Culture Change in the Bristol Emergency Department

After five months of helping to manage the emergency department at Bristol Hospital, it is tempting to talk about the various changes in the department – our metrics, efficiencies, ongoing efforts to improve throughput, or our relations with nursing, ancillary services, and other departments within the hospital. But I fall back on the one factor that I believe makes it possible for us to positively impact all those other factors: our culture.

Company culture is notoriously difficult to pin down. It expresses itself through the people, everyone from a company’s top leadership, which has been making frequent trips to Bristol to staff shifts in the ER, all the way through the nurses, APPs, receptionists, and janitors that help make an ER run smoothly.

Proof of a changing culture is also hard to pin down, but at Bristol it is indisputable: the ER now is different than the ER before. That is expressed in dozens of ways every week. In one instance it was expressed in a letter from a long-time staff member in the ER. In it, Matt Champeau writes:

Janurary 1, 2012 is when the MEP wave began to change the landscape of Bristol’s ED. As you can imagine this change caused some animosity and apprehension to this established staff of professionals, but it was with a clear mission and calm demeanor that MEP entered the ED and began to take charge and make changes…

The commitment of the organization to quality and efficient care is something that I have never in my career experienced. To some, this wave of change was anticipated to be a tsunami that would be the end of our world; but I have found it first hand it to be a calm swell that has enhanced the community, department, and professional lives of the employees.

That is what culture change is all about.

For me, it is about always striving to be better, and recognizing that emergency medicine is not just about going to work and taking care of patients. It’s about thinking through the costs of health care, testing things we may not think need to be tested, finding efficiencies where we didn’t think they existed, and always improving.

We all have different styles of practicing medicine, but we are all on the same page in that we are trying to improve what’s going on in the Emergency Department. You can feel it.