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A new plan for admitting patients from the ED at Johns Hopkins Bayview Medical Center in Baltimore jointly developed by an ED physician and a hospitalist, decreased ED throughput for admitted patients 98 minutes (from 458 minutes to 360 minutes) from the same period a year earlier, despite an 8.8% increase in the ED census.
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A process improvement project addressing the entire emergency service line at The Medical Center of Central Georgia in Macon is expected to increase hospital revenues by $20 million $24 million this year, according to DeLanor Doyle, MD, FACEP, the medical director of the emergency center.
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Even with the outbreak of H1N1 influenza in its relative infancy, and no one knowing for certain how dire the situation might become, ED managers and their staffs are taking the situation very seriously.
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In three years, the ED at Dameron Hospital in Stockton, CA, has achieved total savings of $650,000 through a combination of staffing optimization, creation of atypical shifts and a flexible internal pool, and providing staff the option to take open shifts, all while still meeting the challenging nursing ratios required by the state. These changes were made in concert with The Optime Group, a consulting firm based in Evanston, IL.
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Most managers have been pushing extra hard to improve safety over the last few years, and The Joint Commission says all the hard work is paying off.
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In the latest move in the continuing saga of the National Patient Safety Goal (NPSG) on medication reconciliation, The Joint Commission has said while it will continue to evaluate compliance with the standard during on-site surveys, "it will not be factored into the organization's accreditation decision and will not generate Requirements for Improvement [RF])." The new policy, announced recently, became effective retroactively to Jan. 1, 2009.
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A new program in Houston that involves tight teamwork between The University of Texas Medical School at Houston, the Memorial Hermann Heart and Vascular Institute Texas Medical Center, and the Houston Fire Department EMS, as well as an experimental "cocktail" given in the ambulance to patients meeting certain criteria, has dramatically reduced Percutaneous Coronary Intervention (PCI)-to-balloon time and improved survival rates.
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The senior emergency center at Holy Cross Hospital in Silver Spring, MD, may be a rarity, but based on the responses of patients and staff not to mention our increasingly aging population perhaps more EDs should consider creating a separate unit for older patients.
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Several EDs across the country have initiated policies to encourage patients who don't face "true" emergencies to seek care elsewhere in the community and to find "medical homes," but none have been met with the outrage that descended upon the University of Chicago Medical Center recently.
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The Joint Commission has released a monograph titled "Measuring Hand Hygiene Adherence; Overcoming the Challenges," to help health care organizations target their efforts in measuring hygiene performance.
