Elevating our lifesaving care

Emergency Department Q&A with Dr. Ferroggiaro

 

Dr. Anthony Ferroggiaro

Anthony Ferroggiaro, MD, joined CMH in 2015 as part of a partnership in emergency services with Oregon Health & Science University (OHSU). Dr. Ferroggiaro cares for patients in the CMH Emergency Department (ED) and serves as the program’s medical director. He gave us an update on what has been happening in the ED and what we can look forward to:

What changes have you made since coming to CMH three years ago?

We’ve made a number of changes over the past three years, including transitioning the physician group to board-certified, residency-trained emergency physicians. This is the highest level of training for emergency medicine physicians. 

Recently, we also increased the use of ultrasound within the department. Using ultrasound for evaluations and procedures results in quicker assessment and treatment of patients. 

How have those changes impacted the care patients receive?

Because of our training and our focus on improving operations, the community is receiving better medical treatment than ever before. We can now see patients sooner and treat them more rapidly.

We have focused on reducing patients’ “length of stay” (the amount of time they’re in the ED) and the time it takes for the patient to be seen once they arrive in the ED — this is often less than 10 minutes. Because of the higher level of training, once the board-certified physician sees a patient, they can manage their care more quickly. Patients who come to the CMH Emergency Department, on average, spend less time in the ED than in prior years. 

We also continually focus on providing good service. We monitor the responses from patient satisfaction surveys and use it to work with physicians and caregivers, reinforcing areas of strength and making improvements as necessary.

How do you continue to improve the quality of care patients receive?

We have a very strong chart and case review system that allows us to continually improve our clinical care. We specifically monitor and review each patient that we’ve treated for heart attack, trauma and stroke. In today’s medical practice, this is essential in keeping physicians up-to-date on science and medicine. This will keep us always learning and evolving our clinical practice in alignment with scientific discovery.

In addition, I work with Jill Tillotson, RN, the ED Manager, to focus on our operations or processes within the ED. We focus on rapidly assessing patients, length of stay within the ED, proper documentation and proper treatment administration, as well as the level and quality of our equipment.

When the Oregon Health Authority re-approved our trauma designation (Level 4), the survey team called out our continued improvement efforts in trauma management as one of our strengths.

How do you keep sharp on your skills and make sure that new doctors want to come here?

As part of the OHSU Department of Emergency Medicine, we are in continual medical training. Each physician is required to attend weekly lectures and to review up-to-date topics in emergency medical science. We also teach at the School of Medicine and within the OHSU Department of Emergency Medicine’s residency program.

We started the rural residency program here in 2016. Through the program, doctors in their second year of residency training at OHSU come to CMH for a month. With oversight by the attending physician, a resident physician cares for patients in the ED. This gives them the opportunity to practice rural emergency medicine, which differs greatly from urban areas because the physician is responsible for a greater part of the patient’s care.

This is great experience for resident physicians’ future practices once out of training, and we hope it will encourage them to consider practicing emergency medicine in a rural community like Astoria.

What role do you see the ED playing in the community?

We are here 24/7 for any injury or illness that residents or visitors to the area might have — even in the middle of the night when patients cannot call their primary doctor. We provide high-quality, highly scientific emergency medical care. We are also educators and enjoy teaching resident physicians about the joys of practicing emergency medicine in a rural setting. 

With Regina Mysliwiec, MD, as EMS Medical Director, Medix leadership and Life Flight leadership, we have further linked emergent and critical care services — especially trauma care. That way, critically ill or severely injured patients can be resuscitated in Astoria and transported to Portland hospitals for further stabilization and treatment. This quick, efficient chain of care is saving lives.

What lies ahead for the ED?

There are good things ahead for the ED. The CMH strategic plan includes an expansion of the department. This will allow us to manage even more patients in a timely manner. We are also pleased to welcome Steve Donnelly, MD, in August. He is dually trained in emergency medicine and family medicine. I see him playing a large role in linking emergency care and subsequent ongoing primary care services.