ED Management
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To avoid misdiagnoses and unnecessary care, take the time to engage patients, listen to their concerns
Leana Wen, MD, MSc, an emergency medicine physician and the director of Patient-Centered Care Research at George Washington University in Washington, DC, has spent a lot of time talking about how patients can do a better job of advocating for themselves when they interact with the health care system. Her book, When Doctors Don’t Listen: How to Avoid Misdiagnoses and Unnecessary Testing, (St. Martin’s Press) is now out in paperback.
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TJC: New reporting changes give hospitals added flexibility on core measures
Hospitals now have new options to consider in the way they report on the ORYX performance measures, according to the Oakbrook Terrace, Ill-based The Joint Commission (TJC). While hospitals will still need to report on six sets of core measures, the accrediting agency explains that hospitals will no longer be mandated to report on acute myocardial infarction, heart failure, pneumonia, and surgical care improvement project (SCIP). The only measure set that will be mandatory for 2015 is perinatal care, and that is only for hospitals that have at least 1,100 live births per year. Other than the perinatal care requirement, hospitals will be able to select from the full complement of core measure sets.
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Culture Change in the ED: Still Ample Room for Improvement
After many years of involvement in emergency medicine, the author sees changes in the ED.
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Researchers offer up a mnemonic tool to guide clinicians who must assess decision-making capacity in patients during emergency situations
Clinicians from Johns Hopkins University School of Medicine have developed a mnemonic-driven tool to help clinicians quickly assess whether patients have decision-making capacity during emergency situations.
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Borrowing yet another technique from manufacturing, investigators find that ‘operational flexibility’ can offer dividends to ED operations
Specifically, the analysis found that the addition of a three-bed flex track produced a mean patient waiting time of 30.9 minutes. The traditional division between fast track and high-acuity beds produced a mean waiting period of 40.6 minutes, and a department where all the beds were totally flexible produced a mean wait time of 35.1 minutes.
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How to Effectively Boost Hand-washing Compliance
Administrators at Henry Ford Hospital regularly use "mystery observers" in the ED to check up on how compliant clinicians and staff are.
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Despite positive new research findings, use of antiviral meds against the flu remains controversial
A new study lends support to the Centers for Disease Control and Prevention's (CDC) move in January to recommend early, aggressive treatment with antiviral drugs in patients who present with symptoms of the flu. The new research, conducted by investigators at the University of Michigan, the London School of Hygiene and Tropical Medicine, and the University of Alabama, and published online in The Lancet, found that oseltamivir, which is marketed as Tamiflu, can shorten the duration of symptoms by about a day, and reduces by 44% the development of respiratory infections.1
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With flu numbers among staff increasing, hospitals report challenges, need for vigilance
With this year’s flu vaccine much less effective than hoped, with a migration of the predominant strain from the predicted strain, EDs in some regions are getting slammed with patients presenting with flu-like symptoms. Further, even hospitals with mandatory flu vaccination policies are having to scramble to cover the shifts of emergency personnel out sick with one of this year’s vaccine-resistant strains.
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The Joint Commission: Hospitals make strides on core measures with more achieving “top performer” status
With all the challenges that frontline health care providers have faced this year, from Ebola and the Middle East Respiratory Syndrome (MERS) to the sweeping implementation of the Affordable Care Act, news from The Joint Commission (TJC) that hospitals are continuing to make significant strides on key quality measures was certainly welcome.
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Study: New approach to handoffs slashes errors, preventable adverse events; other medical centers move to implement the protocol
A new approach to hospital handoffs has shown it can significantly reduce medical errors as well as preventable adverse events. The approach, dubbed the I-PASS bundle, uses a mnemonic to alert providers to all the issues that need to be covered during a handoff, but also includes a written handoff tool, communication training, a sustainability campaign, and a process for feedback.