Sebastian River proud of ER team’s ‘door-to-doc’ time

One thing that’s not likely to change in the immediate aftermath of Steward Health’s takeover of the Sebastian River Medical Center is the day-to-day operations of the hospital’s emergency department.
There’s to be a simple reason for that, which can be summed up with the common phrase: If it ain’t broke, don’t fix it.
The hospital’s emergency medical director, Dr. John Fernandez, can’t help but smile when he points out, “We have a door-to-doc time which is the lowest in the state. It’s somewhere between 10 and 15 minutes. On a bad day, maybe 20 minutes.”
Very few – if any – other area hospitals can come close to that.
“We have front-end optimization mechanisms to get patients through triage,” the genial Fernandez explains. Then he points out, “In fact, triage is something of a misnomer now because we ‘direct-bed’ everybody. Regardless of their level of severity. We try to find them a place immediately where a physician or a mid-level provider can get to them.”
The ER’s success, Fernandez claims, is a result of a total team effort; he cites Jason Redding, the center’s youthful-looking director of emergency services and nursing administration, as a prime example.
Redding, says Fernandez, “is a very effective leader and we’re lucky to have him. He transferred up here from Mercy Hospital in Miami and has been a boon to our organization since his tenure began.
“[It seems] he gets promoted every month, so each time I see him, I’m not sure what to call him. But that’s a good problem,” Fernandez adds with a grin.
Knowing exactly what to call Redding might be tricky even without all those promotions.
In his own words Redding says, “I originally started off as a firefighter paramedic, became a police officer and worked for quite some time as a full-time police officer. I then became an ER nurse and traveled around the country working in ERs, and then moved into management, working for [healthcare conglomerate] HCA. I worked for HCA in Panama City and Miami and then came here.”
While no ER anywhere can claim a 100 percent success rate, Fernandez is noticeably proud to say his Sebastian team members “are leaders in sepsis and stroke management as well as heart attacks [and] time-to-cath-lab. We lead the pack.”
About a year ago, SRMC launched an innovative “call ahead” program for its ER that Fernandez says “allows people to set a time when they are expected to show up so that reduces the queue. It reduces any kind of waiting that they may have to go through, gets us their registration info ahead of time and problem-orients us to what we should be looking for to try to help them.”
At least for now that, too, will continue.
Considering that the Centers for Disease Control and Prevention reports that just over 135 million Americans – or roughly 44 percent of the country’s total population – will go to a hospital ER this year, SRMC’s consistently low wait times seem all the more remarkable.
Will changes eventually come to this particular ER?
Of course they will.
Still, Fernandez is clearly happy with the Steward model. “Steward,” he states, “is an ACO, which is an ‘accountable care organization,’ but it’s a modernized version where healthcare quality, maintenance and utilization reviews are all at the front of their business model.”
“So,” he continues, “what you can expect from a Steward Family Hospital is higher efficiency, reduced hospital admissions and [vastly] reduced re-admissions.”
When asked if there is a way to prevent ER cases altogether, Fernandez’s smile grows even wider.
“That’s a great question,” the medical director says. “I think the emergency department is the final common pathway that, sooner or later, everyone will find their way through [thanks to] some mishap, accident or illness no matter how well they try to prevent it. Emergency physicians and nurses are still vital to our community. You can’t live without them. If you were on a desert island, the doc you’d want to be with is an emergency physician.”
Compacting that into an even simpler message, Fernandez says, “We’re the MacGyvers of medicine. We’ll figure out anything. No matter what it is.”
The Sebastian River Medical Center is at 13695 U.S. 1 in Sebastian. The phone is 772-589-3186. In case of emergency, dial 911.


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