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Emergency medicine's new frontier on Catalina Island
Partnering with Catalina's medical center to run its ED benefits patients and physicians
After more than a year of partnering with Catalina Island Medical Center to run its emergency department (ED), UC Irvine Health emergency medicine specialists have expanded patient care and improved patient satisfaction.
"We have collaborated together to provide great quality care and an exceptional patient experience," said Jason Paret, chief executive officer of Catalina Island Medical Center in Avalon.
Patient-centered care has been expanded to include an additional 1,900 patients since the partnership was launched Sept. 1, 2016. That care has been well received by island residents and visitors alike.
"Over the past 12 months, our emergency department patient satisfaction scores have ranked nationally in the 97th percentile," Paret said.
Before UC Irvine emergency medicine specialists began staffing the Catalina Island Medical Center's ED, primary care physicians had to juggle emergency care and their outpatient clinical duties. Now, patients in the medical center's ED are seen by UC Irvine Health's board-certified emergency medicine specialists.
These doctors are trained to treat all urgent and emergent illnesses and injuries, including life-threatening allergic reactions, snake bites, diving and other marine accidents, trauma, strokes, cardiac and abdominal emergencies. The ED now also provides the following 24 hours a day:
- Radiology technicians with access to a CT scanner, X-ray machine and full laboratory capabilities
- A board-certified radiologist who is immediately available to assess results electronically
- ED specialists credentialed to use the center's ultrasound machine as a bedside diagnostic tool
Additional services offered include outpatient laboratory results, infusion of intravenous antibiotics, wound care, physical therapy and long-term care.
Expanding the medical center's services also have been prioritized by UC Irvine Health physicians. Ideas include:
- Increasing the number of laboratory studies performed
- Creating telemedicine consults with other UC Irvine Health specialists
- Offering short-term hospitalization on the island
Improving these systems of care would allow more stable patients to remain on the island and would reduce the number of patients needing helicopter transport to the mainland for care. Many Catalina Island residents have expressed reluctance to leave the island for personal and financial reasons.
Other possible services being explored for the Catalina Island Medical Center include:
- Chemotherapy
- Gynecological services
- Pain management
- Palliative care
- Additional assisted-living facilities
The partnership with Catalina Island Medical Center has had the added benefit of giving UC Irvine Health physicians the chance to hone their skills at a hospital that doesn't have a fully stocked trauma and resuscitation bay, or easy access to consult with other UC Irvine Health specialists.
More limited resources means that ED specialists must use their clinical skills and intuition to truly practice the "art of medicine," said Dr. Sangeeta Sakaria, co-medical director of the medical center's ED.
For Sakaria, who has a background in global health, wilderness medicine and flight medicine, working at the Catalina ED offers the perfect blend of all of her interests.
UC Irvine Health emergency medicine physicians, who are required to serve a minimum of seven days each year at the Catalina Island ED, find the experience both exciting and educational, in part because they see cases they wouldn't typically handle, she said.
Sakaria said they hope to add an elective in marine and dive medicine so that emergency medicine residents can also rotate through the Catalina Island ED and gain valuable practical experience.
With fewer patients per day when compared with UC Irvine Medical Center’s ED, physicians are able to spend more time with patients and discuss issues that are often reserved for primary care doctors. Building rapport with the island community and tourists also has led to stronger doctor-patient relationships and the unprecedented patient satisfaction scores.
Working on Catalina Island does pose challenges for emergency medicine physicians. When on shift, he or she is the only emergency physician on the island and must respond to calls at all hours for multiple days in a row. It also means spending time away from family and requires carefully managing sleep hygiene to be able to care for patients with life-threatening emergencies.
From Sakaria and Paret's perspective, the continued collaboration between UC Irvine Health and Catalina Island Medical Center will inevitably lead to adding services and maximizing opportunities to advance patient health and wellness.
"We are working to be consistently at the 99th percentile in patient satisfaction,” Paret said.