Horizon Health ER Seeing Sicker Patients

Additional providers help maintain patient flow

Emergency room usage can be a good indicator of a community’s overall health.

At Horizon Health, ER visits are increasing with more patients presenting with multiple and more complicated medical conditions. For ER staff, that means more time spent evaluating and treating patients, and ordering tests, if needed.

“We’re not a walk-in service anymore,” said Samantha McCarty, Horizon Health director of emergency services. “It is truly caring for sick patients.”

To reduce wait times and maintain patient flow, Horizon Health is adding additional providers to assist ER physicians. The initiative was prompted by patient and staff feedback.

“We noticed we were having lengthier wait times,” Samantha explained. “We also wanted to improve quality of care. The only way to do that was to have another healthcare provider in the ER with the physician.”

Currently, seven ER physicians provide 24-hour coverage, seven days a week. Six nurse practitioners provide additional support, working 12-hour shifts/seven days a week during the ER’s busiest times (10 am–10 pm). The nurse practitioners see patients, begin treatment, order testing, and discharge patients. Their holistic approach and nursing training adds a different perspective to care, complementing physicians who have science-based/medical training, Samantha said.

“Patients will always see a physician when they come to the ER,” she said. “There may be times when they are not the sickest patient. Therefore, the nurse practitioner can get them seen more quickly, treat and diagnose them, while the physician is working with a much sicker patient.”

Matt Stetler joined Horizon Health as an ER nurse two years ago and transitioned to a nurse practitioner in 2024. He said having nurse practitioners in the ER is a win-win situation.

“Patients benefit because they are not waiting as long to be seen, especially if they are extremely sick,” he said. “Having an extra set of hands takes pressure off of the doctors who are already working 24-hour shifts.”

Approximately 8,000 patients visited the ER in 2013. That number climbed to more than 10,500 visits in 2023. Now more than ever, patients have two or more medical conditions that can complicate their treatment. These often include chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF), diabetes, kidney failure, lung disease, and obesity.

“Patients are coming in sicker than they were 10 years ago,” Samantha explained. “The length of stay is also longer because we must do more testing and treatment based on the conditions we’re seeing.”

Nurse practitioners in the ER may look familiar to many patients. That’s because some of them also staff other Horizon Health services.