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Emergency Services Getting An Upgrade

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By DEREK MAUL

Tribune correspondent

Published: August 13, 2008

BRANDON - Just about everyone has an emergency room horror story to tell, or one they have heard. Randy Spivey is no exception.

The difference is that Spivey has dedicated his considerable talents to making such stories a thing of the past.

"We're actually rebranding," he said, pointing to the logo on his shirt: Emergency Center at Brandon Regional Hospital.

It's an important distinction for Spivey, Brandon Regional's director of emergency services. In addition to changing the name of the emergency room to the Emergency Center, he changed "waiting room" to "reception."

"The expectation has shifted for everyone," he said. "People don't come in to wait."
Hospital leaders brought Spivey in from Nashville to improve emergency care in Brandon. He moved his family to Florida in June 2007, works closely with medical director Doug Scott and is on site 60 to 80 hours a week.

"This is the fifth emergency department I've run since 1990," he said. "I've been in emergency care since high school."

His challenge today? "Daily problem-solving and trying to deliver the best care possible," he said. "When people come in, they're looking for speed of service, bottom line."

Patients also care about communication, he said, knowing "what we're doing, when we will be doing it, and what the follow-up will be."

The easy-going Tennessee native implemented procedures designed to yield results.

"First, we looked at building camaraderie throughout the organization," he said. "Good relations with every facet, including getting EMS units in and out efficiently."

Then hospital staff members started tracking other patient services. That included how long it took to drop patients off at the Emergency Center and how much time passed between patient sign-in, triage, assessment, getting the patient a bed, arranging a first physician visit and making decisions about further treatment.

The Emergency Center is busy. Spivey said the staff sees about 200 patients a day, about 68,000 to 70,000 a year. About 15 to 16 of the center's 126 staff members are on duty at any given time, he said.

"Numbers are important, but I tell staff that every one of those numbers is a patient. When I can decrease time to treatment, I'm increasing patient care. The biggest challenge is primarily the volume of patients. Emergency centers across the country have increased in volume," Spivey said.

The hospital is documenting significant improvements, Spivey said, but there is more work to do.

For example, a recruitment initiative is intended to bolster the Emergency Center staff. "We've been successful bringing in quality RNs," Spivey said. He said he's intent on "building up the staff, providing education and good people taking care of patients. We want to make sure we support all our staff."
Spivey grew up on a small farm in Hartsville in central Tennessee. He recalls taking jobs cutting tobacco and hauling hay.

"My last year in high school, I worked as a tech in the local hospital and helped out in the ER," he said. The facility had one bed. "There was a buzzer, and we'd open as needed."

He rode ambulances serving as an emergency medical technician while attending the University of Tennessee in Nashville and later added training in critical care to his resume. He earned his registered nurse degree at UT in 1981.

The training was put to good use at St. Thomas Hospital in Nashville, where he worked in critical care for eight years and served on heart transplant teams.

"Weekends in critical care, then metro general ER during the week," he said. "The best of both worlds."
Spivey took management classes from Middle Tennessee State University and was hired to run emergency services at Nashville's Southern Hills Medical Center in 1990. He found his niche.

He married Lisa Flueallen in 1980. Also an RN, she now works in Tampa General Hospital's pediatric emergency room.

"We're glad we're here," Spivey said. "It may be hot, but it's miserable in Tennessee in August."

He said Brandon and the Tampa Bay area have a lot to offer. "Entertainment, the beach, sports - I'm a huge football fan. Then I have an old BMW I work on. I used to be a golfer, and my biggest hobby was martial arts. I want to get involved again."
Spivey also is a member of Atlanta-based Disaster Medical Assistance Teams, which sends medical professionals to assist when disasters strike, and he works for the Hospital Corporation of America instructing other medical professionals in how to respond to chemical, biological, radiological and nuclear threats or disasters. HCA is Brandon Regional's parent company.

MEET RANDY SPIVEY
WHAT: Director of emergency services, Brandon Regional Hospital
BORN: Hartsville, Tenn., 1959

EDUCATION: University of Tennessee, Nashville; Middle Tennessee State University, Murfreesboro, Tenn.

MARRIED: Lisa Flueallen, 1980

CHILDREN: Tyler, 19; Audrey, 17

MOVED TO BRANDON: June 2007

Derek Maul can be reached at derekmaul@gmail.com.

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