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To avoid misdiagnoses and unnecessary care, take the time to engage patients, listen to their concerns
Leana Wen, MD, MSc, an emergency medicine physician and the director of Patient-Centered Care Research at George Washington University in Washington, DC, has spent a lot of time talking about how patients can do a better job of advocating for themselves when they interact with the health care system. Her book, When Doctors Don’t Listen: How to Avoid Misdiagnoses and Unnecessary Testing, (St. Martin’s Press) is now out in paperback.
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TJC: New reporting changes give hospitals added flexibility on core measures
Hospitals now have new options to consider in the way they report on the ORYX performance measures, according to the Oakbrook Terrace, Ill-based The Joint Commission (TJC). While hospitals will still need to report on six sets of core measures, the accrediting agency explains that hospitals will no longer be mandated to report on acute myocardial infarction, heart failure, pneumonia, and surgical care improvement project (SCIP). The only measure set that will be mandatory for 2015 is perinatal care, and that is only for hospitals that have at least 1,100 live births per year. Other than the perinatal care requirement, hospitals will be able to select from the full complement of core measure sets.
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Culture Change in the ED: Still Ample Room for Improvement
After many years of involvement in emergency medicine, the author sees changes in the ED.
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Researchers offer up a mnemonic tool to guide clinicians who must assess decision-making capacity in patients during emergency situations
Clinicians from Johns Hopkins University School of Medicine have developed a mnemonic-driven tool to help clinicians quickly assess whether patients have decision-making capacity during emergency situations.
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Borrowing yet another technique from manufacturing, investigators find that ‘operational flexibility’ can offer dividends to ED operations
Specifically, the analysis found that the addition of a three-bed flex track produced a mean patient waiting time of 30.9 minutes. The traditional division between fast track and high-acuity beds produced a mean waiting period of 40.6 minutes, and a department where all the beds were totally flexible produced a mean wait time of 35.1 minutes.
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How to Effectively Boost Hand-washing Compliance
Administrators at Henry Ford Hospital regularly use "mystery observers" in the ED to check up on how compliant clinicians and staff are.
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Despite positive new research findings, use of antiviral meds against the flu remains controversial
A new study lends support to the Centers for Disease Control and Prevention's (CDC) move in January to recommend early, aggressive treatment with antiviral drugs in patients who present with symptoms of the flu. The new research, conducted by investigators at the University of Michigan, the London School of Hygiene and Tropical Medicine, and the University of Alabama, and published online in The Lancet, found that oseltamivir, which is marketed as Tamiflu, can shorten the duration of symptoms by about a day, and reduces by 44% the development of respiratory infections.1
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With flu numbers among staff increasing, hospitals report challenges, need for vigilance
With this year’s flu vaccine much less effective than hoped, with a migration of the predominant strain from the predicted strain, EDs in some regions are getting slammed with patients presenting with flu-like symptoms. Further, even hospitals with mandatory flu vaccination policies are having to scramble to cover the shifts of emergency personnel out sick with one of this year’s vaccine-resistant strains.
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Medicaid is making an impressive impact
The year 2015 is shaping up to be another big one for the joint federal-state Medicaid program. It is the second year of the Affordable Care Act’s (ACA’s) broad expansion of Medicaid to individuals below 138% of the federal poverty level. Medicaid enrollment surged in 2014, which helped to drive down uninsurance nationwide. By October 2014, 68.5 million individuals were enrolled in Medicaid, an increase of 9.7 million, or 17%, from the average monthly enrollment in July to that of September 2013.1 That enrollment is in addition to the 950,000-person increase in enrollment among six states and the District of Columbia that had chosen to expand Medicaid prior to 2014.
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Research eyes noninvasive test for endometriosis
Endometriosis is a common health problem for women. An estimated 11% of U.S. women have the gynecologic disorder, which happens when the lining of the uterus grows outside of the uterus.1 In women with endometriosis, when the endometrial tissue enters the abdominal cavity, it attaches to organs in the abdominal and pelvic cavities, such as the ovaries, the intestines, or other organs or tissues. This tissue continues to follow the monthly menstrual cycle, and the resulting bleeding can cause inflammation, scarring, and pain. It is prevalent in 38% of infertile women and in 71-87% of women with chronic pelvic pain.2