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While patient simulators can clearly be used to assess the performance of ED staff in pediatric trauma cases, they also can be used to improve their performance in these cases. Thats what the ED at Cincinnati Childrens Hospital Medical Center has been doing since May 2002.
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The bad news: Nearly three-quarters of ED physicians may experience depression at some point in their careers, and nearly half consider harming themselves. The worse news: Nearly half of those with such problems do not seek treatment.
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Two significant process changes at Methodist Willow-brook Hospital in Houston, have led to dramatic improvements in efficiency, says its ED management team. Consider the following:
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Conventional wisdom among emergency medicine professionals is that the various sizes of the EDs in the United States, when placed in a bar chart, would look like a bell-shaped curve; that is, the greatest number of EDs would be found among the mid-sized EDs, or those with 25,000-30,000 visits per year.
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At Baylor All Saints Medical Center at Fort Worth (TX), the ED managers werent taking any chance of being unprepared when the accreditation surveyors showed up for a regular unannounced survey.
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A recent North Carolina study showing hospital EDs failed to properly stabilize seriously injured children during trauma simulations is a sign of a larger national problem with EDs being ill-prepared to handle pediatric trauma patients, reports Elizabeth A. Hunt, MD, MPH, assistant professor of anesthesiology and critical care medicine at Johns Hopkins Childrens Center in Baltimore.
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An ambitious collaborative involving an entire hospital system plus experts from a neighboring engineering school are systematically analyzing the causes of capacity constraints and developing strategies to address them at one hospital. To date, they have already achieved a nearly 33% improvement in the number of ED admits in under 90 minutes from 32% to 42.3%. Ultimately, they hope to develop a toolkit that will ensure a typical door-to-doc time of fewer than 20 minutes.
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The creation of two new positions in the ED has improved flow and increased patient safety, according to Gregory Smolin, DO, FACOEP, FACEP, medical director of the ED at Memorial Hospital of York (PA) County. The new staff members, called flow technicians or flow techs handle a wide range of responsibilities including handling discharge instructions, finding charts and results for the doctors, and checking to see that all patients have received the treatment that was ordered.
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The Centers for Medicare & Medicaid Services has posted answers to two new frequently asked questions (http://questions.cms.hhs.gov) about the Health Insurance Portability and Accountability Act administrative simplification standards.
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Its after lunch, and your volume is peaking. You think things cant get any more hectic, but here come accreditation surveyors visiting your department as part of an unannounced survey.
