ED Management
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Frontline Providers Look for Answers Regarding Return of Acute Flaccid Myelitis
Confirmed cases of acute flaccid myelitis (AFM) in 2018 reached 90 by the end of October, according to the CDC. While the CDC has yet to confirm what is causing AFM, experts strongly suspect that the disease stems from common viral infections. Still, it is not yet clear why just a small number of patients go on to experience paralysis in one or more limbs, a characteristic disease feature.
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Health Systems Tackle Opioid Epidemic With Comprehensive Initiatives
It has been nearly a year since The Joint Commission unveiled new pain management standards as part of an effort to combat the opioid epidemic. While all accredited hospitals are held accountable for their implementation and adherence to the standards, some health systems have responded by centralizing their opioid-related initiatives under a single, purposeful umbrella to produce more powerful results.
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Collaborative Slashes Sepsis Mortality, Produces Tool to Help All Hospitals
For the past six years, The Joint Commission’s Center for Transforming Healthcare (CTH) has been working with health system partners to identify the root causes for sepsis mortality as well as solutions that will address these problems effectively. In the process, participating organizations have reduced their own sepsis mortality rates by a collective 25%, although some organizations have made even greater strides. The work with CTH will culminate in a Targeted Solutions Tool that will enable all accredited hospitals to take on the issue in their own settings.
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Standardizing Diagnosis, Management of Young Patients Who Present With Head Injuries
New guidelines from the CDC have established practice-changing recommendations in the diagnosis and treatment of pediatric mild traumatic brain injury (TBI). This information is especially important to frontline providers, as statistics suggest an increasing number of children are presenting to the ED with concussions. The guidelines include 19 sets of recommendations pertaining to the diagnosis, prognosis, and management of pediatric mild TBI. The guidelines identify best practices based on current evidence and are intended to help standardize and improve the way these cases are managed, both while patients are in the doctor’s office or ED and after they have been discharged.
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Hospital Uses Hurricane Florence Near-miss to Improve Emergency Plans
Before the storm made landfall, leaders at East Cooper Medical Center in Mount Pleasant, SC, reduced the facility’s patient census to a minimum, arranged to house staff for the duration of the storm emergency, and appealed to the state for an exemption to the mandatory evacuation order. The facility avoided the worst of the storm but staff still practiced emergency preparedness anyway, learning lessons to better prepare for future incidents.
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Another Powerful Hurricane Season Underscores Importance of Strategic Planning
While emergency providers in the region proved up to the task, some hospitals report that it was fortuitous that forecasters originally anticipated that Hurricane Florence would make landfall with much stronger winds. This caused many to make additional preparations, which paid big dividends.
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Psychological Evaluation Unit Provides Specialized Expertise, Calmer Atmosphere for Behavioral Health Patients
Elliot Hospital in Manchester, NH, has unveiled a new $1.5 million psychiatric evaluation unit within the confines of its ED to boost resources and access to care for patients in psychological distress. The center is designed to offer an atmosphere more conducive to emotional healing. Administrators note that the added resources also should help ease crowding and boarding at the level II trauma facility.
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A Growing Number of ED-based Physical Therapy Programs Taking Root
While a few ED-based physical therapy programs have existed for decades, the practice is gaining new converts as emergency clinicians increasingly turn to physical therapy for expertise with conditions ranging from vertigo and orthopedic issues to wounds, vestibular issues, and gait training. Long-standing programs have shown that leveraging physical therapy in emergency medicine can be a financially viable approach with the proper administrative support and guidance.
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Coordination Center Uses Real-time Data to Speed Collaborative Decision-making
To handle increasing volumes better, Yale New Haven Hospital has opted to centralize operational decision-making in a new Capacity Coordination Center. Here, a nurse navigator representing the health system’s two busy adult EDs works with representatives from EMS, admitting, bed management, and other key operations to manage incoming and outgoing traffic optimally and to anticipate clinical services that may be needed further upstream.
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Study: Drug-resistant Bacteria Increasingly Common in Urinary Tract Infection Patients
New research suggests that antibiotic-resistant infections remain a challenging problem, leaving frontline providers with few options when tried-and-true medicines fail to knock out invading bacteria.