Seattle nurses take health care to streets, reduce ER visits

Nurses combatting overcapacity with compassion

Two Seattle nurses devised a strategy to curb repeated emergency visits by heart failure patients. Opting for a mobile approach, they deliver crucial medical interventions directly to patients' homes.

SEATTLE - Harborview Medical Center alerted staff to critical capacity issues this week, an issue that was exacerbated significantly during the COVID-19 pandemic and left the hospital facing a dire shortage of beds amid a surge in patient admissions.

Responding to the heightened pressure on the Level One Trauma Center, nurses Kate Smith and Jaimie Pechan devised a proactive strategy to curb repeated emergency visits by heart failure patients. Opting for a mobile approach, they traded their scrubs for car keys, delivering crucial medical interventions directly to patients' homes.

nurse takes a man's blood pressure on the streets of seattle

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"I’m confident that there were a lot of people who thought that this was a really good idea because it's so clearly a need in the healthcare system, but the pandemic kind of created this perfect storm," said Pechan.

"We all know that hospitals are under pressure in terms of their emergency rooms and bed space," remarked Smith. "Especially through the pandemic, but it continues. I mean health care is squeezed all the time."

Currently, Smith and Pechan serve 75 patients across King County using their sedan-turned-mobile clinic. Their initiative focuses on providing critical care to meth-cardiomyopathy patients in their communities. In just six months, this door-to-door service has helped reduce ER visits from their patients by 25% and shorten hospital stays by an impressive 43%.

"Something that we see a lot is that people will be discharged and a month later they’ll be back in again," Smith explained.

These patients, known as high-utilizers, often deal with chronic illnesses, addiction, or psychiatric disorders, driving up healthcare costs and causing overcrowding.

"And we all know that hospitals are under pressure in terms of their emergency rooms and bed space," Smith added. "Especially through the pandemic, but it continues. I mean, healthcare is squeezed all the time."

"What Jaimie and I do is we hope to just take that pressure off our emergency rooms and in-patient teams," she added.

"There are patients we see that are very, very sick," Pechan noted. "There are patients that really should be in the hospital that we see, but they won’t come in."

In a week, Smith and Pechan diligently check in with at least 40 patients, many residing along Aurora Avenue. One success story includes Michael Carpenter, who battled meth addiction and unstable housing before receiving critical care from the nurses.

two nurses check a man's blood pressure on the side of street

Nurses Kate Smith and Jaimie Pechan check on a patient on June 26, 2024, in Seattle, Wash. (FOX 13 Seattle)

"I could barely walk five feet without getting out of breath. My heart hurts when it beats," Carpenter recalled. "They showed that they cared."

Years later, Carpenter is clean and has stable housing.

"One of the silver linings of getting a heart failure diagnosis is that you suddenly realize how sick you are," Smith said. "That can often bring life’s choices very clear in what you have to change, and Michael’s a great example."

Kenneth Bell, another patient, has also made significant strides in his health journey.

"When he was sick out on the street, we were seeing him almost every week," Pechan said. "Now, he takes his medications 100 percent of the time. The fact that he’s so stable is remarkable."

"They’d come find me and make sure I was alive," Bell said. "It means a lot."

The program launched during the COVID-19 pandemic, continues to gain momentum. A part-time pharmacist now ensures that their 75 patients receive their life-saving heart medication, while a cardiologist has joined the team, offering critical services like ultrasounds one day a week.

For further details on this initiative and its ongoing success, visit Harborview Medical Center’s website or contact their public relations office.