Stephen Robert is a New York City financier turned philanthropist whose work has increasingly focused on improving access to equitable healthcare. After spending three decades at Oppenheimer and Co. and rising from junior portfolio manager to chief executive officer, Stephen Robert transitioned his attention to board leadership and charitable initiatives. Alongside his wife, he co-founded the Source of Hope Foundation to support sustainable aid efforts in underserved communities around the world. His commitment to healthcare equity is reflected in his support for the Stephen Robert and Pilar Crespi Robert Rapid Medical Evaluation Center at Columbia Presbyterian Hospital in Manhattan. The center was established to reduce emergency room wait times and enhance care for patients in a predominantly low-income area, aligning his philanthropic mission with the principles of rapid medical evaluation.
Advancing Patient Care Through Rapid Medical Evaluation
Rapid medical evaluation (RME) is an emergency department strategy that involves physicians, nurse practitioners, and other care providers assessing patients as soon after arrival as possible. Healthcare professionals often achieve RME by developing a dedicated area in which to perform diagnostics, including lab tests and medical imaging. Initially developed around the turn of the century, the main purpose of RME is to decrease wait times and boarding times for patients, particularly in facilities that experience high patient volumes. RME can also allow facilities to increase patient capacity, in addition to staff benefits.
The primary objective of RME is to minimize the time patients spend waiting for medical analysis and treatment in emergency care settings. Longer wait times can lead to several issues. Emergency room wait times in the United States can vary significantly, but the average patient can expect to wait for at least one hour, if not several. One study determined that the national median emergency room wait time in the US was two hours and 42 minutes.
Researchers associate extended emergency room wait times with a diversity of risks and challenges. A patient’s condition can worsen before they see a care provider, potentially with fatal consequences. One study found that a patient who waits over 12 hours is more than twice as likely to die within one month of their visit compared to patients who wait less than two hours. Another study found that reducing patient waiting time by one hour can reduce the likelihood of death in high-risk patients by nearly 13 percent.
Similarly, reduced wait times for patients reduces occurrences of patients leaving without being seen (LWBS). LWBS patients receive no medical treatment and may have little to no understanding of their underlying medical condition, greatly increasing the risk of complications and mortality.
RME consists of several processes. Facility leaders must develop an approach that allows for quick triage, which involves prioritizing patients based on the urgency of their need for care. Care providers must subsequently assess patients and quickly complete all necessary tests and initial treatments, or, if possible, begin rapid discharge processes. In an optimized emergency department, providers can complete these steps before a standard treatment room opens up.
The RME workflow tends to emphasize more straightforward cases, allowing physicians and nurses to quickly diagnose and treat lower-acuity conditions, opening up emergency room services for more complex, time-sensitive, and resource-intensive issues. This strategy improves patient flow, optimizes efficiency, and reduces overall length of stay for all patients.
Time to provider (TTP) is a major aspect of effective RME. A facility’s TTP score has a major influence on patient satisfaction. A well-developed, fully realized RME program can reduce TTP to just 15 minutes in many cases. Such a short wait time has a positive impact on LWBS rates, resulting in improved patient services and increased hospital revenue. Meanwhile, patient satisfaction increases, improving a facility’s reputation as an effective and compassionate care provider.
Optimized RME often translates to an increased emergency department capacity, allowing facilities to meet the needs of more patients. Furthermore, facilities can decrease their frequency of ambulance diversion, which involves an overwhelmed emergency department directing local ambulance transporters to bring patients to other medical facilities in the area. At its core, RME functions as a cost-effective expansion of emergency department services and capabilities.
Finally, an effective RME strategy leads to improved nurse retention rates. Nursing is a stressful line of work – national registered nurse vacancy rates sit at almost 10 percent, and turnover rates at facilities can approach 20 percent. RME represents a team-based strategy that supports more efficient and effective patient services, which enables a broader culture shift, a more engaged care team, and improved job satisfaction among nurses.
About Stephen Robert
Stephen Robert is a New York City based businessman and philanthropist who spent three decades at Oppenheimer and Co., ultimately serving as chief executive officer. After retiring from the financial industry, he focused on board service and charitable initiatives through the Source of Hope Foundation, which he co-founded with his wife. His philanthropic work includes support for healthcare access, education, and sustainable aid projects in underserved communities in the United States and abroad.
Angela Spearman is a journalist at EzineMark who enjoys writing about the latest trending technology and business news.
