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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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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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In anticipation of unannounced survey visits by The Joint Commission, the ED at St. Jude's Medical Center in Fullerton, CA, created a "Code JUDE," or Joint Commission Unannounced Disruption Event, drill to help it prepare.
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Involving the patient in their own care, an important component of the National Patient Safety Goals for several years, including 2009, also can be a big help for EDs looking to control hospital-acquired infections (HAIs), says Christopher Beach, MD, vice chair, Department of Emergency Medicine, at the Northwestern University Feinberg School of Medicine and Northwestern Memorial Hospital in Evanston, IL. So can education, he adds.
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With The Joint Commission's 2009 National Patient Safety Goals focusing on hospital-acquired infections (HAIs), ED managers say the key to compliance remains one of the most basic but difficult to implement strategies of all: hand washing.
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In the wake of a flash flood in June that forced the closing of Columbus (IN) Regional Hospital, the ED reopened about two weeks later in a mobile unit called the Carolinas Mobile Emergency Department-1 (MED-1).
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ED managers should be pleased with the proposed increases in ambulatory payment classifications (APCs) for fiscal year 2009, says Dennis Beck, MD, FACEP, CEO of Beacon Medical Services in Denver and chair of the quality and performance committee of the American College of Emergency Physicians (ACEP).
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At first glance, it sounds like only good news for ED managers who are frustrated at their inability to have specialty services adequately covered.
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In a move that emergency medicine experts hope will provide at least partial relief to the call coverage challenge, the Centers for Medicare & Medicaid Services (CMS) has proposed a new regulation that would allow hospitals to establish community call arrangements at a regional level to satisfy their Emergency Medical Treatment and Labor Act (EMTALA) on-call physician requirements.
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Just because surveys by The Joint Commission are no longer announced, it doesn't mean you can't prepare for them, say ED experts.
