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The following are examples of fever discharge instructions provided to parents at Presbyterian Hospital of Dallas:
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By locating a social worker in a hospital ED to help members overcome barriers to primary care, Horizon NJ Health, a West Trenton, NJ-based managed care organization, was able to decrease ED visits by 45% among its members who had a face-to-face conversation with the social worker.
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Haywood Emergency Physicians, which had managed the ED at Haywood Regional Medical Center in Clyde, NC, since 1991, was ousted by a unanimous vote of the hospital's board in late December 2006 and replaced by the corporate physicians staffing firm Phoenix Physicians following a heated contract dispute.
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By creating inexpensive fever kits and providing them free of charge to parents of children between 3 months and 5 years of age who presented and were discharged, the ED at Presbyterian Hospital of Dallas has saved approximately $300,000 since the initial pilot program began in July 2004.
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Harried ED managers who are trying their best to get patients upstairs apparently have some strong allies in this battle: The patients themselves.
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An adult patient arrives at the ED in the middle of the night with a presenting complaint of head trauma of unknown origin, and associated pain and dizziness.
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When Mike Hill, RN, the ED director at Montgomery Regional Hospital in Blacksburg, VA, reported to work at about 7:30 a.m. on April 16, 2007, he noticed a large number of people in the trauma room. Although he didn't know it yet, "They were working the second victim of the first shooting" at Virginia Tech University.
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The availability of group and individual counseling for hospital staff following two shootings within eight months of each other in Blacksburg, VA, was invaluable, says Mike Hill, RN, the ED director at Montgomery Regional Hospital, which treated 17 victims of the recent shootings at Virginia Tech University.
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A new study in The New England Journal of Medicine formally confirms what many ED managers already know: Patients who are admitted to the ED on the weekends do not receive the same level of care as those admitted during the week.
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By laying a strong culture of safety as a foundation, ED leaders at Moses Cone Health System in Greensboro, NC, have achieved impressive process improvements tied to patient safety. For example:
