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The world of the ED manager changed significantly in July, when the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator (ONC) for Health Information Technology released the final rule for the definition of the term "meaningful use."
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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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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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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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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 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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The creation of a new area to quickly assess homeless and uninsured individuals, many requiring behavioral health services, has helped ease pressure on EDs in the Lee Memorial Health System in Fort Myers, FL. It has also earned the system a 2010 AHA NOVA Award for "Community-Based Alternatives to the Emergency Room."
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The headlines of late might well have blared their own version of Paul Revere's warning: "The bed bugs are coming! The bed bugs are coming!" TV networks have run special reports on how bed bugs have been "invading" U.S. hospitals, and as the front door to these facilities, EDs have had their share of challenges.
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