ED Management – February 1, 2023

Leverage Telemedicine to Speed Care for Lower-Acuity Patients

By leveraging telemedicine technology, the ED at Stanford Hospital established a Virtual Visit Track, a solution that accelerated care for lower-acuity patients and helped staff effectively manage at least some of its pandemic-related challenges. Furthermore, it is an approach that might even be more applicable for health systems that operate multiple EDs.

During Patient Surges, Rapid Assessment Zone Reduces Risk for EDs

Using this approach, an ED reported declines in the rate of patients who leave without seeing clinicians, along with shorter median arrival-to-provider and length of stay times.

Concerned About Understaffing, ED Nurse Calls 911 for Help

Although ill-advised, this extreme move underscores healthcare providers' feelings of desperation amid ongoing staffing problems.

EMS-Driven Protocol Delivers a Low-Barrier Pathway to OUD Treatment

What if pre-hospital providers were empowered to both initiate overdose patients onto medication-assisted treatment in the field and also schedule follow-up appointments for ongoing care?

Trauma Patients at Risk for Developing Opioid Use Disorder

Better identification and referral of patients with opioid use disorder could enhance the quality and continuity of care these patients receive, while also reducing reliance on EDs and the crowding that ensues.

Effectively Intervening with Patients Facing Housing Instability

There is a moral and humanitarian case for healthcare organizations to engage on the housing issue, but there also is a business case.

To Understand a Patient’s Housing Status, Ask the Right Questions

Staff at every point of contact should be alert to relevant patient needs, including housing status, food insecurity, and ability to pay. All these go into making medicine human.

Some ED Patients Undergo Unwanted End-of-Life Care

Despite uncertainty, it is possible to provide value-concordant care in the ED. Identify those patients, and initiate decisions based on goals of care, not just by a default reflexive pathway. This could help improve patients’ experiences and outcomes broadly, by targeting the right treatments to the right patients.

Multiple Legal Issues with ED End-of-Life Care

An attorney argues missing the opportunity to respect autonomy in care decision-making for a patient who no longer desires curative care should be considered a poor outcome.

Malpractice Lawsuits Allege Wrongful Prolongation of Life

The top problems in these cases are charting and communication among caregivers.