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A recent follow-up study in the Archives of Surgery shows that improvement in patient safety has resulted from the implementation of Medical Team Training at a number of Veterans Health Administration (VHA) hospitals.
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When it's typical for patients to wait four hours or more to see an emergency physician, and your leave-without-being-seen (LWBS) rate is pushing 10%, you know it's time to rethink the whole process. And these were the grim realities facing the ED at Baylor Medical Center in Garland, TX, as recently as two years ago, explains Steve Arze, MD, the medical director of the ED.
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All of the discussion in recent years about the risks from exposure to radiation from computed tomography (CT) scans has hardly dampened enthusiasm for the technology in the ED. To the contrary, a new study suggests that CT use in the ED increased by a whopping 330% between 1996 and 2007, according to a retrospective look at data from the National Hospital Ambulatory Medical Care Survey, which is a national survey of services in emergency departments conducted by the Centers for Disease Control in Atlanta, GA. However, the study also suggests that the increase in CT use may be associated with a dramatic reduction in hospitalizations.
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There is no question that hospitals face innumerable challenges in meeting the "meaningful use" of health information technology (HIT) criteria established by the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009.
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Five years after the Centers for Disease Control (CDC) in Atlanta issued recommendations calling for all health care settings to routinely screen patients for HIV in areas where HIV prevalence is at 0.1% or higher, the practice has failed to take hold in most EDs, even though many obstacles to testing, such as burdensome informed consent requirements, for example, have been cleared away.
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The potential for violence in the ED is well-recognized and often discussed. Several organizations such as The National Institute for Occupational Safety and Health at the Centers for Disease Control in Atlanta, GA, for example, cite the ED as being one of the most dangerous places in health care to work, and a study completed last year by the Des Plaines, IL-based Emergency Nurses Association noted that every week, between 8% and 13% of ED nurses experience some type of physical violence in the course of doing their jobs.
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No matter what model of accountable care organization (ACO) the Centers for Medicare and Medicaid Services (CMS) settles on, case managers are sure to be key players as providers focus on managing care efficiently and effectively across the continuum.
