ED Management
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Center Addresses Needs of Acutely Intoxicated Patients, Links Them to Treatment
Soon, EDs in Baltimore may feel some relief from the crushing volume of patients with substance use problems, thanks to the creation of a new type of facility designed for patients who are under the influence of drugs or alcohol and need a place where they can safely recover while receiving short-term medical care.
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Emergency Clinicians Steer Patients With Substance Use Problems Into Effective Treatment
To address an increasing volume of ED patients with substance use issues, leaders at the University of Maryland Medical Center in Baltimore decided to integrate peer recovery coaches into the emergency medicine team. The peer recovery coaches are people in long-term recovery from their own addictions who have received training on how to counsel other addicts toward positive change and facilitate their transition into appropriate treatment programs. The approach has been in effect for two years, and administrators say it is affecting patients and emergency staff positively.
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The Case for Educating At-risk Patients About Firearms Violence
Investigators from the Violence Prevention Research Program at the University of California, Davis have unveiled a new resource for clinicians to guide them in their discussions with patients about firearms violence. Called the “What You Can Do” initiative, developers are encouraging frontline clinicians to familiarize themselves with the risk factors for gun violence, provide counseling to appropriate patients on safe firearms practices, and to intervene when there is an imminent threat of harm.
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Hospitals Leverage Safety Huddle to Reduce Patient Harm, Boost Transparency, and Drive Culture Change
When implemented effectively, safety huddles can reduce harm and foster a culture of safety and accountability. Hospitals that have been successful with this process recommend that huddles be driven by executive leadership and include a structure that provides for accountability.
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Providers Address Homelessness to Reduce ED, Hospital Use
Recognizing that chronically homeless patients typically present with multiple medical problems that lead to excessive ED and hospital use, hospitals are working with community partners to develop programs aimed at providing these patients with stable housing and the kind of supportive services that can better meet their needs.
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New Four-step Protocol Boosts Care, Outcomes for STEMI Patients
Investigators have developed a protocol that not only improves outcomes for patients with ST elevation myocardial infarction (STEMI), but also reduces gender disparities that have been observed in both the care and outcomes of patients who present with the condition. Researchers note that although the protocol is different than common practices in most U.S. hospitals, the results show that further improvements are possible in the care of STEMI patients.
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High-sensitivity Troponin Test Finally Available to U.S. Emergency Providers
Some emergency providers in the United States finally can access a high-sensitivity troponin assay that enables them to detect heart attacks and other cardiac problems faster than older troponin tests. While it can take several months to safely and effectively switch to the new test, the benefits to both patients and providers are considerable. Although evidence from Europe suggests the tests uncover more evidence of cardiac disease, follow-up is required.
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Injectable Opioid Shortages Causing Adverse Consequences for Some Physicians, Patients
It’s ironic that even while the country is confronting a dangerous opioid epidemic, providers report that they are having trouble getting their hands on the powerful pain killers — a situation that is dangerous as well. The shortage, which primarily involves injectable opioid painkillers, is reportedly caused by drug manufacturing difficulties as well as the government’s efforts to address addiction by clamping down on drug production. However, the problem is resulting in adverse consequences for clinicians and patients.
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Colorado Program Significantly Reduces Opioid Prescribing in 10 EDs During Six-month Period
A pilot group of 10 EDs in Colorado has shown impressive reductions in opioid prescribing by encouraging the use of alternatives to opioids (ALTO) in the care of five key pain pathways. Between June and November 2017, the pilot sites reduced the use of opioids by 36% when compared to the same six-month period in 2016. The Colorado Hospital Association, which championed the initiative, is moving to expand the ALTO approach used in the pilot to other hospitals in the state.
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Surgeon General: Clinicians Must End Addiction Stigma, Use Evidence-based Care
During a recent town hall, the surgeon general stressed the importance of recognizing that substance use disorder is a chronic disease that must be treated with the same skill, compassion, and urgency that clinicians use to treat other chronic health conditions.