ED Management – December 1, 2023

Calling ED Boarding a Public Health Crisis, ACEP Pushes Policymakers to Act

Although there are many possible solutions, both legislative and administrative, the industry continues searching for the right formula to solve the problem.

Many Patients Avoid Going to EDs Because of Fear of Boarding, Delays

Emergency physicians should convey to patients that they will receive care, regardless of the boarding crisis. Stick to the foundation of emergency medical care: stabilize, ensure patients are not experiencing a life-threatening emergency, and manage their urgent conditions.

EMTALA Concerns if Patients Ask About Delays

Are discouraging comments an EMTALA violation? Investigators would examine factors such as what exactly was stated, under what circumstances the comment was made, whether the information was truthful and accurate, and whether it discouraged the patient from staying in the ED and receiving care.

Hospitalist Triage Role Expedites Admission Decisions for ED Patients

This intervention alone likely will not reduce the number of boarded patients. But with accurate data in hand, the focus can shift to alleviating the downstream bottlenecks that prevent patients from going to inpatient beds sooner.

Shorter Length of Stay if ED Workup Completed Before Surgical Consult

Researchers reported completion of workups, such as basic labs and imaging before consultation, resulted in patients spending less time in the ED. Average consultant-to-decision time was 2.5 hours for patients with complete workups vs. 4.9 hours for those with incomplete workups.

Emergency Care Providers Help Identify Candidates for Hospital-at-Home Program

Project planners intend to care for hundreds of patients per year in the hospital-at-home program, thereby offloading some of that capacity from inpatient hospitals.

Telestroke Facilitates Care for Rural Stroke Patients

In the year before the telestroke program was implemented, 11 of 15 eligible patients received thrombolytics in less than one hour, and there was a mean door-to-needle time of 61 minutes. After the telestroke program was implemented, 11 of 12 eligible patients received thrombolytics in less than one hour, with a mean door-to-needle time of just 38 minutes.

Study Shows Effect of Pediatric Readiness on Racial, Ethnic Disparities Regarding Mortality

Researchers estimated that if the three quartiles of hospitals that are least pediatric ready raised their readiness levels, there would be a threefold reduction in the mortality disparity of medically ill patients.

Racial, Ethnic Disparities in Restraint Use

Use restraints only when absolutely necessary, and in accordance with established protocols and regulations. Undergo training on appropriate restraint techniques. Ensure regular monitoring of restrained patients. Continuously reassess the need for restraints. Clearly document the rationale for restraint use.