In July 2023, Emergency Physicians Associates (EPA) took over physician staffing at Santa Clara Valley Medical Center’s (SCVMC) Emergency Department.

The transition required an all-hands-on-deck, collaborative approach to tackle many challenges negatively impacting department culture and patient experience.

Today, the partnership remains a resounding success, with enhanced operational efficiency, improved patient outcomes, and a collaborative environment among healthcare professionals.

Ambitious Goals for the Santa Clara Valley Medical Center (SCVMC) Emergency Department

Santa Clara Valley Medical Center (SCVMC) is the community’s healthcare safety net. It provides high-quality tertiary care as a Level 1 Trauma Center, Regional Burn Center, STEMI, and Stroke Receiving Center. SCVMC also has an exceedingly capable PICU and NICU. The Emergency Department sees approximately 100,000 patients annually and hosts Emergency Medicine residents rotating from Stanford.

In early 2023, its Emergency Department was chronically understaffed after the turnover of multiple commercial medical groups. It struggled with high patient volumes, long wait times, and a concerning rate of patients leaving without being seen. The busy, urban Emergency Department couldn’t provide its patients the attention and care they deserved.

“We came in there with the imperative to affect change and collaborate and make this place the flagship emergency department in the county.” – Daniel Nelson, M.D., Chair, SCVMC Department of Emergency Medicine

A Collaborative Approach: Rebuilding SCVMC From Within

While ED staffing transitions sometimes involve starting from scratch, SCVMC required a more nuanced approach. This project would incorporate existing physician staff and established systems, meaning that EPA needed to build trust and understanding to transform culture from within.

Several key elements defined EPA’s approach at SCVMC:

• Patient-Centered Care: The team prioritized patient care above all else.
• Physical Presence: EPA leadership made a concerted effort to be present on the ground 24/7 throughout the transition, lending a hand wherever needed.
• Collaborative Culture: EPA focused on building strong partnerships with nursing, administration, and the medical staff.
• Gradual Integration: EPA listened first, then methodically implemented changes.

“We made an effort to be physically present, every day, on the ground, letting them know that they had a partner in changing and growing the department,” says Daniel Nelson, M.D., Chair of SCVMC’s Emergency Department. “We met everybody to earn their trust first. We were able to win over some rather skeptical people and develop a real team that’s growing.”

Rapid Transformation, Lasting Improvements

The changes at SCVMC were immediate and impressive—the results of a true team effort. After EPA’s first month, the left without being seen (LWBS) rate dropped from 5.57% to 2.17%. The median length of stay (LOS) for discharged patients decreased from 309 minutes to 203 minutes.

Despite record-high patient volumes, EPA has continuously improved its efficiency and quality of care over the year since SCVMC’s partnership with EPA began.

As of June 2024, SCVMC boasts:

“Our strategy involved being present and showing our partners, the nurses, that our first priority was the patient,” explains Brian Saavedra, M.D., CEO of Emergency Physicians Associates, who served as the department Medical Director throughout the transition. 

“Once you have a culture where the physicians and the nurses feel that they’re on the same page and are supporting each other, everything falls into place.” – Brian Saavedra, M.D., CEO, EPA

SCVMC: A Model of Care and Collaboration 

EPA’s influence extends well beyond the Emergency Department, becoming a cornerstone of hospital-wide collaboration and care improvement. They have partnered with multiple departments to enhance efficiency and increase patient care delivery. Working closely with cardiology, they have optimized STEMI transfer processes; with radiology, they have refined workflows to expedite diagnostic capabilities; and with neurology, they have helped shape plans for cutting-edge interventional stroke care. These collaborations reflect EPA’s commitment to delivering the highest quality care while improving operational efficiency across the entire hospital system.

EPA physicians have also actively contributed to public health initiatives across the broader community, offering expert insights on a wide range of topics. From interviews addressing the dangers of “pink cocaine” and heat-related emergencies to participating in distracted driving awareness campaigns, their involvement underscores a commitment to community well-being and public safety.

The SCVMC success story demonstrates EPA’s ability to adapt its approach to different hospital environments. By focusing on collaboration, trust-building, and patient-centered care, EPA continues to transform SCVMC’s Emergency Department into a model of high-quality care for the community.