ED Management – August 1, 2008
August 1, 2008
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Medicare's shifting of call panels could be good news for ED managers
In a move that emergency medicine experts hope will provide at least partial relief to the call coverage challenge, the Centers for Medicare & Medicaid Services (CMS) has proposed a new regulation that would allow hospitals to establish community call arrangements at a regional level to satisfy their Emergency Medical Treatment and Labor Act (EMTALA) on-call physician requirements. -
Proposed 2009 OPPS: Quality push continues
ED managers have the opportunity to increase reimbursements under the proposed 2009 rule for the Outpatient Prospective Payment System (OPPS), but they also will come under greater scrutiny by the Centers for Medicare & Medicaid Services (CMS) for the quality of their care. -
CMS proposal could have unintended consequences
At first glance, it sounds like only good news for ED managers who are frustrated at their inability to have specialty services adequately covered. -
ED fares well on APC increases
ED managers should be pleased with the proposed increases in ambulatory payment classifications (APCs) for fiscal year 2009, says Dennis Beck, MD, FACEP, CEO of Beacon Medical Services in Denver and chair of the quality and performance committee of the American College of Emergency Physicians (ACEP). -
ED swings into action following helicopter crash
When an Aero Med helicopter crashed and burst into flames on the roof of an 11-story tower at Spectrum Health Butterworth Hospital in downtown Grand Rapids, MI, on May 29, 2008, during a training run, the ED team swung immediately into action to get to the two victims and prepare the department to receive them. -
Mobile units let ED reopen after flood
When a flash flood hit Columbus, IN, in June, Columbus Regional Hospital had to be evacuated. But just two weeks later, the ED was able to reopen, thanks to a mobile unit called the Carolinas MED (Mobile Emergency Department)-1, which was first deployed in New Orleans in the wake of Hurricane Katrina. -
ED staff trained on new equipment
In the wake of a flash flood in June that forced the closing of Columbus (IN) Regional Hospital, the ED reopened about two weeks later in a mobile unit called the Carolinas Mobile Emergency Department-1 (MED-1). -
Mobile unit can be available quickly
When an ED is forced to close due to a disaster and requests delivery of a mobile unit called the Carolinas Mobile Emergency Department-1 (MED-1), "we like to think we can be mobile in 72 hours," says Tom Blackwell, MD, medical director for the Center for Pre-Hospital Medicine, Department of Emergency Medicine, at Carolinas Medical Center, Charlotte, NC, and one of the two physicians who spearheaded the development of the mobile unit. -
Is 'the ED was just too crowded' ever a defense?
Crowding is increasingly becoming a factor in litigation involving ED care and is putting nurses and physicians at increased risk for being named in a lawsuit. -
Consider these arguments to defend docs, department
When you are faced with more patients than resources, and a lawsuit results, one possible defense argument that would encompass the hospital and the emergency physician is that everyone did everything that could be reasonably expected under bad circumstances. -
ED boarding adds to risk
The ED physician has some liability to care for these tremendously ill patients, "and you are doing so in a unit that is not really designed for ICU patients," says Robert Shesser, MD, professor and chair of the Department of Emergency Medicine at George Washington University Medical Center in Washington, DC. -
Could electronic records get your ED sued?
Increasing numbers of EDs are implementing electronic medical records (EMRs), including computerized physician order entry (CPOE), with the goal of improving patient safety. However, not much is known about the liability risks of these new tools. -
Emergency management given separate chapter
In The Joint Commission's revised standards, rationales and elements of performance for 2009, which will take effect on Jan. 1, 2009, the emergency management standards have, for the first time, been placed in their own chapter. -
ED Accreditation Update: Hospital-acquired infections are a major focus of National Patient Safety Goals for 2009
When The Joint Commission announced its National Patient Safety Goals for 2009, it became clear that the recent interest in hospital-acquired infections (HAIs) has only intensified. -
ED Accreditation Update: Hand washing is key to stop infection spread
With The Joint Commission's 2009 National Patient Safety Goals focusing on hospital-acquired infections (HAIs), ED managers say the key to compliance remains one of the most basic but difficult to implement strategies of all: hand washing. -
ED Accreditation Update: Patient involvement, education can help
Involving the patient in their own care, an important component of the National Patient Safety Goals for several years, including 2009, also can be a big help for EDs looking to control hospital-acquired infections (HAIs), says Christopher Beach, MD, vice chair, Department of Emergency Medicine, at the Northwestern University Feinberg School of Medicine and Northwestern Memorial Hospital in Evanston, IL. So can education, he adds. -
ED Accreditation Update: Meds reconciliation: Breathe a sigh of relief
After years of lobbying by emergency medicine groups and a summit last fall to take a closer look at the issue, a significant change has been made in the National Patient Safety Goal concerning medication reconciliation for 2009. ED managers welcome the change. -
ED Accreditation Update: Preparation can lead to good survey results
Just because surveys by The Joint Commission are no longer announced, it doesn't mean you can't prepare for them, say ED experts. -
ED Accreditation Update: Preparation pays off for emergency department
In anticipation of unannounced survey visits by The Joint Commission, the ED at St. Jude's Medical Center in Fullerton, CA, created a "Code JUDE," or Joint Commission Unannounced Disruption Event, drill to help it prepare.