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Extending the Emergency Department to the Arena

March 23, 2011
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Interview with John Fontanetta, M.D., FACEP, Chairman, Emergency Medicine, Clara Maass Medical Center

Fontanetta: The advantage to having the same system we use in the emergency department was that our staff did not need training. The whole key was putting the right tools in the right place. I think, often, when you are dealing with these remote situations, people don't think about creating the right environment. Without the right tools in place, it is difficult to provide the right kind of care.

HCI: What has the feedback been from the CMMC clinicians who work in the Arena? From the patients?

Fontanetta: The clinicians love it. They have everything they need to do their job and they get to go out and work in a fun, festive environment. It's something a little different. As for the patients, we have a patient satisfaction rate around 95 percent. The response has just been marvelous-they've told us they've had a great experience. We're happy to hear it.

“We've had patients with respiratory distress, congestive heart failure, and allergic reactions. Our set up means the hospital is ready and waiting for them by the time they arrived.”

HCI: Can you give me a real-world example of care at the Arena?

Fontanetta: We've had many situations where we've been able to treat patients and then allow them to go back and watch the game. For example, we had an excited child who fell as he was walking into the Arena and lacerated his forehead. As you can imagine, his concern wasn't the big cut on his forehead, but missing the game. The laceration was too big to treat on site. But thanks to the coordination between the emergency department and the arena, everything was set up and waiting for him at CMMC. We were able to stitch him up and get him back to the Arena by the second half of the game.

We've also had a handful of life-threatening emergencies. We had a patient with a brain hemorrhage who was appropriately identified and then transported to the hospital. We've had patients with respiratory distress, congestive heart failure, and allergic reactions. Our set up means the hospital is ready and waiting for them by the time they arrived. And, of course, there have been all manner of other smaller problems we've been able to handle on-site. We've done a lot of good work there and we're proud of it.

HCI: What has the feedback been from the Red Bull Arena staff?

Fontanetta: They are very happy. It was their aim to provide the same level of care and concern at the Arena that you could find at our emergency department. We've been able to do just that.

HCI: What are some of the bottom-line results that Red Bull Arena and CMMC have experienced thanks to this relationship?

Fontanetta: Beyond expedited, quality care to the Arena's visitors, we've helped Red Bull Arena with their risk management. We help them identify potential risks and keep on top of possible issues, reducing potential liability. For us, it's a great service we can provide to our community. And it's also a way for 27,000 game spectators to associate the name Clara Maass with high-quality medical care and community involvement.

HCI: What advice would you offer others trying to establish similar set-ups with local venues?

Fontanetta: To do this kind of job right, you need the right support. First off, make sure you have the right providers in place to give the right care. This isn't a place where you should send residents. You want trained emergency providers who are used to dealing with an unpredictable environment. Second, make sure you have the right cooperation from that venue. Red Bull Arena has been marvelous-they have the attitude that they are willing to do what it takes to maintain the comfort and safety of their spectators. You want that. You need that. Finally, don't underestimate the technology. Our EMR, our VPN, having all the right equipment in the Arena treatment room to handle everything from a sprained ankle to a full cardiac arrest-we have that. You shouldn't settle for anything less than the tools you need to do your job right.

Healthcare Informatics 2011 April;28(4):21-22

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