July 30, 2008

HRMC has new ED Director

It takes a team effort from all hospital departments to have a properly functioning Emergency Department, according to the new Emergency Department director at HRMC.

“The Emergency Department is the gateway to the hospital,” said Coward, whose first day as director was July 7. “Wait times, which concern people requiring emergency medical attention, are not Emergency Department specific. It’s a process that involves several areas,” Coward said.

Roger Coward is the new Emergency Department Director at Haywood Regional Medical Center.

Patients go through a triage process in the Emergency Department to allow the most serious cases to be seen first. However, the length of stay for many patients can be shortened, he said, by going ahead with lab work, X-rays and other tests. The patient can then be stabilized and returned to the Emergency Department lobby with a beeper to await the availability of a treatment room.

Between 40 and 50 percent of the hospitals in the nation experience crowded emergency departments, according to the Centers for Disease Control National Center for Health Statistics. The national average length of stay in emergency rooms is more than three hours, he said, which is line with the average length of stay at Haywood Regional’s Emergency Department.

“At any emergency room I’ve ever been in, the length of the wait has been an issue,” Coward said.

A method that helps boost the patient satisfaction ratings of an Emergency Department and which will be used at HRMC is the Single Point of Discharge process, he said. An SPD nursing team reinforces what physicians tell patients about their treatment and discharge instructions. The team works on the patient’s clinical and personal needs, provides education and helps find necessary resources, such as referrals and outreach programs.

Coward became familiar with the Single Point Discharge process when he worked at Mission Hospital in Asheville. It was there that he entered into the management side of nursing in Mission’s Emergency Department. Prior to that he worked at Haywood Regional for 15 years, before returning to head up the HRMC Emergency Department.

HRMC has a contract with Clyde Emergency Solutions, an affiliate of Phoenix Physicians to provide physician staffing for the Emergency Department. HRMC has requested that the Emergency Department be staffed with a second doctor during peak times. Two physician assistants are assisting with the patient volume and a patient advocate has been hired.

“The physician assistants have helped dramatically reduce the wait time,” Coward said.

Peak hours in the Emergency Department are typically before the hospital’s Urgent Care Centers open and after they close. Expanding the hours the centers are open could help alleviate some of the overcrowding, he said.

Coward was working as area director for Winners Corp., the multi-store company that includes Wendy’s fast-food restaurants, prior to entering the healthcare field.

“I decided to go into nursing and received my associate degree in nursing at Midland Technical College in Columbia, S.C.,” Coward said. He has been working on his bachelor’s degree through a program at Gardner-Webb University, especially designed for Mission Hospitals. He will transfer his studies to Western Carolina University in January, completing most of his work online.

Coward’s wife works as a nurse at Mission. They live in Canton and have 21-year-old twins and a 9-year-old daughter. Coward is upcoming president of the Blue Ridge Emergency Nurses Association for the western region of the state. He has served as the county’s medical examiner for nine years.