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ED managers who don't currently use a documentation tool that prompts you to take actions that will ensure optimal reimbursement are missing an opportunity to significantly enhance revenues, says Robert B. Takla, MD, FACEP, vice chief emergency services at St. John Hospital and Medical Center, Detroit.
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Documentation templates can require a significant investment, especially when you also are planning to hire additional staff to further enhance your documentation process. Showing supreme confidence in your plan, say the experts, can go a long way toward convincing management the investment makes sense.
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The recent death of a 49-year-old woman in the psychiatric ED of Kings County Hospital in Brooklyn, NY, after more than a 24-hour wait, dramatically illustrates the challenge of EDs trying to serve these patients.
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A psychiatric ED can relieve the overcrowding pressure in the main ED, but it doesn't guarantee a solution to the boarding problem, says Steve Sterner, MD, chief clinical officer and an emergency physician at Hennepin County Medical Center in Minneapolis, and chair of a joint American College of Emergency Physicians (ACEP)/Minnesota Medical Association task force evaluating psychiatric bed availability and the boarding of psychiatric patients.
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If it is not practical to create a psychiatric ED at your facility, you can create a separate area within your department for psychiatric patients, says Steve Sterner, MD, chief clinical officer and an emergency physician at Hennepin County Medical Center in Minneapolis and chair of a joint American College of Emergency Physicians (ACEP)/Minnesota Medical Association task force evaluating psychiatric bed availability and the boarding of psychiatric patients.
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When patients present in an ED with chest pain, blood can be drawn, and the patient's enzyme levels will indicate whether there has been cardiac tissue damage. At present, however, no similar test is available to detect kidney damage.
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A woman who initially had come into the ED at Northwestern Memorial Hospital in Chicago with a miscarriage returned three days later. She was extremely upset because she had continued to bleed.
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In light of a recent study in the Annals of Emergency Medicine, some experts recommend that EDs use "read-backs" by asking the patient to repeat back what they have been told to verify whether patients have understood their instructions. However, support is not universal among ED managers.
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While a recent study in the Annals of Emergency Medicine showed that English-speaking adults often have difficulty understanding physicians' instructions, patients who don't understand English present an additional challenge for ED managers.
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The floods that ravaged Cedar Rapids, IA, in July caused several hospitals to evacuate their patients, including Mercy Medical Center, a 370-bed regional medical facility.
