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In addition to increased numbers of mentally ill patients, EDs are seeing more uninsured patients than in the past, and the numbers could grow, warns Brian Hancock, MD, president of the American College of Emergency Physicians (ACEP) in Irving, TX. Your budget planning should factor in more uninsured patients, not just the same level you have coped with for years.
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Question: How do we avoid patient hoarding, in which nurses or physicians intentionally delay moving a patient out to delay the next patient and give themselves a breather? Weve already warned that hoarding wont be tolerated, but it still happens and thwarts our efforts to improve patient flow through and decrease waiting time.
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Question: I know EMTALA signs are to be placed in registration areas, EDs, and public entrances. Right now we have signs in each of our four ED rooms, in the front hospital entrance, and the registration area. But I need to know if I should hang a sign in our back entrance leading to the ED. This entrance is not considered a public entrance, so do I need to put a sign there?
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Your ED is overflowing with patients, the wait time is heading toward double-digit hours, and youre short-staffed again. So when you walk by an exam room and see a patient sitting there sipping contrast fluid the same contrast he was drinking an hour ago your blood pressure goes through the roof.
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When working with your radiology department to reduce the time it takes to get abdominal computed tomography (CT) scans for emergency patients, be sure to look at the issue from their perspective, suggests the nations leading radiologist.
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If it seems youre seeing more patients with mental illnesses recently, youre not imagining it. The number of people with mental illness seeking care in the ED has surged recently, and the increase is taking a toll on other ED care, says J. Brian Hancock, MD, president of the American College of Emergency Physicians (ACEP) in Irving, TX.
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Hsu J, Reed M, Brand R, et al. Cost sharing: Patient knowledge and effects on seeking emergency department care. Med Care 2004; 42:290-296. Saketkhoo DD, Bhargavan M, Sunshine JH, et al. Emergency department image interpretation services at private community hospitals. Radiology 2004; 231:190-197. Lyons MS, Lindsell CJ, Trott AT. Emergency department pelvic examination and Pap testing: Addressing patient misperceptions. Acad Emerg Med 2004; 11:405-408.
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Hospitalists are becoming much more common in American health care and soon could change the way EDs work with physicians, says Ron Greeno, MD, chief medical officer and senior vice president of physician services at Cogent Healthcare in Laguna Hills, CA, one of several companies that provide hospitalist services across the country.
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Even if you dont want to offer a service guarantee like those EDs that promise to treat patients in 30 minutes or less, you probably wouldnt mind streamlining your ED and improving patient flow through. So how do those hospitals promising fast service improve their EDs enough to make that promise possible?
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These are some of the patterns and unusual illnesses detected by the bioterrorism surveillance system being used in some Florida hospitals.
