The Alexandria Plan Celebrates 50 Years
Inova Alexandria Hospital Honors Nation's First Fully Staffed Emergency Department

Emergency medicine turns 50 this year. And we can thank Inova Alexandria Hospital, formerly Alexandria Hospital, for this milestone.

It was back in the 1960s that "groups of physicians started to leave their respective practices to devote their work completely to emergency care," says Brian J. Zink, MD, author of the book, Anyone, Anything, Anytime – A History of Emergency Medicine.
Alexandria Hospital's James DeWitt Mills, MD, along with three associate physicians, Chalmers A. Loughridge, MD, William Weaver, MD, and John McDade, MD, comprised the first of such groups.

In 1961, these docs established a formal plan and contract with the hospital to have 24/7 emergency care provided by full-time emergency physicians. The concept became known as the Alexandria Plan. (A celebration of the plan's jubilee birthday was held June 24.)

Prior to the formation of the Alexandria Plan, physicians on staff worked in hospital emergency rooms on a rotating basis. Among them were general surgeons, internists and psychiatrists. Physicians in training, such as interns and residents, also staffed emergency departments, often without supervision. Experienced nurses were typically the stalwarts of care in early emergency rooms. Many smaller hospitals only had nurse supervisors who summoned physicians if they deemed the medical situation appropriate.

Trendsetters

That decision in 1961 to allow for a full-time physician staff in the emergency department set the course for emergency medicine throughout the country. Today, more than 120 million Americans visit emergency departments each year.

Inova Alexandria Hospital's emergency department is still going strong, caring for more than 10,000 patients arriving by ambulance each year.

"We started the trend and we haven't missed a beat since," says Martin Brown, MD, Chief of the Department of Emergency Medicine at Inova Alexandria Hospital. "We continue to be trailblazers. As an example, we are part of the Inova Alexandria Stroke Center, which is accredited by The Joint Commission."

Besides 24-hour emergency care, Alexandria Hospital — thanks to lessons learned during the Korean War — was also one of the first to use triage-type services as part of emergency medical services in the field. The 9/11 attack on the Pentagon revealed just how critical these services are.

Earning Its Stripes

While Alexandria is responsible for pioneering 24-hour emergency department staffing, the field of emergency medicine was not officially recognized until nearly 20 years later. It took the establishment of the American College of Emergency Physicians (ACEP) in 1968, as well as recognition of emergency medicine training programs by the American Medical Association and the American Osteopathic Association, and a historic 1979 vote by the American Board of Medical Specialties for emergency medicine to become a recognized medical specialty.

Thinking back on that last memorable trip to the ED, aren't you glad it did?

We've Come a Long Way
See Emergency Department wait times

Inova Health System has launched a new feature available that displays estimated wait times at our nine emergency rooms. The times displayed represent the estimated length of time from when a patient is registered to when they are assigned a "first provider" — a doctor, nurse practitioner or physician assistant.

Displayed wait times are refreshed every 10 minutes. Of course, these wait times are provided for informational purposes only and cannot be guaranteed upon arrival. For example, patients arriving by ambulance or with life-threatening injuries or illnesses will be treated before others with less-serious ailments. However, the feature provides a useful, easy-to reference guide when choosing where to go in case of a non life-threatening emergency
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Inova has also developed an iPhone application that will display this information for those who are not near a computer and need quick access to real-time updates.