Washington County Hospital Introduces New ER Staffing Model

Washington County Hospital (WCH) has begun implementation of a new emergency medicine staffing model. WCH is transitioning from on-site physicians to providing certified trauma-trained nurse practitioners in its emergency room (ER), with physician oversight.
In addition to staffing the ER with highly-trained advanced nurse practitioners, WCH will utilize telemedicine technology connections to consult with ER physicians at SSM Health Cardinal Glennon Hospital-St. Louis for pediatric patients, SSM Health Good Samaritan Hospital-Mt. Vernon, SSM Health St. Mary’s Hospital-Centralia, and SSM Health SLU Hospital in St. Louis (as part of the Mid-America Stroke Network) to treat patients and/or stabilize for transfer to a tertiary level facility.
While this concept may be brand new to WCH, it’s not new to similar hospitals around the country. Critical access hospitals (CAHs), like WCH, are more likely to be staffed by physician assistants (PAs) or nurse practitioners (NPs), according to research presented at the 2016 meeting of the American Academy of Physician Assistants (AAPA). “Emergency care for our patients is the primary reason to keep rural hospitals in local communities,” says Nancy Newby, Chief Executive Officer, WCH. “That’s why WCH is partnering with SSM Health and Midwest Emergency Department Service (MEDS) to provide a new model of cost-effective emergency care that will focus on providing an exceptional patient experience.”
Emergency department patients at rural hospitals using telemedicine see a clinician, such as advanced nurse practitioners, six (6) minutes sooner than patients in hospitals that have no such technology, a recent study from the University of Iowa shows. And if that first clinician assessment is through a telemedicine encounter, as was the case with 42% of the interactions examined in the study, the door-to-provider time is shortened by nearly 15 minutes, says study lead author Nicholas Mohr, MD, an emergency physician and associate professor at the Carver College of Medicine at the University of Iowa.

New ER Staff

The advanced nurse practitioners who will be staffing the ER at WCH include:

• Leslie Williams, RN, MSN, FNP-BC, possesses more than 10+ years of hospital ER and urgent care experience in six metro east/southern Illinois locations while holding board certification (since 2008) from the American Nurses Credentialing Center (ANCC), a subsidiary of the American Nurses Association (ANA), is a certification body for nursing board certification and the largest certification body for advanced practice registered nurses in the United States.
• Dr. Richard Baker, DNP, NP-C, a board-certified family nurse practitioner with 21 years of experience in emergency medicine, family practice, occupational medicine, long term care, residential care, hospice/palliative care, wound care and geriatrics. Dr. Baker received his Doctor of Nursing Practice degree from Saint Louis University (2014); he also holds certifications in advanced trauma life support (ATLS), advanced cardiac life support (ACLS), pediatric advanced life support (PALS), and basic life support (BLS).
• Derek Pechacek, FNP-C, is certified by the American Academy of Nurse practitioners (AANP) and also holds registered nurse licensures in Illinois and Missouri; he also possesses ACLS, PALS, and BLS certifications; and brings more than eight (8) years of emergency room experience working at St. Anthony’s Hospital in Alton (IL), HSHS St. Elizabeth’s Hospital and Urgicare Center (Belleville and O’Fallon), and Barnes-Jewish Hospital (St. Louis, MO).
• Elizabeth Raye Kraus, APN, MSN, FNP-BC, has more than seven (7) years of emergency room experience encompassing HSHS St. Elizabeth’s Hospital and Urgicare Center (Belleville and O’Fallon), SSM Health St. Mary’s Hospital-Centralia, HSHS St. Joseph’s Hospital-Highland, HSHS St. Joseph’s Carlyle Immediate Care, HSHS St. Joseph’s Hospital-Litchfield (IL), Belleville Memorial Hospital, and Sparta Community Hospital; she holds a national certification from the American Nurses Credentialing Center (ANCC), is PALS and ACLS trained, and currently holds an Illinois RN license.
The University of Iowa study also shows that most patient encounters in rural ERs can be completed by local staff without an outside consultation.
The consultation rate was about 3.5%, meaning that if 30 people walked into a rural emergency department, 29 were going to be treated without ever consulting the telemedicine provider.
However, that 30th person is the one that the local clinician pushes the button and asks for consultation in the treatment of the patient.
This type of enhanced service at WCH wouldn’t be possible without its partnership with SSM Health in Southern Illinois, which was announced back in May.
“In today’s health care environment, it is important for hospitals to establish alignment with a strong system,” says Newby. “This is just one example of the resources WCH gains from SSM Health to assist in guiding our future. Our priority is to ensure quality health care is provided in our community for the long term future.”

ER Open House Event

Washington County residents have an opportunity to personally meet all four (4) advanced nurse practitioners during an open house event on Wednesday, August 1, 9am – 11am in the ER at Washington County Hospital. This free event is being offered for local residents to meet the newest members of the WCH emergency medicine team.