Healthwise Maui

EDITOR’S NOTE: Physicians, providers and administrative staff who practice at Maui Health System hospitals and clinics answer questions from the public in Healthwise Maui, which will appear regularly on Thursdays. Maui Health System operates Maui Memorial Medical Center, Maui Memorial Medical Center Outpatient Clinic, Kula Hospital & Clinic and Lana’i Community Hospital and accepts all patients. To submit a question, go to the website at mauihealthsystem.org/contact.

Q: What is the hospital doing to improve waiting times in the emergency room?

Dr. Lee Weiss, chairman of Emergency Medicine: Most patients’ No. 1 question about the emergency department is how long it will take to be seen by a doctor. After all, the ER is a busy place — we see around 68,000 emergency patients a year, making Maui the second-busiest emergency department in the state.

We track patients from the moment they arrive in the ER to the moment they’re discharged. Gathering this information helped us make simple changes, like adjusting shift times, so that we have more people on staff during peak arrival times and streamlining processes like getting lab results back faster.

Now, the average length of stay in the emergency department is down to around 140 minutes. That’s better than the national benchmark of 180 minutes. And the average time it takes to see a doctor from the moment you enter our doors is just 14 minutes, less than half the 30-minute national benchmark.

We’re happy with those results, but we’re working on reducing the wait even further. Starting next year, we’ll begin implementing a program called “Provider in Triage.” With this program, a doctor will meet each patient from the moment they walk in the door, reducing the waiting time to almost zero. After all, if I was a patient, I’d want to be seen by a doctor right away.

Q: I’ve been heavy my entire adult life, and I’ve struggled with losing the weight. Now I’m considering bariatric surgery, like a gastric bypass. But a family member told me surgery is taking the easy way out.

Dr. Arthur Chasen, head of Bariatric Surgery: Bariatric surgery — like gastric bypass, and sleeve gastrectomy — is most definitely NOT the “easy way.” That’s because, for the surgery to work, you have to make major changes to your lifestyle, including eating four to five small, nutritious meals a day, getting seven hours of sleep a night, and exercising for an hour each day.

Everyone who goes through bariatric surgery on Maui has to participate in a follow-up program for at least one year after the procedure. The program includes meeting with a counselor and nutritionist, and checking in with your surgeon (that’s me) to monitor your progress. You’ll also attend regular meetings of a support group, which includes talks and classes on healthy lifestyle choices, and discussion groups.

I’ve seen many people who, for one reason or another, couldn’t seem to make these lifestyle changes on their own, but were successful after surgery. Why? Of course, the follow-up support really helps. But I also think part of it is mental — once someone has made the decision to have surgery, they are really making a commitment to changing their life, and they’re willing to do whatever it takes.

And finally, unlike your willpower, the surgery never takes a day off. If you’re on a diet and feel like taking a break, that day off may turn into two, which may turn into a week, and you may quit your diet. But the surgery never lets you quit.

* Physicians, providers and administrative staff who practice at Maui Health System hospitals and clinics answer questions from the public in “Healthwise Maui,” which appears on Thursdays. Maui Health System operates Maui Memorial Medical Center, Maui Memorial Medical Center Outpatient Clinic, Kula Hospital & Clinic and Lana’i Community Hospital and accepts all patients. To submit a question, go to the website at mauihealthsystem.org/contact.

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