HMC provides Level II emergency services (24-hour physician coverage with specialty consultation available). In accordance with the HMC Mission/Vision statements, the Emergency Department provides evaluation and care to any individual who presents requesting care. All who present receive a timely assessment (triage) and are then classified according to the acuity of the presenting complaint. In addition, a medical screening exam (MSE) is performed by a licensed practitioner to determine whether an emergency medical condition (EMC) exists. (See EMTALA Compliance Policy.) In the case of the emergent patient, evaluation and stabilization of the patient are done under the direction of the physician, and the patient is admitted or transferred in accordance with EMTALA guidelines.
The Emergency Department sees more than 18,000 patients per year. Three to five percent of these are emergent patients requiring immediate evaluation and stabilization. Multiply injured trauma patients are stabilized and transferred to a Level I trauma center, usually VUMC. Transport of these patients is by ground; BCEMS; or air transport, VUMC Life Flight. HMC serves as the satellite unit for this air service that expedites transport of trauma and acute MI patients.
Departmental resources include modern-day monitoring equipment, Certified Emergency Nurses and/or ACLS/PALS/TNCC trained personnel, and 24-hour accessibility to diagnostic services to support rapid, thorough assessment of patients.
HMC Emergency Department participates in the community planning for emergency preparedness with the local Emergency Management Agency, Bedford County EMS, and the local fire and law enforcement agencies. The provision of emergent care during episodes of mass casualty or community exposure to hazardous waste is accomplished through a collaborative relationship with BCEMS and the affiliate agencies.
Direction of emergency services is provided by a Board-Certified physician who is credentialed as an active staff member. Clinical management activities are directed by the Nurse Manager who is accountable for strategic planning, overall organization, staffing, budgeting, staff development, risk management, and performance improvement (PI) activities. These individuals coordinate and report emergency services activities to the medical staff via the Emergency Room Committee which is comprised of representatives from the various services (OB, Family Practice, Medicine Service, Anesthesia, Radiology, and Surgery) and hospital administration. Results of PI activities are reported to the ER Committee for collaborative input from the medical staff.
The ER is staffed at all times with two trained ER Nurses certified in BLS, ACLS, PALS or EMS – P, and BTLS or TNCC. During peak hours (1100-2300) an additional nurse, ACLS/PALS certified, and an ER tech are assigned. ER clerks who have computer and interpersonal skills are BLS trained and comply with annual competency requirements in identified basic nursing skills are staffed on days and evenings. ER techs are primarily EMT-Ps who have advanced training in resuscitation and triage and also meet annual competency requirements.