Mineral Wells Index, Mineral Wells, TX

March 30, 2014

Patient placement

PPGH balances providing quality care while striving to reduce unnecessary ER admissions, costs


It’s Saturday and your child’s sick with a sore throat that won’t go away. A visit to the doctor might help, but the only option you see is to take your child to the emergency room.

But often, emergency care isn’t the best option, said Harris Brooks, CEO of Palo Pinto General Hospital. Emergency room visits are expensive and emergency care, while high-quality, is set up for triage – based on degrees of urgency – to assess the patient and determine what further treatment is needed.

Children often get more appropriate care when seen by a primary care physician, who can give a child a full assessment not always available from emergency care, he said.

Some people, especially if they are uninsured or on Medicaid, choose the emergency room over primary care because they see it as their only option for treatment, he said. Pediatric visits, in these cases, seem to occur frequently nationwide and is also true for PPGH.

“We recognized an inordinate amount of pediatrics going to the emergency department,” he said.

Stats showed that about 25 percent of emergency room visits were pediatric cases, he said. So, to reduce these visits, in August the hospital decided to add pediatricians who would accept all pediatric patients, including those on Medicaid or the uninsured.

This move, Brooks said, allows the hospital to treat more patients, expedite emergency care and improve overall quality of care to everyone.

Dr. Bart Robbins is currently participating in the program, and sees patients during regular office hours, he said. Dr. Anantha Bhandari also is considering participating.

The hospital is able to offer this level of care through monies provided by the 1115 Waiver, a statewide program from the Texas Health and Human Services Commission to aid hospitals with high numbers of Medicaid and uninsured patients, he said.

With the program in place the hospital is already nearing its goal of reducing visits by 3 percent to 4 percent, he said.

“The emergency department is happy to see everyone, no matter what,” James Fesser, ER director at PPGH, said. The department sees many illnesses, such as sore throats and ear infections, that could be best treated in other departments.

On average the ER sees about 1,800 monthly visits with admits between about 150 to 170, he said. These admits don’t count those admitted for observation, stays that are less than 24 hours. About 3 percent to 4 percent of patients are transferred to other hospitals for higher levels of care or for specialties such as neurology that PPGH doesn’t offer.

Elopements, or patients who check in but leave without being served, have declined to 1 percent, he said. “This is far below the national average.”

With pediatricians in place to reduce ER visits, the ER will be able to better serve patients, he said.

“You decrease the demand, then the workload decreases,” he said. A decrease in workload allows emergency personnel to aid patients faster and give them the best care possible.