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Geriatric emergency management (GEM) nurses at Toronto's Humber River Regional Hospital (HRHH) use a strict set of criteria when assessing elderly patients in the ED and determining if they are "high-risk" patients.
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Eight EDs in the Canadian Province of Ontario have benefitted from government funding in the hiring of geriatric emergency management (GEM) nurses.
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ED managers have tried several options to offset growing volume, but Bret Nicks, MD, assistant medical director at Wake Forest University Baptist Medical Center in Winston-Salem, NC, says the hybrid observation unit he oversees beats other alternatives.
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The ED at Middle Tennessee Medical Center (MTMC) in Murfreesboro certainly qualifies as busy: it sees nearly 63,000 patients a year and averages more than 170 patients a day.
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Ongoing initiatives in the ED at Middle Tennessee Medical Center (MTMC) in Murfreesboro have led to improved patient flow.
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Monty Gooch, RN, BSN, director of emergency services at Middle Tennessee Medical Center (MTMC) in Murfreesboro, says that one of the keys to his department's smooth patient flow door-to-doc time of 35-40 minutes despite steadily growing volume is the way it works closely with other departments.
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The National Quality Forum (NQF), expressing its desired to reduce overcrowding and improve quality of care, has endorsed 10 national voluntary consensus standards for hospital-based ED care. The standards are:
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The establishment of a communitywide patient information sharing system by the Wisconsin Health Information Exchange (WHIE) was a collaborative effort from the start, says Kim Pemble, WHIE's executive director.
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Every year at about this time, the Centers for Medicare & Medicaid Services (CMS) publishes its final Out-patient Prospective Payment System (OPPS) payment rule for the following calendar year, and every year emergency medicine experts express their dissatisfaction with one aspect or another of what CMS has wrought. This year, however, might prove to be an exception.
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As part of its Outpatient Prospective Payment System (OPPS) payment rule for 2009, the Centers for Medicare & Medicaid Services (CMS) has established a multiple imaging composite methodology, which means it will provide a single composite ambulatory payment classification (APC) payment each time a hospital bills more than one procedure from an imaging "family" on a single date of service. The families are:
