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Shelton Mason County Journal
Shelton, Washington
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Mason County Journal
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May 22, 2014     Shelton Mason County Journal
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May 22, 2014
 

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Thursday, May 22, 2014 - Mason County Journal - Page A-15 "A primary care doctor thinks about the most likely diagnosis. As an emergency doctor, I think about the most dangerous diagnosis. I don't really care about the things that don't kill people. I'm here to deal with the things that do kill people." II or a CT scan. The child was stabi- e, suffered head injury and multiple 1:42 a.m. Dr. Andrea Plaskiewicz (left) and nurse Staci Lorton review a CT scan of a seriously injured 2-month-old baby as staff care for the infant in the diagnostic imaging room. (Note: This photo was slightly modified to remove the name of the patient on the computer screen). , r TIMES ARE LOWER THAN ANYWHERE IN WESTERN WASHINGTON." cause it's not just a room," he said. The department consists of doctors and nurses like any other, but works closely with diagnostic imaging, laboratory and other de- partments. "It literally takes the entire facility," Gushee said. Before the remodeling, the ED had eight patient rooms, many of them too small to meet hospital building codes, Gushee said. Now, the ED has 13 rooms for patients, sev- eral of which are specialized for cardiac emer- gencies or patients in critical condition. Gushee said ED doctors and nurses had an opportunity to comment on the department's new design. "We mocked it up out at the airport in a warehouse," he said. "I think it was expensive, but money well-spent." Moll credited former CEO Bob Appel with that idea. He said getting opinions from doc- tors, nurses and other ED staffbefore building the new department cut down on the need for changes later. "By taking these proactive steps this was a very major component in why the project was able to be completed ahead of schedule," he said. Doctors on duty in the ED sit back-to-back, and often elbow-to-elbow in a room large enough for two desks with several computer monitors each for viewing results of X-rays, CT scans and MRIs. Through windows on three sides of the room that are rapidly becoming obscured with taped up notes, information on diagnoses and hospital policy, doctors can see and interact with nurses clustered at desks around them. The nurses' station looks across hallways to patient rooms. "It does allow us to be more central," Gush- ee said. Technological upgrades in the Emergency Department have also helped. Mason General and its clinics now have electronic medical records, meaning that doc- tors can access their patients' records in a few seconds, rather than relying on patients to supply their own medical history. This helps the ED run more efficiently, Gushee said. The more doctors know about a patient, the fewer tests they need to run to make a diagnosis. Staff can monitor each patient's vital signs from a touch-screen monitor in the nurses' station, and monitor technicians input patient information to two large-screen monitors that are updated with patient wait times, tests ordered and diagnoses. Doctors and staff can quickly look up to screens situated at two cor- ners of the nurses station to get a quick over- view of all patients, including those still in the waiting room. The ED also has a Telestroke system, which allows staff to confer with neurologists by vid- eo to provide care quickly to stroke patients. Dr. Joseph Hoffman said he hopes to use that technology to confer with specialists in other fields as well. And the hospital will soon get a new CT scan machine, which will produce images with better resolution than its current machine, Gushee said. "Emergency departments are for emergencies" Mason General gets its share of patients in critical condition, many of whom are stabilized and airlifted to Harborview in Seattle. Stan- dard complaints of ED patients include ab- dominal pain, broken bones and other injuries. Gushee said even after 20 years in the ER, some cases surprise him. About 30 percent of visits to the Mason General ED are not for emergencies, continued on next page Dr. Andrea Plaskiewicz confers with Harborview Medical Center in Seattle about a seriously injured 2-month-old baby, the alleged victim of abuse. After stabilizing the child for transport by helicopter to Harborview, Plaskiewicz said, "the worst thing about these cases is that after you're all done, it's back to the next patient as if nothing happened." hi n I