Staff buy-in is key with freestanding ED

If you've never opened a freestanding ED before, there will be a number of lessons learned, and that was certainly the case for Michael Cetta, MD, medical director of the Shady Grove Adventist Emergency Center in Germantown, MD.

"Lesson No. 1 is: Get buy-in from your medical staff and consultant staff — orthopedics, plastics, and so forth," he says. "It's very important that they are on board, accepting of the new facility and willing to support it."

How did he obtain this support? "I did a lot of 'propaganda' to them and to the EMS folks," he says. In addition, he brought several of the specialists through the facility before it opened, to get their input. "For example, we bought a portable C-arm because an orthopedist who toured the facility said we needed it if we wanted him to come up and do a wrist reduction," Cetta says. In addition, the main Shady Grove hospital has a very complex plastics closure tray, so he purchased those as well. "The ENT docs also have particular trays, and once we found that out, we got those," he adds. The same was true for slit lamps. "The doctors at Shady Grove know how to use that type, so it was a simple, logical choice, and a very good decision," says Cetta.

All of this groundwork was extremely beneficial, and necessary, Cetta says. "If we had just thrown this thing out there and not prepared people for it, regardless of how beneficial it was, they would only have seen it as something that would affect their comfortable lifestyle," he says. "People don't necessarily see change as good — even if it is really very good."