GIMC_ED_Description.pdf

GALLUP INDIAN MEDICAL CENTER EMERGENCY DEPARTMENT

The ED at Gallup Indian Medical Center sees close to 40,000 pts/year. We are a level 3 trauma center for the McKinley County area. We see from 90 to 150 pts/day. Our ED is busy and our acuity is high. The majority of our physicians are ED trained and boarded. We take care of severely ill patients.

Our most common procedures are intubation, giving lytics, central line placement, U/S, paracentesis, etc. Our shifts are 10 hours shifts with midlevel support. We have needs in the day, evenings and nights. Our highest volumes are between 4p to midnight. We are seeing close to 40,000 patients a year.

Our shifts hours are as follows

MDs/DOs 6:30 am to 4:30 p, MDs/DOs 9 a to 7p, MDs/DOs 11am to 11pm (Super Track)

MDs/DOs 3p to 1a and

MDs/DOs 6p to 4am.

MDs/DOs 9p to 7am

Midlevel coverage is 7am to 6pm and 6pm to 6am. East area and main ED after the east area closes at 1am.

Physicians can work initially a maximum of 7 shifts then rest then work some more shifts. Our ED is busy therefore, allowing a day of rest provides a provider that is ready to start in the next cycle. Our adult patients compromise 70% of our volume and our pediatric is 30%. The ED is divided in the Main ED with

14 beds, ED East with 4 beds and the ED Super Track Area (2 beds). The main ED is covered mostly by

ED physicians, the East area both mid-levels and physicians as well as the Super track area.

ED providers do not admit patients to the hospital as we have other services that take care of admissions. We have hospitalists, pediatrics, ob/gyn, orthopedics, surgery, optometry, behavioral health, podiatry, anesthesia and ENT. We have X ray and CT 24 hours a day, 7 days a week. We have

U/S every day from 8am to 4pm and on call after 4pm when available. Most of our transfers are to

Albuquerque for Neurosurgical cases, significant poly trauma, STEMIs, Stroke that receives thrombolytics, urological cases, and pediatric ICU cases. We have a good support system from other services. Triage is done mostly by nurses and assigning patients to the main ED (ESI 1, 2 and complex 3) or ED East (lower acuity 3, 4 and 5).

Our orientation takes 1 to 2 days, but providers will NOT work alone while new to our facility.

The initial 2 days of orientation is paper work and then providers work in the ED to learn more about our processes. We understand that our system is complex, therefore, new providers will be given 3 months to learn and understand our system. The expectation is that as new providers see patients, they will learn the challenges of our facility. Our EMR is RPMS or the government EHR. Providers that have worked in the government i.e. VA will have an easier transition to our system. There is regular dragon capability if desired. There is no housing provided by the hospital. Our locum’s providers might rent rooms in houses or stay in long stay hotels. There is continuous need for ED providers at GIMC. The biggest challenge to attract permanent providers is the fact that we are rural and that not much city life takes place in Gallup. However, we are a paradise for outdoor lovers. In the past year, salaries for EM providers have increased and that makes our facility more attractive to others.

Our strongest asset is the providers that work here. We take care of patients but take care of each other as well. If you will come here and experience our facility, you will find that support.