par with any in the metro. Staff should not have to be concerned about their lives when they’re trying to save the lives of others.”
Read the whole story at: http://www.wctrib.com/news/local/4353075-er-renovation-address-growing-safety-challenges