David Hieber PA-C
Dave Hieber, PA-C, worked in EMS during college, experience that cemented his path to PA school and the field of emergency medicine. When he graduated 6 ½ years ago, he joined MedStar Emergency Physicians where he has become the Lead Emergency Medicine PA managing a large group of PAs at MedStar Franklin Square Medical Center. Those PAs work in all aspects of the emergency department (ED); many, including Hieber, hold a Certificate of Added Qualifications in Emergency Medicine.
“I have fun at work,” Hieber says. “One day recently I left the hospital thinking that I am happier now at the end of my shift than when I started. There aren’t many jobs where you can say that at the end of the day.”
Hieber’s first love is taking care of patients, but he is also focused on process improvement that leads to efficiencies in hospital metrics and patient care. For example, he was recently asked to work on a pilot project to get providers to patients quicker in the ED. The pilot team worked to developed a telemedicine process so that patients are seen by a provider in triage to get their treatment started while they wait.
“There are small hospitals that don’t need a full-time provider in triage but do need part time support,” says Hieber. “My role was to bring my expertise as a PA to the process of how telemedicine triage should operate, what resources would be needed, and what could be done by removing all physical barriers. We discussed how to queue many patients at multiple locations. We tested where the monitors were placed and positive scripting language, and ran simulations with nurses, and actors as patients, to create the most ideal patient experience.”
Now, a physician at a hospital in Maryland can oversee the triage of patients in multiple remote hospital EDs at one time. This allows orders to be started so that results are ready when the patient does see the PA or the doctor in person.
They are now looking to see where else this system could prove beneficial. “We do know that where it is already operational, we have driven down door-to-provider time and decreased length of stay in the ED,” he said.
According to Amanda Joy, PA-C: “Dave is a champion for PAs. He works on projects to not only improve our system but those that have national implications. His work with the telemedicine team could allow PAs in areas with limited attending coverage to have real-time physician consultation for complicated cases. This project has the potential to improve ED flow and allow faster throughput time to departments plagued by overcrowding and hospital systems dealing with higher acuity and boarding. These innovative concepts also have the potential to change access to healthcare for patients living in remote areas.”
Hieber has worked to streamline other processes as well, including one to improve follow up on lab results that come back after the patient has left the ED. The follow up that was previously handled by multiple clinicians in four hospitals in between patient visits was consolidated into one location and staffed by two PAs working part-time to manage all post-discharge labs a few hours a day. This eliminated distractions by providers trying to see patients and do follow ups, and it improved consistency with a single call-back number and a voicemail system. Says Hieber, “This process change allows us to more easily track utilization and quickly identify trends in antibiotic resistance. It also made patients happier as they were not bounced around when they called for results. They were able talk to a provider right away.”
“David leads by example, and innovation is his current impact,” adds Joy.
Hieber sums it up this way: “The job I have enables me to do the things I love best--practice medicine while incorporating my passion to lead initiatives that drive change.”