CHRISTUS hospital in Texas opens drive-thru emergency room

June 2020

June 10, 2020

CHRISTUS Good Shepherd Medical Center-Longview in northeast Texas is giving some patients who visit the emergency center at its NorthPark campus the option of seeing a provider without ever leaving their cars.

Sheri Ruschmeyer, the hospital's administrative director of emergency services, said she and her colleagues had been considering drive-thru service before the spread of the new coronavirus prompted hospitals to restrict access and services and many patients to avoid visits.

Team members at CHRISTUS Good Shepherd NorthPark Emergency Care Center in Longview, Texas, are staffing its drive-thru emergency room.

"We were thinking about doing something similar maybe a little bit later into the summer, but we realized that it was something that might be a great option for folks in this environment, so we pushed it a little bit faster," Ruschmeyer said.

The drive-thru opened May 27 under an awning in the circular driveway outside the emergency center, which is part of a medical plaza. It's open from 10 a.m. to 10 p.m. daily.

Dr. Faber White, medical director of the CHRISTUS Good Shepherd emergency department, said he is unaware of any similar setup in the region or among CHRISTUS hospitals. He pointed out, however, that studies of drive-thru emergency care go back at least to 2010, when researchers at Stanford University School of Medicine found that it was a feasible model for care during pandemics.

White said Good Shepherd's emergency drive-thru went over well out of the gate. "Patients have given us a lot of positive feedback at all levels of the process," he said. "They seem to really like it."

Same care, new location
The process starts when a registered nurse greets motorists at a checkpoint on the NorthPark campus. For patients who are coming for emergency care, the nurse does a quick assessment of their conditions and determines what level of care they need. If the nurse determines that it's appropriate for someone to be seen at the drive-thru ER and the patient is open to that, the nurse will direct the driver there.

Ruschmeyer and White said drive-thru care is most appropriate for people with urgent care-type conditions, such as rashes, suture removals, earaches and flu-like conditions.

At the drive-thru, a team of staffers register patients, take their vital signs and do a triage assessment before a doctor, nurse practitioner or physician assistant performs an examination. If the provider determines that a patient needs services that can't be provided at the drive-thru, such as X-rays, staff members escort the patient to a private room inside the emergency center.

Charges are the same as for emergency room visits, Ruschmeyer said. The only difference in billing is that co-pays are added to the bills that are sent to patients rather than being required on the day of service.

Coaxing patients back
White said that while emergency visits typically decline after the winter cold and flu season, the visits dropped off even more sharply when the COVID-19 pandemic began. "We were down roughly 40% from our peaks, which is a fairly significant drop, more than what we usually see as we enter into the spring season," he said.

Like other hospitals, Good Shepherd has tried to assure the community by means such as social media posts that the precautions it has in place like universal masking and intense cleaning prevent the spread of the virus. "Unfortunately, I've taken care of cases in the emergency department of patients who delayed coming in for treatment because of this fear of getting sick from going to the ER and getting exposed to COVID," White said.

He is hopeful that patients will be less reluctant to seek emergency care if they can stay in their car or at least stay outside of the hospital doors. For some of the examinations he's done at the drive-thru, he's asked patients to sit at a nearby bench.

White said: "All we've heard for the last two months is stay home, don't get out, you'll get sick. I think that feeds this perception that people have that if they go out and do anything indoors, they're likely to get sick and we do have to try to combat that a little bit.

"If it makes people more comfortable and likely to come seek emergency care knowing that we have this process in place, then I think that's great."

Pilot program
Ruschmeyer said that the drive-thru is a pilot project. The hospital plans to study the metrics and the community feedback after a few weeks to decide whether it's a valuable service.

"We would love for it to go over so well that we continue on and it becomes a permanent part of our ED process, but we'll have to see how it's received," she said.

Within its first few days, the site literally weathered its first storm, which included a tornado watch. "I was at home and the team was sending me funny videos that said we're here for you rain, sleet, sunshine, tornadoes," Ruschmeyer said. "So that was a lot of fun."

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