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Monty Gooch, RN, BSN, director of emergency services at Middle Tennessee Medical Center (MTMC) in Murfreesboro, says that one of the keys to his department's smooth patient flow door-to-doc time of 35-40 minutes despite steadily growing volume is the way it works closely with other departments.
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The National Quality Forum (NQF), expressing its desired to reduce overcrowding and improve quality of care, has endorsed 10 national voluntary consensus standards for hospital-based ED care. The standards are:
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The establishment of a communitywide patient information sharing system by the Wisconsin Health Information Exchange (WHIE) was a collaborative effort from the start, says Kim Pemble, WHIE's executive director.
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Every year at about this time, the Centers for Medicare & Medicaid Services (CMS) publishes its final Out-patient Prospective Payment System (OPPS) payment rule for the following calendar year, and every year emergency medicine experts express their dissatisfaction with one aspect or another of what CMS has wrought. This year, however, might prove to be an exception.
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As part of its Outpatient Prospective Payment System (OPPS) payment rule for 2009, the Centers for Medicare & Medicaid Services (CMS) has established a multiple imaging composite methodology, which means it will provide a single composite ambulatory payment classification (APC) payment each time a hospital bills more than one procedure from an imaging "family" on a single date of service. The families are:
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If someone told you that an ED had experienced a 60% increase in volume between 2000 and 2008, you wouldn't be surprised to learn that the average length of stay (LOS) for their patients also had increased dramatically.
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Decreased renal and hepatic blood flow. Decreased glomerular filtration rate. Decreased total body water. Increased percentage of body fat.
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"This is one of my favorite problems to 'diagnose,'" says Joan Somes, PhD, MSN, RN, CEN, FAEN, ED educator at St. Joseph's Hospital in St. Paul, MN.
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Psychiatric patients can leave your ED without warning or cause harm to themselves or someone else, says Nancy Bennett, RN, MSN, ED educator at The Hospital of Central Connecticut in New Britain.