Hennepin Healthcare’s new emergency department says the diverse staff and community health practices help patients

Hennepin Healthcare’s emergency department has a new chair, one of the first racially recruited people to lead an academic emergency department in the US Dr. Thomas Wyatt (Shawnee/Quapaw) is believed to be the first Native American physician to chair an emergency department in Minnesota.

HCMC is the busiest and largest tier 1 hub in the province. It is considered a safety hospital, providing care for low-income, insecure and vulnerable people. And like many similar hospitals, it’s difficult to get follow-up care for patients, especially those with mental health problems and drug use.

Dr. Wyatt spoke with MPR News senior health reporter Erica Zurek about serving a diverse population, overcrowding in emergency departments and investing in preventive care.

This interview has been edited for length and clarity.

Tell us about the patient population of Hennepin Healthcare.

It’s no surprise that Hennepin Healthcare serves such a diverse and unique patient population. They are not only people within the district, but people from all parts of the country and neighboring districts.

We have one of the largest urban American Indian populations in the entire country and certainly the largest in Minnesota. We have a large Somali and Hmong population, Latino patients, Black patients. Although the majority of Hennepin County is white, the patients we serve are diverse.

Some studies show that patients do better when they see their providers who look like them and have similar life experiences. This is important because providing cultural acceptance to patients makes a difference in their care and not only how they are treated, but also their outcomes.

In the emergency department we have a diversity committee that has been in place since 2017 and we are trying to focus on things like recruitment, education and community outreach. That has been an important part of who Hennepin Healthcare is.

It sounds simple, like, hey, let’s hire a team of doctors, providers and nurses who are like the patients we serve. We see a large number of American Indian patients in the emergency department, so we are recruiting more American Indian doctors.

But it is not that easy because we are not many doctors out there. So, it is to get people involved early, to be intentional and to put resources in place to identify people – for the few different people I talked about – who want to have a health career.

A recent study released by the Minnesota Department of Health and Wilder Research found that statewide 17 percent of behavioral health patients stayed in emergency rooms and inpatient settings for days or weeks. longer than necessary. The most common reason the study found was a lack of available beds in residential treatment centers and psychiatric facilities for adults and youth to be referred. How does this relate to what you see in the Hennepin Healthcare emergency room?

It’s not just Hennepin Healthcare’s problem. It’s the whole health system problem. And it’s not just in our district, it’s across the country. In the last decade or so, we are seeing more and more people suffering from things like mental illness and alcoholism.

We can handle emergency after emergency, and that includes emergencies for people with mental health issues or addiction or overdose. But once we get through that phase of intensive care, I don’t think our health care system — I’m talking about the whole country — has found a way to help with that.

The hospital and sometimes the emergency department becomes a kind of unsafe part of the whole system. We see people in our emergency departments or hospitals who would be better served if they were in some type of outpatient facility, such as a nursing home or outpatient treatment for alcoholism. . But people are often kept in the hospital because those places are not available.

Some of it has to do with not being prepared. Some of it has to do with gender. And those essential services are not reimbursed in the same way as acute care.

So, I think that many people, legislators in particular, the government and [federal] The Centers for Medicare and Medicaid Services needs to start paying attention to that. Otherwise, what will happen is that people with real emergencies will not have a way to get into the system because it is blocked by those waiting to be placed in the most difficult facilities.

Do you see a solution for this in HCMC?

There is not enough capacity. That’s part of the problem. And is it related to this epidemic? It is certainly possible. Is it related to the rise of mental illness, especially among young people? Is it social media? There are many different theories about it, and I don’t know the right answer, but clearly something has changed.

Mental illness and substance abuse get a lot of attention, rightly so, but the emergency department is also where people go if they’re hungry or malnourished. They come if they are homeless or homeless and looking for a place to live.

There are not enough social services provided or available in the villages. Again, this is not just a Hennepin County or Minnesota thing. It’s nationwide. People will come to the emergency department and of course we’ll feed them, and we’ll help try to get them a bed or something.

Hennepin County used to be known for never turning down, never turning down a referral to an outside hospital and we have to turn it down these days because we don’t have the capacity to take everybody. But sometimes it’s part of the moral hazard, which we can only do as an intensive care unit, especially as an emergency department. That’s not cool.

As you mentioned, some people are dealing with mental health or substance abuse problems before they get to the emergency room. Should there be more focus on preventive care?

We have found that with this epidemic our health infrastructure is not working. How can we improve on this as a health care system, as a country and as individual states? This should be the focus, in my opinion, because if you look at other European countries, for example, which do preventive medicine well, they have better results than what we do in our country. That’s because they invest in it and use it properly.

This is a discussion that our policymakers and government officials who help set reimbursement rates for health care should be thinking about: How preventive care and public health play into our health care system health care?

We know it’s not reimbursed and that’s not a financially viable way to run health care, at least in our country. But I think we really need to look at whether we have the right model to provide the best care for our American patients.