In 2017, Kito Lord, MD, MBA, moved to Memphis from Philadelphia to lead the Department of Emergency Medicine at Regional One Health and to help expand the UTHSC Emergency Medicine Residency program into the hospital, which is one of the busiest trauma centers in the country.
Recently, Dr. Lord was named to the 2019 list of Rising Stars in Healthcare Under 40 by Becker’s Healthcare. A leading source for business and legal information for leaders in the health care industry, Becker’s Healthcare has a portfolio of five-industry publications including Becker’s Hospital Review.
He was recognized for his efforts to generate efficiencies, advance patient outcomes, and improve care management as medical director of Regional One Health’s Emergency Medicine Department. First he orchestrated a clinical redesign of the emergency department reducing the number of steps to see a doctor from 26 to three, installing a rapid assessment zone (RAZ) to improve the treatment of lower acuity patients through the department. Then, Dr. Lord led efforts between the Trauma and Emergency departments to improve patient care, access, and training of residents – a win-win for the community.
Dr. Lord, site director for the UTHSC Emergency Medicine Residency program, championed the idea of Emergency Medicine and Trauma physicians working together to care for patients with traumatic injuries. Working with Peter Fischer, MD, trauma and critical care surgeon at the Elvis Presley Trauma Center, and James R. Walker, MD, chair of the Department of Emergency Medicine at UTHSC, they created an innovative plan to improve their care delivery model.
“We are making a lot of operational changes to reduce the amount of time that patients spend in the waiting room,” Dr. Lord said. “Making the door-to-doc (doctor) time quicker, so that patients are being treated more efficiently. We also had a goal to reduce the number of patients who left because the wait is too long. Every patient deserves timely, efficient and compassionate care.”
Collaboration among the two departments has allowed residency trained emergency medicine physicians to staff the critical assessment area that was previously staffed by trauma surgeons. Emergency medicine physicians specialize in emergent stabilization and treatment of all types of conditions. The collaboration has increased attending and resident staffing in a very busy trauma center. “Every patient gets seen by an emergency medicine trained attending physician and it allows the trauma team to focus on those sicker patients,” Dr. Lord said.
During the summer, the program graduated its second residency class that completed trauma rotations at Regional One Health and received cross-training beyond emergency medicine. “I know our residents are coming out really well trained and well rounded,” he said. “Hopefully a lot of them will stay in the city of Memphis, and that means high-quality emergency medicine physicians in the city.”
Beyond 24-hour staffing, improvements include a 32 percent reduction from arrival time to seeing a provider, with an average waiting time of 18 minutes for non-critical patients; a two-hour reduction in the decision to admit or discharge a patient from the time they see a physician; and a 74 percent reduction to the amount of time the center is at capacity and unable to take in new patients.
“By moving our lower acuity patients through our system more quickly, we have more space for our sicker patients that come in,” Dr. Lord said. “The amount of critical advisory, times when the ER is at capacity, has decreased since the emergency medicine doctors have been in the trauma area. We’ve reduced the length of stay in the trauma area by about two hours.”
The departments also collaborated with nursing staff.
“We brought nursing to the table,” Dr. Lord said. “We tore down those antiquated barriers between doctors and nursing to align our goals and work together to improve the care we deliver to our patients.”
The Emergency Medicine Departments was also the first in the hospital to use business intelligence software for clinical operations and patient care. The software is integrated into the electronic medical records platform, allowing the departments to better track statistics and give feedback to staff on a real-time basis.
Dr. Lord received his undergraduate degree from Morehouse College, his medical degree from Howard University College of Medicine, and completed his emergency medicine residency at the Yale School of Medicine. In addition, he earned his MBA from the Yale School of Management and completed an administrative fellowship in Quality, Safety, and Healthcare.
Dr. Lord says his MBA training influenced him to look for efficiencies, but the HR classes he took played a larger role in these improvements. “We all agree patient’s deserve high quality care, we often disagree about how to make that happen. It’s about working together and motivating people to move forward, teamwork, and collaboration toward a shared goal,” he said. “Changing the culture regarding how we approach patient care and the bottom line and being able to navigate both together.”