Lafayette Regional Health Center, a critical access hospital 60 miles east of Kansas City, Missouri, was running an Emergency Department (E.D.) with a small group of dedicated local physicians. As with many small hospitals, the E.D. operated on the overworked shoulders of three physicians, who each pulled 24-hour shifts.


These physicians were committed, but their small number often made them vulnerable to staffing issues. The medical director developed significant medical issues and was unable to work overnight. This challenge, combined with the Kansas City market’s short supply of emergency medicine clinicians, meant that the hospital quickly bordered on an inability to keep the E.D. open.


On March 23, 2016, HCA formally requested assistance from Envision Physician Services to staff its E.D. We used our large presence in the Kansas City metro area to place a call to our emergency medicine clinicians the following day with the goal of ensuring patient care was not interrupted. Three shifts needed to be filled that week. We met that requirement by the end of the first day, then filled 15 shifts for the following month by the fifth day. More than 140 shifts were filled during the next five months by Envision Physician Services emergency medicine clinicians, and patient care was never interrupted.


Lafayette Medical Center officially joined the Envision Physician Services family in October 2016. Since then, the performance of the E.D. has continued to improve. It is consistently ranked in the top tier of measurable quality and E.D. throughput in the region.


We owe the success to the leadership of Patrick McHugh, M.D., as well as Lindsey Bailey and Brent Walker. However, most of the success was due to the many providers who stepped up at a moment’s notice to make sure Lafayette did not suffer interruption to the care of their community.