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Between 2001 and 2005, average length of stay in the ED at Northwestern Memorial Hospital in Chicago has dropped from 85 minutes to 45 minutes. Throughput has fallen from 308 minutes to 230 minutes during the same period. In addition, patient satisfaction (Press Ganey Associates, South Bend, IN) scores have increased from 74.6% to 84%.
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ED managers recognize the need to prepare their departments for a huge surge of patients in the wake of a disaster in the community. What some of them may not be as well prepared for is the very unique distribution of complaints and patient types that will present in such situations, experts warn.
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Its going to come to every ED, warns Sarah Vogel, MD, FACEP, ED director at Albany (NY) Memorial Hospital. You have two choices, Vogel says. You can get proactively involved with [information systems] and administration and choose the best system for you, or you can hide under your protocols.
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An intensive staff education program and a targeted revision of medical charting has enabled the pediatric ED at New York Presbyterian Hospital/Weill-Cornell Medical Center in New York City to boost pain score documentation from 7.4% before the intervention to 38.2% after its implementation.
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By addressing ED problems as hospitalwide problems, the ED leadership at Shady Grove Adventist Hospital in Rockville, MD, has reduced ambulance diversions by 72%, reduced average length of stay by 25 minutes (from 397 to 372), and boosted patient satisfaction from 3.96 to 4.11 on a scale of 1-5. Also, the number of patients boarded in the ED has dropped from an average of 190 per month to 120 per month.
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The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has published a series of tips for facilities preparing for and responding to emergency situations. The tips include:
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In the September issue of ED Legal Letter, two common contract clauses - malpractice insurance and restrictive covenants--that can be harmful to the interests of an emergency physician.
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The Patient Safety and Quality Improvement Act of 2005 provides full privilege for information shared with a patient safety organization, with the goal of encouraging voluntary error reporting.
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An ultrasound image shows a patient who had been shot in the chest and was not doing well. The physician thought the patient's lung was collapsed, and he put in a chest tube.
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With an increasing number of emergency department (ED) physicians using ultrasound, are malpractice lawsuits also on the rise? Quite the contrary, according to proponents of ED ultrasound.