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By locating a social worker in a hospital ED to help members overcome barriers to primary care, Horizon NJ Health, a West Trenton, NJ-based managed care organization, was able to decrease ED visits by 45% among its members who had a face-to-face conversation with the social worker.
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Haywood Emergency Physicians, which had managed the ED at Haywood Regional Medical Center in Clyde, NC, since 1991, was ousted by a unanimous vote of the hospital's board in late December 2006 and replaced by the corporate physicians staffing firm Phoenix Physicians following a heated contract dispute.
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Most ED managers breathed a sigh of relief after The Joint Commission approved an interim action, effective Jan. 1, 2007, that changed the requirement for pharmacy review of ED medication orders [element of performance (EP) 1 for standard 4.10 of medication management].
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By creating inexpensive fever kits and providing them free of charge to parents of children between 3 months and 5 years of age who presented and were discharged, the ED at Presbyterian Hospital of Dallas has saved approximately $300,000 since the initial pilot program began in July 2004.
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Harried ED managers who are trying their best to get patients upstairs apparently have some strong allies in this battle: The patients themselves.
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An adult patient arrives at the ED in the middle of the night with a presenting complaint of head trauma of unknown origin, and associated pain and dizziness.
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After a baby was nursed by the wrong mother at Immanuel St. Joseph's Mayo Health System in Mankato, MN, the family members involved were understandably very upset and very vocal. They alerted the news media, which reported on the incident, and staff were educated about processes to ensure this would not occur again.
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Previously, patients diagnosed with community-acquired pneumonia were to receive antibiotic administration within four hours of presentation. Now, The Joint Commission standards call for antibiotic administration within six hours.
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In the wake of a first-of-its-kind settlement regarding the discharge of a homeless woman by a Kaiser Permanente hospital in Southern California, indications are that the disturbing issues it aims to address are far from unique.