Hospitals must keep up with changing times

By Anthony “Skip” Cimino

When Robert Wood Johnson University Hospital Hamilton announced recently that it would guarantee every emergency room patient an evaluation within 15 minutes, it was a move that acknowledged the changing landscape in health care. Patients today are smarter, more mobile and more media savvy. In this economy, they are looking for the best deal and the best service.

Hospitals must step up and meet the challenge, or face the consequences. The Wall Street Journal reported that nearly two dozen New Jersey hospitals have closed in the past 20 years. That’s bad for the businesses – and bad for residents, who have fewer choices and have to travel farther for health care.

At RWJ Hamilton, we have looked for ways to give patients the best possible care while remaining a strong institution.

RWJ Hamilton’s emergency department sees more than 50,000 patients a year. We are putting a lot on the line with our guarantee, which ensures emergency patients receive an evaluation within 15 minutes and a medical examination within 30 minutes. If the hospital does not meet this standard, that portion of the patient’s visit is waived.

But we know we must become smarter and more efficient – as all hospitals must.

The best businesses are the ones that manage customer expectations, and the same goes for hospitals. The best thing about our 15/30 guarantee is that patients know what to expect when they walk through the door – they can trust RWJ Hamilton to provide safe, high quality, efficient emergency care.

That care has been bolstered by the establishment of emergency teams, in which nurses and doctors work together in assigned areas. It has also been enhanced by the creation of a state-of-the-art pediatric emergency department, to provide care for the 8,000 pediatric patients that come in the RWJ Hamilton emergency room each year.  

The expansion is the result of a lot of thinking about ways to make the business better. It actually goes well beyond the emergency room. By streamlining emergency care, the hospital is improving care all along the line. A patient with a serious problem will get to an inpatient room more quickly, and a patient with a minor problem can be discharged to make way for others.

It’s easy to see how it affects the rest of the hospital. Once an emergency room bottleneck is cleared up, other departments must fall into line. Suddenly, lab reports and X-rays are moving more efficiently, so doctors can make decisions.

Accountability spreads throughout the hospital campus.

It affects every department: housekeeping, nursing, even patient escorts. For RWJ Hamilton where about 70 percent of patients enter through the emergency room – well above the national average – it makes sense for us to start the process there.

But all hospitals must study their practices to ensure their survival.

It is especially important for hospitals to be smart and nimble at this time. The new federal health care plan, being phased in over the next several years, changes the playing field for all health care providers.

For now, there are few good primary care options for the uninsured, who often turn to emergency rooms. But as the state and federal governments take aim at health care costs – and lowering the number of the uninsured – hospitals must stay on top of all the changes.

What new challenges will arise for hospitals? And, more importantly, where are the opportunities to grow and prosper?

Operational efficiencies. Reducing internal bureaucracy. Streamlining redundant processes. They are more than just words. They are a way of doing business.

Going forward, all hospitals – not just RWJ Hamilton – are going to have to do more than say they’re getting smarter and more efficient.

They’re going to have to guarantee it.


Anthony “Skip” Cimino is President and CEO, Robert Wood Johnson University Hospital Hamilton.

  Hospitals must keep up with changing times