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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.
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At first glance, it sounds like only good news for ED managers who are frustrated at their inability to have specialty services adequately covered.
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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).
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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).
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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.
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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.
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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.
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A few years ago, cardiac stress testing would not have been an important subject for emergency physicians. With the growth of observation units run by emergency physicians, however, more of us are ordering these tests and then acting on the results.
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The successful repair of congenital heart diseases has led to an increase in the incidence of pediatric dysrhythmias. The presentation of dysrhythmias can be a diagnostic challenge to clinicians, and is especially difficult since most children present with vague and nonspecific symptoms such as "fussiness" or "difficulty feeding."
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Which is the correct antibiotic? It's an increasingly complicated question for ED physicians, and presents significant liability risks.
