2018 MEDICAL DIRECTORSHIPS AT THE WILLIAM W.
BACKUS HOSPITAL
Kyle McClaine, MD, FACEP.
Chief of Emergency Services for the William W. Backus Hospital and Backus Plainfield Emergency Care Center,
Director of Pre-Hospital Emergency Medical Services
I completed my residency training in emergency medicine at
Brown University in 2000 and have been working in the emergency
department of the William W. Backus Hospital since then. I have
served as the Scheduling Coordinator, Emergency Medical Services
(EMS) director, and Associate Chief of Emergency Services. I was
appointed to the Chief of Emergency Services in June 2018. I
am honored to be granted this responsibility and look forward to
working with all of the hospital departments and related community
services in the East Region and I will continue our mission of
providing the best and most coordinated patient care.
Over 75,000 patients per year seek care at our two emergency
departments: 55,000 in Norwich and 20,000 in Plainfield. Emergency
Medical Services transports an average of 40 patients per day to
Norwich and 5 to Plainfield.
Our accomplishments in the past year include reducing our
door-to-provider time from 50 minutes to less than 20 with the
development of a front end provider initiative, improvements to
our triage process and restructuring of our leadership team. We
held a multidisciplinary Kaizen in April and have been working with
senior leadership to support the ongoing mission and needs of our
departments. Prehospital EMS care was improved this year with
the reinstatement of a dedicated EMS coordinator, improvements
to EMS base station functionality, and enhanced prehospital
communication with telemedicine capabilities.
Immediate challenges to ED physicians include problems with the
Electronic Medical Record and Information Technology adversely
impacting on provider and overall department efficiency and
accuracy, triaging patients for ED care, and the recruitment, training
and retention of experienced staff. The heavy burden of data entry
and electronic record keeping is stressful and time consuming,
contributing to physician attrition. Redirecting lower acuity patients
from the ED to Urgent Care Center or primary care offices will
relieve the burden of non-acute patients in the ED and improve
efficiency of services. Strategies to redirect patients are still elusive.
Some of our projects and ongoing improvements include:
• The redesign and expansion of triage and front-end treatment
space
• Process improvement of patient flow to improve throughput for
both admitted and discharged patients.
• Expansion of pre-hospital telemedicine capabilities
• Integration of prehospital patient care reports directly into EPIC
via a health data exchange
• Re-focused performance improvement in Sepsis, STEMI and
stroke care
• Development of medication treatment assistance and referrals
for patients with opioid use disorders
• Testing of new algorithms for non-myocardial infarction chest
pain patients
• Construction of a dedicated and locked behavioral health
treatment area within our existing convenient care space
• Redesign of existing space to maximize efficient patient
treatment with reduced waste and improved efficiency and
coordination
• Community engagement and outreach for injury prevention,
substance abuse, and other initiatives.
In addition, we are partnering with physicians and administration
throughout the Hartford HealthCare system to identify, improve,
and ultimately reduce transfers out of our hospital and region. We
are working with administrative leaders and the Central Logistics
Center (CLC) to develop policies and practice for surges in volume
with adjustment in boarding and bed movement. n
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