Emergency Department


(718) 963-7391

Mission Statement

The Emergency Department supports the Hospital’s Mission Statement to provide excellence in care through prevention, education, and treatment in a safe environment. The E.D.’s goal is to continually improve the efficiency & quality of the healthcare delivery system, utilizing a strategy of constant community needs assessment in such areas as prevention, patient satisfaction, and adoption of best clinical and administrative practices.    

The Emergency Department is located on the first floor of the “A” building. Emergency services are provided for both adult and pediatric patients in separate and distinct areas. Integrated services are provided for the patients served, through a multi-disciplinary effort from various departments in the hospital.    

Scope  

Continuous emergency care services are provided according to The Joint Commission Accreditation Manual for Hospitals, New York Code Rules and Regulations (part 405) and the New York City Regional 911 Emergency Department Standards, under the joint direction of the ED Nursing Director, Chairman, and Vice President of the Emergency Department.  

Nursing Care is based on the standards of the Emergency Nurses’ Association (ENA). Care is supervised by the Vice President of Nursing through the Director of Nursing and the Clinical Care Coordinators. The role of the Clinical Care Coordinator has been expanded to provide clinical, educational and managerial support to the Registered Nurses and the staff. Medical leadership is provided and supervised by the Chairman & Medical Director of Emergency Medicine. The Vice President of Emergency Services oversees the operations of the E.D., and along with the Chairman and Nursing Director, works to ensure the seamless integration of services provided by the various departments comprising the emergency care team.   

Patients from neonate to over 100 years of age are seen and treated. Patients up to the eighteenth (18th) birthday are seen in the Pediatric E.D. All others are seen in the Adult E.D.

Types of Patients

The Emergency Department treats an average of 224 patients per day. The breakdown is as follows:

Area

Adult
Adult Fast Track
Pediatric
Obstetrical patients triaged to L&D

Average # of
patients per day
69
75
71
9

Average % of
patients per day
30%
34%
32%

An average of 30% of the patients seen in the Adult E.D. are admitted for inpatient care.
An average of 10% of the patients seen in the Pediatric E.D. are admitted for inpatient care.

Assessment

Visits to the E.D. originate in the following ways:

  • Ambulatory, walk-in
  • Private car, public transportation, taxi/car service
  • NYC FDNY Ambulance (through the 911 system) calls 
  • Volunteers and private ambulance calls 
  • Transfers from Nursing Homes and other Health-related facilities
  • Clinic referrals for emergent problems 
  • EHS referrals for emergent problems outside of the scope of care for EHS 
  • Employee illness/injury/referrals when EHS is closed 
  • Referral from P.M.D./P.C.P.

Patients are assessed at time of presentation to the E.D. by means of triage done by the Registered Nurse. There are separate triage areas for Pediatric and Adult patients. Triage is done in the triage area for ambulatory patients and those arriving by ambulance are seen within the treatment area of the E.D. in the area designated for Ambulance triage. Each patient is assigned a Triage priority level and time frames for examination and reassessment are driven by this level. Upon arrival to the Emergency Department, all patients receive a triage assessment, which includes assessment of pain. 

Subspecialists are available for consultation and evaluation for emergency department patients on an on-call basis. Diagnostic Radiological services are available 24 hours per day, seven days per week. Clinical Laboratory services, including Blood bank services are readily available 24 hours per day, seven days per week.    

Wyckoff has a Voluntary 911 Ambulance service, providing BLS and ALS service to the Brooklyn and Queens communities. 

Scope and Complexity

Patients presented to the E.D. for evaluation and treatment run the gamut from such minor complaints as simple upper respiratory tract infections (Level V) to those who present with cardiopulmonary arrest (Level I). There is a high incidence of asthma in the patient population served, both Pediatric and Adult. A Fast Track area is available 24 hours, 7 days a week to serve those patients who do not require emergency care but without the emergency system, would be without medical care. Patients with obstetrical emergencies are triaged to the Labor and Delivery Triage area for appropriate evaluation and care.

Special services, procedures and equipment include:

  • Simple and complex I.V. medications
  • Cardiac Monitoring/Pulse Oximetry  
  • Pain Management
  • Neurological / Neurosurgical Illness / Injury
  • Administration of Thrombolytic Therapy 
  • Victims of Abuse: Child, Domestic, Elder, Sexual
  • Ventilators 
  • Infusion and Titration of certain cardiovascular, vasopressive, antiarrhythmic and other  medicated drips  
  • Moderate Sedation
  • Central Line placement
  • And as required by 911 Edition Standards  

Patients with certain conditions may need to be transferred to another acute facility after initial evaluation and treatment are provided. Examples include:

  • Psychiatric conditions requiring evaluation and Admission
  • Burns requiring the services of a burn center
  • Pediatric cases requiring intensive care

Support Services

A full complement of support services is available to the Emergency Department staff. Consultation with specialty and sub-specialty Attending physicians is available as outlined in the 911 Standard, as well as required transfer agreements.

In addition, there is support from:           

  • Respiratory Therapy
  • Laboratories
  • Social Work Services
  • Radiology
  • Pharmacy
  • Infection Control
  • Patient Advocate
  • Environmental Services
  • Engineering 
  • Security
  • Registration and Admitting 
  • Food and Nutritional Services
  • Medical Records
  • Purchasing and Storeroom

Staffing

The Emergency Department staffing is based on the requirements from the New York Code of Rules and Regulations (part 405) and the New York City Regional 911 Emergency Department Standards, and National Benchmark Standards. A Registered Nurse is assigned to Triage in both the Pediatric and Adult EDs. There is a sufficient number of physicians and registered nurses, based on volume and census within the E.D.

Level of Care/Services Provided

The WHMC Emergency Department meets all New York Code of Rules and Regulations (part 405) and the New York City Regional 911 Emergency Department Standards related to:

  • Staffing
  • Physicians
  • Nursing
  • Other Staff
  • Professional Training and Education (including BCLS, ACLS, PALS, ATLS, etc.)
  • Orientation
  • Continuing Education
  • Facility Layout, Treatment Areas
  • Equipment and Supplies (general, life threatening emergencies, other treatment rooms)
  • Ancillary Services
  • E.D. Medical Records 
  • Manuals and References
  • Performance Improvement
  • Pediatric Emergency Care
  • Emergency Preparedness

 The Emergency Department/Medical Center has obtained the following designations:

  1. Emergency Heart Station
  2. 911 Ambulance Destination Facility
  3. Stroke Center

The Emergency Department is in the process of obtaining the following designations:

  1. Sexual Assault Forensic Examiner Center of Excellence
  2. Therapeutic Hypothermia Center (NYC FDNY)

Recognized Standards and Practice Guidelines

  • New York Code of Rules and Regulations (Part 405)
  • 911 NYC Regional Emergency Department Standards

Performance Improvement

Goals:

  • To establish a planned, systematic and ongoing program to monitor patient care and identify opportunities for performance improvement.
  • To enhance patient care and safety through actions taken as a result of monitoring and evaluating activities. 
  • To initiate/ participate in relevant Performance Improvement Teams.
  • To integrate the Emergency Department’s continuous performance improvement activities with monitoring and evaluating activities throughout the Medical Center through communication to the hospital-wide Quality Management Program and the Medical Board.
  • To identify patterns of care/trends with a potential for suboptimal outcome and improve processes to correct deficiencies and improve care.
  • To establish a mechanism to address issues in a reasonable order of priority (high risk, high volume, problem prone, as required by regulatory bodies). 
  • To ensure communication, reporting and documentation to all appropriate bodies and the involved members of the health care team.