Emergency Department Management & Law
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Opinions Evolve Regarding When to Ventilate a COVID-19 Patient
While there is no consensus on the issue, there are physicians from the frontlines in New York who now favor performing more noninvasive ventilation. Some are trying to avoid using a ventilator at all.
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Smaller EDs Should Treat Lower-Acuity Patients Outside the Hospital
A California-based hospital set up an area in its parking lot to screen for COVID-19. Many people who arrive are low acuity (i.e., looking for a test, showing no signs of the virus, and can be treated in their cars). Still, the facility is prepared to admit high-acuity patients who may need more complex care inside the facility.
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Prepare to Ramp Up Quickly, Treat All Patients as if They Have COVID-19
Prepare for a rapid escalation of cases as soon as evidence of community spread of COVID-19 emerges. At this point, assume everyone is carrying the virus, and act accordingly.
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Rule No. 1: Take Care of Staff
There is no denying the fear and anxiety that frontline staff are experiencing as they race to care for COVID-19 patients. Employees are living in personal protective equipment, and they are witnessing people of all ages go through terrible courses of illness. In one New York-based facility, leaders formed “code lavender” teams for instances in which staff members may have seen or been involved with some type of crisis.
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Plan for a Range of Demand Scenarios
When preparing for any disaster, plan for a range of scenarios, including worst case. Determine where beds and staff will come from under the direst of circumstances. Use predictive modeling to anticipate daily care needs and identify alternative locations where patients could be relocated if the community demand reaches a boiling point.
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Leveraging Hospital Incident Command to Battle COVID-19
Frontline providers battling COVID-19 in New York, where the outbreak may go down as the worst in the United States, share the latest updates and techniques that are paying dividends.
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Collect in ED before or after discharge? Both methods have their challenges
The most daunting challenge of collecting in the emergency department setting involves the simple fact that ill, injured, and tired patients just want to go home, as opposed to having a discussion about how much money they owe.
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Use scripting to collect ED copays
Emergency department registrars use this scripting to collect copays at the Cooper Health System in Camden, NJ.
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Emergency department collections nearly double with price estimates
Rising deductibles and lack of information on out-of-pocket costs make emergency department collections difficult, but patient access departments are succeeding with tools and training. Collections at Genesis Health System nearly doubled with a payment estimate tool, and collections rose by 10% at Cooper Health System because staff ask consistently.
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Misplaced NG tubes a major patient safety risk
Misplaced nasogastric and percutaneous endoscopic gastrostomy tubes pose a serious threat to patient safety and a liability risk for hospitals. New technology might improve the detection of misplaced tubes.