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What should ED managers be doing while they wait for The Joint Commission to publish a new standard for medication reconciliation? Take a team approach, recommends Diana S. Contino, RN, MBA, FAEN, senior manager of health care with Deloitte Consulting in Los Angeles.
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The use of a cardiac MRI in the observation unit at Wake Forest University Baptist Medical Center in Winston-Salem, NC, resulted in lower cost at the hospital of about $588 per patient because 79% were managed without admission, according to a study published online in the Annals of Emergency Medicine.
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Citing anticipated benefits for patient care, for caregiver health, and for the bottom line, Emory Healthcare in Atlanta has put a limit on overtime hours for its nurses, including those in its two EDs.
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The management team in the ED at in St. Clair Hospital in Pittsburgh, PA, calls it "managing by walking around." They say it has been one of the keys to their continual improvement in patient satisfaction.
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The bad news: Most ED experts believe that health care reform will only exacerbate the steady growth of volume in the nation's EDs. The good news: ED managers have several weapons in their arsenals to help keep patients flowing through and out of their departments.
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While some publications have focused on the restriction of Propofol use by ED physicians and nurses under new rules issued in December 2009 by the Centers for Medicare and Medicaid Services (CMS), many observers say the issue is much larger, and that it deals with who can administer what ED providers consider procedural sedation and what CMS considers anesthesia.
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HealthGrades, a Golden, CO-based health care ratings organization that provides the public with ratings on more than 750,000 physicians and 5,000 hospitals, has just released a study it claims "evaluates hospital emergency medicine for the first time."
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The Wisconsin Health Information Exchange (WHIE), which has enabled EDs in the Milwaukee area to electronically access patient data for about three years, has helped the participants save time and make better-informed patient care decisions, according a recent study from the Medical College of Wisconsin in Milwaukee.
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Computer systems might be costly, but they can also save you a good deal of money in a short time. For example, the computer system installed at Beaufort (SC) Memorial Hospital and implemented in December 2009 recouped its costs of about $500,000 in just three months.
