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When the patient first presented at the entrance to the ED at Greenville (SC) Memorial Hospital on Nov. 9, 2004, his face was blue, with a burning sensation on his face and in his lungs. What transpired between that moment and the time the ED resumed normal functions following a nine-hour divert demonstrates the value of careful disaster planning and the sobering reality that all the planning in the world cant guarantee a flawless response.
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This column addresses readers questions about the Emergency Medical Treatment and Labor Act (EMTALA). Does EMTALA apply to a patient who presents to the ED with a scheduled appointment?
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The national rise in obesity is significantly affecting the nations EDs. In fact, a recent nationwide survey of Irving, TX-based VHA hospitals showed 90% of the respondents said they had treated obese patients who were first seen in the EDs.
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While your facility, no doubt, has a HIPAA-compliance policy, which, among other things, covers electronic communications, it might be a good idea to craft one that is specific to your ED, experts say.
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That was quick . . . In late November 2004, Methodist Hospital in St. Louis Park, MN, replaced its existing emergency physician staffing group, Emergency Physicians Professional Association (EPPA), with EmCare, a Dallas-based corporation providing services to more than 300 hospitals in 37 states. On Jan. 20, 2005 a mere 61 days later Methodist announced it was re-establishing its relationship with EPPA.
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While the transmission of electronic information has become an integral part of our daily business and personal lives, for health care providers, including ED managers, it carries with it a special set of obligations and responsibilities.
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The screening/counseling initiative employed by HCA facilities in Houston and Ocala, FL, appears to be in compliance with the Emergency Medical Treatment and Labor Act (EMTALA), says one expert. However, he notes that there are many aspects of the act that apply to these processes, and its crucial that ED managers understand what they are and how they can affect the design of such initiatives.
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When Ocala (FL) Regional Medical Center announced a new screening initiative that would involve counseling nonurgent patients to seek alternative care, a funny thing happened: Local competitors Monroe Regional and Timber Ridge became involved when they heard about our initiative, because they felt they would then be inundated by patients who were not having their treatment here, notes Susan Atkin, RN, ED director.
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The turnover of ED physician contracts at Methodist Hospital in St. Louis Park, MN, has brought into focus some of the major issues evolving in the competition between smaller, physician-owned ED groups and the larger corporate entities, such as EmCare, of Dallas; Team Health of Knoxville, TN; and Sterling Healthcare of Durham, NC. While some of those issues are philosophical, others are legal and may have significant implications for ED managers.
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Probably one of the most difficult tasks facing an ED manager is preparing a fast-moving staff for a review by the Joint Commission on Accreditation of Healthcare Organizations. Most ED staffs thrive in an ever-changing environment and focus attention on what matters most in the next 30 minutes, certainly not the next 30, 60, or 90 days. So whats a manager to do?
