ED Management – June 1, 2024

Root Causes of Significantly Delayed CT Scans in ED Settings

EDs often experience delays obtaining computed tomography scans, with some patients waiting multiple hours for the test. This situation causes bottlenecks in patient flow, increasing length of stay and overall ED crowding.

Delayed CT? ED Documentation Can Increase, or Mitigate, Risk

When CT scan delays occur, ED providers sometimes want to document in the chart all the factors beyond their control. “But trying to call out delays in the chart puts up a flag,” warns Bryan Baskin, DO, FACEP, vice chair of safety and quality at the Cleveland Clinic’s Department of Emergency Medicine and an assistant professor at Cleveland Clinic Lerner College of Medicine. Documenting objectively, such as stating, “The CT scanner was down for two hours,” is probably appropriate, he says.

San Diego County EPs Making Sure Life-Saving Technique Is Available to Cardiac Arrest Patients

The Centers for Disease Control and Prevention notes that every year more than 365,000 people in the United States will experience an out-of-hospital cardiac arrest. However, even in cases where quick-thinking bystanders skillfully administer cardiopulmonary resuscitation before paramedics arrive to take over, the odds of surviving a cardiac arrest are bleak. But what if there was a way to improve the odds of survival in such cases?

An Alternative Model for ECPR: Keeping the Pool of Physicians Skilled in the Procedure Small

Extracorporeal cardiopulmonary resuscitation, or ECPR, is relatively new to UF Health’s Shands Hospital in Gainesville, FL. Interestingly, unlike the model for ECPR being deployed by hospitals in San Diego, where dozens of emergency physicians are being trained in the technique, developers of the ECPR program at UF Health have decided that it is important to restrict the number of emergency physicians who perform ECPR.

EDs Are Seeking to Minimize Restraint Use

At Hennepin County Medical Center’s ED, quality improvement and quality assurance have been a long-term focus. “There was an interest, particularly in the wake of the local and national events of the summer of 2020, to reexamine our restraint practices and look for opportunities to minimize coercive care in our ED,” reports Aaron E. Robinson, MD, MPH, a faculty physician in the Department of Emergency Medicine at Hennepin County Medical Center and assistant medical director at Hennepin Emergency Medical Services.

Gender Affects EPs’ Decision-Making on Restraint Use

Gender affects the way emergency physicians (EPs) approach decision-making for management of agitated patients, according to a recent qualitative study.

ED Nurses Would Not Recommend Their Workplace Because of Safety, Staffing Concerns

Emergency nurses are much more likely to report high burnout, job dissatisfaction, and intent to leave compared to inpatient nurses, according to a recent analysis of nurses practicing in 60 U.S. hospitals.

Race, Ethnicity Data Are Important for QI but Sometimes May Be Incorrect

Many EDs have been collecting race and ethnicity data for quality improvement purposes for decades. Rama A. Salhi, MD, MHS, MSc, an assistant professor in the Department of Emergency Medicine at Massachusetts General Hospital, and colleagues set out to learn more about the accuracy of the data being documented by EDs.

Some ED Patients Are Suicidal but Present with Unrelated Complaints

Many youths who die by suicide interacted with the healthcare system in the year before death. This raises the question: Should ED providers be screening all youth for suicide risk, regardless of their chief complaint?

Simple Interventions Prove Powerful in Boosting the Acceptance of Preventive Vaccines in the ED

While emergency staff are busier than ever these days, there is no denying that EDs are particularly well-positioned to recognize and address the healthcare needs of underserved patients, many of whom rarely receive preventive care services such as flu vaccinations. Furthermore, new research has shown that, with not much effort or time on the part of clinicians, EDs can double or even triple the percentage of unvaccinated patients who receive their flu vaccinations — a move that likely prevents more expensive, future healthcare use for some of these patients.

New ED Clinicians Pose Safety Concerns

Newly trained clinicians entering clinical practice are the top patient safety concern in healthcare, according to ECRI’s Top 10 Patient Safety Concerns for 2024 Special Report.

Take on CLABSI Infections with Individualized Education, Leadership Support

Central line-associated bloodstream infections (CLABSIs) are a big problem for patients because they often lead to serious complications such as sepsis. Further, managing such cases can significantly run up the tab for hospitals.