Long Wait Times At Marianas Health Center Decreased

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New program helps to speed up emergency room processes

By Moneth Deposa

SAIPAN, CNMI (Saipan Tribune, Dec. 19, 2013) – The sight of people waiting long hours to be treated at the Northern Marianas Commonwealth Health Center (CHC) have now become a rarity with the implementation of a new program that speeds up the accommodation of patients.

The Commonwealth Healthcare Corp. has started enforcing the PCAP program, or the Primary Care Access Point, to end the long wait times at the public hospital. Staffed by physician assistants, patients that come in undergo initial treatment or screening to assess their conditions and are then referred for appropriate treatment.

Dr. Martin Rohringer, director of CHC’s Emergency Services, said the Emergency Room has always struggled to provide care for a large numbers of patients who do not have a regular doctor. As is common throughout the U.S., he said patients often use the emergency room as a convenient facility for minor problems such as coughs, colds, and for long-term illnesses such as high blood pressure, diabetes, or gout.

That often makes CHC’s emergency room the most crowded unit at the hospital, both days and nights.

Rohringer pointed out, however, that the emergency room is primarily designed to treat trauma and emergencies, not minor complaints or chronic illnesses.

"When the ER takes the place of the family doctor, patient care can be slowed down for everyone," he added.

Dr. Paul Gahlinger, who had been designated director of the PCAP program, said that PCAP is the ER’s new patient care program and is designed to speed access while providing more complete care to patients. Under the new program, PCAP is staffed by physician assistants under the supervision of the emergency physician.

"When a patient arrives at the ER, a triage nurse determines whether the patient needs to be seen in the ER or in the PCAP. If directed to PCAP, a patient can often be seen immediately, with little or no wait times. The care is more relaxed, so general health and lifestyle issues are addressed," according to Gahlinger.

That allows physician assistants to take the time to address high blood pressure, smoking, obesity and other general health issues, he added.

After being seen at PCAP, most patients are sent for follow-up care to the Family Care Clinic, although many still return to PCAP.

According to Gahlinger, the PCAP program has been a great success since its start at the beginning of November. Patients, he said, are delighted with the quick access and attention to all their complaints.

Meanwhile, patients who actually need emergency care face much shorter waits at the hospital’s ER.

It was disclosed that the lengthy emergency room waits are the single greatest complaint at CHC and cause of dissatisfaction among patients. Before PCAP was implemented, it was not unusual for patients to have to wait up to two hours or more.

"In fact, such waiting times are actually the norm in most of the U.S. For example, wait times average 2.3 hours in Iowa and a miserable 5 hours in Arizona. With the PCAP program, wait times have decreased to as little as minutes, depending on the time of day," the doctor said.

Meanwhile, he said, "care is much improved for island residents who do not have the benefit of a regular doctor."

Gahlinger is a recent hire at CHC and is a former professor at the University of Utah’s Department of Family and Preventive Medicine. He has additional specialties in occupational medicine, geriatric medicine, public health, and the management of chronic pain and addiction.

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