Carol Wolfenbarger: Quality and patient care top priority in Emergency Department

By Carol Wolfenbarger
Chief Executive Officer, Mission Hospital McDowell


Carol Wolfenbarger

At Mission Hospital McDowell (MHM), we’ve made it a top priority to study how patients flow through our Emergency Department’s care process. There are many complex, unpredictable situations that happen simultaneously – and change constantly – there. As we study the experiences of our patients, I have much gratitude for our wonderful providers and nursing staff who are there “24/7” to serve your healthcare needs.

We’re also honored that you choose MHM as the place to get your care and want to tackle this unpredictable demand head on by figuring out ways to reduce your ED wait time. One of the benefits we enjoy as part of HCA Healthcare is that we can now track our daily patient flow management performance. To complement this ability and support our effort to improve, we’ve established a multidisciplinary team that meets weekly to review handled flow during the previous week and create action items for improvement in specific areas. This team is enriched by all who treat patients or manage/influence their care, including physicians, nursing, leadership, radiology, laboratory, patient access, quality leadership, and environmental services staff.

I recently had an experience trying to manage another type of flow – water – that parallels wonderfully with our patient flow issue. In my own home, I suddenly became a junior plumber when I had to troubleshoot why a couple of our sinks were draining sluggishly at my home. First, I checked the drain trap – nothing there. Then I removed the straight pipe to the wall – again, nothing. I removed the long drain pipe that connects to the opening in the sink, still nothing.

I was now worried that my problem was a biggie, and one that would require professional assistance, but I decided to make a last ditch effort: I removed the first portion of the drain that attaches to the sink. Eureka! The take-away? Flow issues really start at the beginning.

This is the type of approach we use to examine opportunities to improve at MHM too. Similar to my experience with the sink, MHM is acutely focused on what’s happening with the patient from the beginning of their time with us. Did we get the patient straight to a care area with little to no wait? Did they quickly connect with a physician? What about the timeliness of lab work, X-rays, and the administration of medication? These questions are particularly relevant to ED services.

Emergency care is very different as compared to a scheduled doctor’s visit. Our emergency care team has traditionally prioritized treatment depending on the urgency of each patient’s need for care – the sickest patients get treated first. Our team has developed a new protocol that will provide more timely care for all, regardless of their level of illness.

Now when you arrive at our ED during peak times, you’ll be greeted by a nurse who will quickly determine the area of care according to your illness. If you have a sore throat or a cut, for example, you’ll be ushered into an area designed to care for this kind of need (after all, this type of condition doesn’t require a stretcher). The target time for these services will be less than 90 minutes. As we improve with serving ED patients faster, we have more room in our waiting area, and are offering it to patients as a comfortable place to wait for test results. This is just a glimpse of how MHM is working to streamline not only your care, but your overall experience.

We have gotten favorable reviews for our care delivery in the past – both from watchdog organizations who publish their findings online and from individual patient surveys – and it’s because our conversations around safety, the patient experience, and how to support successful outcomes are not weekly or monthly, but daily. In this way, we constantly seek to find innovative solutions, grow, and make adjustments as needed.

We want every patient to have a tremendous experience at MHM and know that it takes teamwork and creativity on our part to succeed. We’re also aware that you have choices about where you can seek care. On our journey to being your number one choice for care, we will never change our focus on making that care excellent and compassionate.


Mission Hospital McDowell


Carol Wolfenbarger, MSN, RN, FACHE, is Chief Executive Officer of Mission Hospital McDowell. She holds both Bachelors and Masters of Science degrees in nursing administration from the University of Tennessee, is board certified in Healthcare Management and is a Fellow of the American College of Healthcare Executives (ACHE). Carol, who has served hospitals and health systems for more than three decades, has worked to add full-time cardiology services, led growth in outpatient services including imaging and surgery, and the expansion of primary care offering in Burke County since assuming her role as President at McDowell Hospital in 2015. She is an active member in Rotary and serves as a Board member for the Rutherford/Polk/McDowell Health District Board of Directors, the Corpening YMCA Board of Directors, and the McDowell County Chamber of Commerce Board of Directors.