1. 7/2014

2. Jessica Berlin RN Emergency Department Director Berlin Medical Center jberlin@bmc.org 4201 Medical Drive Ponte Vedra, FL 32082

3.  Chartered in 2014 by the state of Florida, Berlin Medical Center (BMC) is a corporation specializing in acute care to the Ponte Vedra community  BMC is a 169-bed acute care facility, not for profit community hospital, with 21 private bays for emergency treatment

4.  The mission of Berlin Medical Center’s fast track area is to promote a dynamic environment which values research, flexibility, willingness and teamwork in order to promote optimal holistic health for our patients and community.

5.  The fast track area will consist of ten beds, staffed by either two nurses or one nurse and one emergency department tech.  The patients here will primarily be of lower acuity. ◦ ailments typically treated in an outpatient setting

6. Currently in our emergency department (ED), we treat an average of 80 patients per 12 hour shift. Adding a fast track area will:  Improve throughput times  Decrease elopement rates from waiting room  Add to daily revenue by increasing the amount of patients seen

7. Current Situation:  Our current nurse to patient ratio in our 21 bed ED is 5:1 ◦ This includes patients with acuity levels anywhere from 1 (most critical) to 5 (least critical)  While nurses are focused on caring for more critical patients, those with lower acuity are forced to wait With fast track area :  A single nurse's assignment would now involve caring for only those patients with acuity levels of 4 or 5

8.  Caring only for lower acuity patients, allows the nurse to focus on treating and discharging patients in the quickest amount of time  New ratio ◦ 4:1 on the critical side ◦ 5:1 on the fast track side  with the addition of 10 new fast track bays

9.  Our marketing strategy will focus on drawing customers to our emergency department as a whole by advertising shorter wait and throughput times  It would be too controversial to advertise specifically for low acuity ailments, deterring from the primary purpose of an ED (to treat life threatening ailments)

10.  Customers and clients will be identified as members, friends and visitors of the Ponte Vedra and Jacksonville community  Ad campaign, including radio commercials and billboards, will focus on common ailments like trips and falls and back pain in the 18-55 age demographic, therefore providing a more efficient approach to care

11.  Our plans for generating publicity will include ◦ Segments on local news and radio programs ◦ Tweeting via our twitter account, @BMCEmergency ◦ Links to our webpage through our Facebook account

12.  Budget ◦ Website: $5,000 ◦ Billboard (4) rental x1 month: $10,000 ◦ TV/Radio: $1,000 ◦ Twitter/Facebook: Free Total: $16,000

13.  Labor for 2 nurses (4.2 FTE): $200,000  Chairs and bedside tables: $15,000  Monitors: $35,000  Computers: $10,000  Stretchers: $50,000  Gases and Construction: $352, 000 ◦ $220.00/sq feet

14. Board of Trustees President Chief Financial Officer (CFO) Billing Purchasing Chief Nursing Officer (CNO) ED Director ED Nurse Manager ED Nurses Chief Professional Services Officer MarketingPublic Relations

15.  Nursing ◦ Average rate of $25.00/hour per nurse ◦ Average rate of $16.00/hour per ED tech ◦ 12 hours per day, 7 days a week ◦ 1 registered nurse and 1 ED tech  $170,000.00 ◦ 2 registered nurses  $200,000.00

16.  Includes left without being seen (LWBS) patients and addition of 3 patients/day/year in growth Year 1Year 3Year 5 Anticipated Revenue*$432,000$464,400$496,800 Operating Costs$462,000$200,000 Marketing Expenses$16,000$13,500$11,000 Carryover Losses---$48,000--- Operating Income$48,000$202,900$285,000

17.  We at the Berlin Medical Center Emergency Department sincerely thank you for your time and consideration for expansion of our ED to include a fast track area.  Not only will this improve throughput, it will also alleviate nurse fatigue, improve staff retention, and eventually generate revenue for our facility.