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Representatives at Emerus Emergency Hospitals, a licensed emergency specialty hospital company based in The Woodlands, TX, have been telling patients at several of its "24-hour EDs" for months now that if they are not seen by a physician within 15 minutes, the hospital will pay for their $1,000 visit. So far, the new policy is working quite well, say Emerus representatives.
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[This quarterly column on coding in the ED is written by Caral Edelberg, CPC, CCS-P, CHC, president of Edelberg Compliance Associates, Baton Rouge, LA. If there are coding issues you would like to see addressed in this column, contact Edelberg at phone: (225) 454-0154. E-fax: (225) 612-6904. E-mail:
[email protected].]
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Your ED patient's bad outcome might have nothing to do with the fact that he or she was held in the hallway while awaiting an inpatient bed. However, it could impact the outcome of subsequent litigation against the ED.
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[Editor's note: This is the third in a three-part series on reducing violence in the ED. In the first article, our experts discussed the importance of a "zero tolerance" policy. In last month's article, we outlined key steps recommended by government agencies for reducing violence and discussed the importance of having clear procedures when it comes to dealing with patients and their families. This month we examine the Sentinel Event Alert recently published by The Joint Commission, which discusses why the ED is particularly susceptible to episodes of violence, outlines leading causal factors, and provides additional guidance for violence prevention.]
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As the ED staff at Valley Medical Center in Renton, WA, was preparing to move into its new "digs," emergency services manager Kayett Asuquo, RN, BSN, MBA, CES, recognized that it was important that they do more than just take a walking tour of the new facilities. They needed to see how it would function as an environment for treating patients.
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[Editor's note: This is the first in a two-part series. This month we examine the performance improvements that one hospital achieved after placing a pharmacist in the ED. We also discuss how a pharmacist's recommendations to dispense a medication orally enabled the ED to save money and improve patient safety. In the August issue, we'll look at additional benefits these pharmacists offer, from the perspective of ED nurses and physicians.]
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In the first phase of a two-phase process, paramedics with Grady Emergency Medical Services in Atlanta now have the option of transporting patients with less-urgent ailments to Grady Health System clinics instead of the ED. Emergency leaders believe this strategy will provide the most appropriate care for these patients and help alleviate some ED crowding.
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Unless your ED is planning an expansion, the amount of space you have to work with is finite. However, as the leadership team at Jersey City (NJ) Medical Center has shown, creative use of that space can significantly improve your department's capacity and help slash wait times and the number of patients who leave without being seen. In less than a year, average wait times went from 3-4 hours to 30 minutes, and the left without being seen (LWBS) rate went from 6% to 1.5%.
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[Editor's note: This article is the first in an ongoing series reviewing the latest findings of the Emergency Department Benchmarking Alliance (EDBA) and how ED managers are addressing the challenges that members have identified. This first article discusses how ED managers are combating steadily increasing volume. The EDBA for 2009 shows increases of 5%-10%. The EDBA findings are significant because they represent feedback from 376 high performing EDs serving 14.8 million patients in the calendar year 2009.]
