ED Management – September 1, 2008
September 1, 2008
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Majority of emergency patients don't understand discharge instructions
A woman who initially had come into the ED at Northwestern Memorial Hospital in Chicago with a miscarriage returned three days later. She was extremely upset because she had continued to bleed. -
Be proactive about improving communications
Given the findings of a recent study in the Annals of Emergency Medicine,1 ED managers should take immediate steps to improve communications with patients, says Bruce Janiak, MD, FACEP, FAAP, professor of emergency medicine, Medical College of Georgia, and vice chair of the ED at MCG Health Medical Center, both in Augusta. -
Read-backs might help — Do you have the time?
In light of a recent study in the Annals of Emergency Medicine, some experts recommend that EDs use "read-backs" by asking the patient to repeat back what they have been told to verify whether patients have understood their instructions. However, support is not universal among ED managers. -
Non-English-speakers present special problem
While a recent study in the Annals of Emergency Medicine showed that English-speaking adults often have difficulty understanding physicians' instructions, patients who don't understand English present an additional challenge for ED managers. -
ED's nonemergent patients must pay first or be referred
Under a new policy instituted in May 2008, patients in the ED at Metro Health Medical Center in Cleveland who have minor ailments must now pay part of their bill before being treated or be referred to one of MetroHealth's 16 clinics in the area. They are guaranteed an appointment within 72 hours. -
ED staff conduct careful research
The ED at Metro Health Medical Center in Cleveland began considering a new policy for patients with minor ailments about two years ago, recalls Charles L. -
Flood fails to 'wash out' ED's ability to communicate
The floods that ravaged Cedar Rapids, IA, in July caused several hospitals to evacuate their patients, including Mercy Medical Center, a 370-bed regional medical facility. -
Redundancy ensures smooth operations
The ED at Mercy Medical Center in Cedar Rapids, IA, had to be moved to another floor on July 13, as flood waters filled the hospital's lower levels. Despite having to uproot patients and equipment, the ED remained in constant contact with internal and external resources due to the presence of redundant communications options. -
Robust IT systems pays big dividends
As the effective response of the ED at Mercy Medical Center in Cedar Rapids, IA, to the recent floods demonstrates, the extra dollars required to invest in top-notch communications systems are well worth it, according to Rich Head, director of information services. -
Documentation tool can boost bottom line
(Editor's note: With this issue, ED Management begins a series on innovative approaches to documentation that can significantly enhance your department's revenues, without making any changes in patient flow and throughput processes. In this month's issue, we address the most effective documentation tools, proper staffing to optimize their use, and how to convince administration to make the required investment. In subsequent issues, we'll cover electronic tracking and chart monitoring, productivity incentives, and excellence in coding and billing practices.) -
Documentation template prompts thoroughness
ED managers who don't currently use a documentation tool that prompts you to take actions that will ensure optimal reimbursement are missing an opportunity to significantly enhance revenues, says Robert B. Takla, MD, FACEP, vice chief emergency services at St. John Hospital and Medical Center, Detroit. -
Confident approach helps sell management
Documentation templates can require a significant investment, especially when you also are planning to hire additional staff to further enhance your documentation process. Showing supreme confidence in your plan, say the experts, can go a long way toward convincing management the investment makes sense. -
Many psychiatric patientswait 24 hours to be seen
The recent death of a 49-year-old woman in the psychiatric ED of Kings County Hospital in Brooklyn, NY, after more than a 24-hour wait, dramatically illustrates the challenge of EDs trying to serve these patients. -
'Psych ED' relieves main department
A psychiatric ED can relieve the overcrowding pressure in the main ED, but it doesn't guarantee a solution to the boarding problem, says Steve Sterner, MD, chief clinical officer and an emergency physician at Hennepin County Medical Center in Minneapolis, and chair of a joint American College of Emergency Physicians (ACEP)/Minnesota Medical Association task force evaluating psychiatric bed availability and the boarding of psychiatric patients. -
Separate area in ED relieves pressure
If it is not practical to create a psychiatric ED at your facility, you can create a separate area within your department for psychiatric patients, says Steve Sterner, MD, chief clinical officer and an emergency physician at Hennepin County Medical Center in Minneapolis and chair of a joint American College of Emergency Physicians (ACEP)/Minnesota Medical Association task force evaluating psychiatric bed availability and the boarding of psychiatric patients. -
Protein marker detects kidney damage in ED
When patients present in an ED with chest pain, blood can be drawn, and the patient's enzyme levels will indicate whether there has been cardiac tissue damage. At present, however, no similar test is available to detect kidney damage.