ED Management
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Paramedics, Screening Protocols, and Involuntary Psychiatric Holds
While there is no simple solution to ED crowding caused by a backup of patients with behavioral health concerns, a new study offers intriguing results on what could be part of the answer for at least some hospitals.
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Critical Access Hospital EDs Reap Savings by Using Advanced Practice Providers, Virtual Physicians
Thanks in part to a little-noticed policy shift by the Centers for Medicare & Medicaid Services, there is fresh evidence that telemedicine can offer rural hospitals a cost-effective solution to the serious challenges they face in trying to recruit and retain physicians to cover their EDs. Further, while efforts to build effective telemedicine networks in the emergency medicine arena have struggled, one network based in Sioux Falls, SD, is in expansion mode, with 185 hospitals in 13 states already hooked up to the network’s hub.
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Prehospital Providers Play Starring Role in Push to Regionalize Care of STEMI Patients
A push to regionalize the care and treatment of patients with ST-elevation myocardial infarction (STEMI) gains steam. Investigators documented improved time to treatment results and a significant decline in mortality among patients treated at sites adopting a regionalized approach. The data come from the Regional Systems Accelerator-2 project in which key stakeholders in 12 regions pledged to work together to improve STEMI care.
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Joint Commission Revises National Patient Safety Goal Regarding Suicide Risk
The move follows a re-evaluation of the National Patient Safety Goal covering this issue that began in 2016, and included research, public field review, and analysis with experts in suicide prevention as well as representatives from healthcare organizations and other key stakeholders.
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Sarasota Memorial Hospital Implements Sweeping Initiative, Raising HCAHPS Scores
Discovering that there was a decline in patient experience scores among patients aged 80 years and older, Sarasota Memorial Hospital in Florida initiated a multidisciplinary effort, dubbed PEACE (patient experience for acute care elders), to address the gap. With continual input from senior advisors from the community, the effort focused on engaging frontline caregivers and improving communications with patients and caregivers at multiple levels.
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State Hospital Association Tackles Workplace Violence With De-Escalation Training, Evolving Toolkit for Member Institutions
The Washington State Hospital Association intends to make meaningful modifications to an existing toolkit to ensure resources and recommendations remain relevant and applicable to new issues and emerging trends facing hospital leaders and workers.
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ACEP, AMA Announce Steps Aimed at Curbing Gun Violence
The American College of Emergency Physicians pledged to review current research and legislation to decide next steps, while the American Medical Association unveiled a new continuing medical education online module to help physicians with the knowledge and preparation to effectively counsel patients on firearm safety.
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Hospitals Work to Improve Procedures Designed to Protect Staff and Patients From Harm
Hospitals are looking for new and better ways to protect staff and patients, both from intruders who mean harm, and patients or family members who become aggressive and agitated. However, defending against active assailants presents the greatest challenge, as hospitals and EDs strive to remain open and welcoming to the communities they serve.
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Creating a Standard of Care for Identifying, Managing Patients With Uncontrolled BP
Given the high prevalence of undiagnosed hypertension, investigators are looking at how emergency providers can play a role in identifying and intervening with patients who present to the ED with high blood pressure readings. The idea is to catch the condition at an earlier stage so that patients do not end up returning to the ED with strokes, heart attacks, and other serious cardiovascular consequences from uncontrolled hypertension.
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Innovative Staffing Model Reduces Handoffs, Boosts Provider Satisfaction
To address the patient safety risks associated with provider handoffs, Seattle Children’s Hospital designed a new staffing model that is built around waterfall-style shifts, in which a new attending physician arrives every three to five hours. The approach has significantly reduced the number of handoffs that occur without increasing attending physician hours. Further, it has won the approval of both providers and charge nurses.