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A Visit to the Emergency Room

HealthReach, Spring/Summer 2012 | Page 2

Average “door to doctor” time of 20 minutes represents the most recent measurement and is subject to change.

Virginia Hospital Center’s Emergency Department offers a standard of care that ranks among the best in the country. Here’s why.

“We perform at an extremely high level compared to hospitals nationwide on what matters most to patients,” says Mike Silverman, MD, Chairman of the Department of Emergency Medicine. In addition to having their medical condition addressed, patients care most about the amount of time it takes to see a doctor, the total time they spend in the emergency room, and how well they are treated.

Nationwide, the average wait to see a doctor (called “door to doctor time”) in an emergency room is 45 minutes. Currently, the average at Virginia Hospital Center is 20 minutes.* The average total time a person spends in the emergency room (called “door to door” time) nationally is just over four hours. At Virginia Hospital Center, that average is less than three hours.

The Emergency Department’s efficiency is important, but delivering high quality care is key. “It’s important for our patients to know that our top priority is providing the highest quality of care,” said Dr. Silverman. “Patients may not expect the short wait times or rapid in-and-out, but they should expect and know that they are receiving high quality care within those timeframes from board-certified emergency physicians.”

The first step for every Emergency Department patient is triage, a nurse’s rapid assessment of the patient’s medical history, symptoms, and vital signs to evaluate the severity of illness. This process is conducted in a separate triage area. If a room is available, patients are taken back to the Emergency Department and triage is done at the bedside. Triage results determine when the patient will be treated in the main Emergency Department or in Express Care.

Located within the Emergency Department, Express Care has eight private rooms and is appropriate for patients with sports or home repair injuries, falls, lacerations, flu, routine infections and other non-life threatening injuries and illnesses.

“An advantage of having Express Care in the Emergency Department is that if a case becomes more complicated than you originally thought, you have all the benefits of being in a major hospital,” says Court Curneen, Associate Vice President, Patient Care Services.

The main Emergency Department area includes 28 private rooms which are large enough for family members to stay with the patient. Patients who have visited other emergency rooms will notice a big difference at Virginia Hospital Center. Patient registration is done at the bedside after triage.

&“Patients see a clinical person before an administrative person,” Dr. Silverman explains. During registration, a registrar collects accurate and important patient information that will be used as patient identifiers for patient safety.

Another important benefit of the Emergency Department is its use of electronic medical records, or EMR. EMRs allow doctors and nurses to work off the same patient record and see what each other is charting in real time. Physicians’ orders for tests and medications are entered electronically, which creates a safer and more efficient process.

Prior to leaving the Emergency Department, each patient receives comprehensive discharge instructions. A nurse reviews what the patient needs to do, what to watch out for and what follow-up treatment is needed. Within one to two days of a patient’s visit, a member of the Emergency Department’s staff follows up with the patient by phone.

“We ask about their experience in the ER, how they’re doing now, if they understand their discharge instructions, and if they have any medical questions,” Curneen says. “If so, we will have a member of our clinical team call them back.”

All these steps have led to Virginia Hospital Center receiving ER patient satisfaction scores in the 99th percentile. “We’re still never satisfied, though,” Dr. Silverman adds. “We are constantly looking at ways to improve the patient experience.”


An emergency room has a language all its own. Can you match these frequently heard ER terms and definitions?


1. The process to determine the severity of a patient’s condition A. EXPRESS CARE
2. The time from when you arrive in the ER until you see a doctor B. EMR
3. A place to treat minor illnesses and injuries C. DOOR TO DOOR
4. Electronic Medical Record D. TRIAGE
5. The time from when you arrive in the ER until you leave E. DOOR TO DOCTOR


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Unlike other emergency facilities, virtually all Emergency Medicine patients who need inpatient care can be admitted right here. No transfer. No hassle. Call ER registration at 703.558.6168.

1701 N. George Mason Drive | Arlington, VA 22205-3698 | tel 703.558.5000
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