Critical Access
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Top Copay Collectors at Pediatric EDs
By performing their job well, registrars reduce worries for families — and bad debt for the hospital. Some patient access employees share how they do it.
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ED Patients Worry About the Bill, Registrars Can Intervene
People come to the ED sick, injured, or in severe pain. This is not an opportune time to ask someone for a $100 copay — or, worse, inform them they are responsible for the entire bill.
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Routine Ethics Consults Helpful if ECMO Is Considered
When a patient is placed on extracorporeal membrane oxygenation (ECMO), usually emergently, families have begun to face the gravity of the situation. Suddenly, ECMO offers new hope. Even though the primary team explains ECMO will be a time-limited trial and a bridge to recovery, transplant, or device, many families remain focused only on the possibility of hope.
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Court Ruling on Life Support Withdrawal Affects Ethics Committees
Hospitals may need to afford more procedural due process when deciding on whether to withhold or withdraw life-sustaining treatment without consent.
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Controversial ‘Public Charge’ Rule Under Further Review
Scrutiny on DHS policy that targeted immigrants using government benefits such as Medicaid.
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Pediatric Psych Visits Surging in EDs, Along with Medical Malpractice Risks
Before pediatric psychiatric patients are discharged from the ED, carefully document the visit and create a follow-up plan with a primary care physician or mental health professional. For patients presenting with suicidal ideation, a social worker or mental health clinician should develop a safety plan.
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American Heart Association Calls for End to Structural Racism
Group “declares its unequivocal support of antiracist principles” in a recent presidential advisory.
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Report Links ED Boarding to Worse Clinical Outcomes
Some hospitals have found a novel solution in the form of resuscitative care units, which are ICUs based in EDs. Patients who need time-sensitive respiratory, metabolic, neurologic, or hemodynamic critical care can receive it in the ED. This prevents these patients from waiting so long for a bed to finally open in the appropriate specialty ICU.
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Improved ICU Physician Staffing Leads to Better Safety Grade
When Doylestown Hospital in Pennsylvania received a C on the Spring 2016 Leapfrog Hospital Safety Grade, leaders launched a campaign to improve patient safety. A central tactic was adapting its staffing model to meet Leapfrog’s ICU Physician Staffing criteria.
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Do Not Intubate Orders Becoming More Common
Rates increased over time, from about one in 10 patients 20 years ago to about one in three patients in the past five years. The exact reasons for this increase remain unclear.