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ED managers may not possess a crystal ball, but the ability to predict future events is nonetheless critical to their success, notes Bonnie Coalt, RN, MS, director of nursing at Miami Valley Hospital in Dayton, OH.
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An administrative huddle at Latter Day Saints (LDS) Hospital in Salt Lake City has been tremendously helpful in determining when to postpone elective surgeries, but it has had a much broader impact on patient flow in the ED and the hospital as a whole.
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No one is claiming its a cure-all for ED overcrowding, but a number of facilities have turned to postponing elective surgeries that required admissions as an important part of a multifaceted plan to ease the burden on their harried ED staff. And when they do, many give the ED manager a key role in the decision-making process.
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Just how serious is the on-call panel coverage situation in California? Serious enough that this fall, the states emergency physicians put up nearly $2 million of their own money in support of a ballot initiative that would have added $600 million a year to pay for uncompensated emergency care. The initiative did not pass.
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Caught between the proverbial rock and a hard place, the University of Mississippi Medical Center (UMC) in Jackson has taken drastic action and announced that on a case-by-case basis, it may decide not to accept future transfers from facilities it believes have the resources to care for those patients themselves. But in so doing, UMC may have put itself in danger of violating the Emergency Medical Treatment & Labor Act (EMTALA), says one expert.
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The patchwork of call panel arrangements is unwieldy, expensive, and may compromise the quality of care for patients in the emergency department. This dramatic finding is part of a new report that outlines the seriousness of the call panel situation in California, often considered to be a state that precedes the rest of the country, and offers recommendations to remedy the situation.
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Recent epidemiologic studies indicate that nearly 4% of Americans are afflicted with food allergies. The spectrum of food allergy ranges from atopic dermatitis or other cutaneous manifestations hours after eating the problem food, to life-threatening events occurring shortly after ingestion. As well, some individuals experience allergic symptoms only if the food is eaten before physical stimuli such as vigorous physical exercise.
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In this issue, the author reviews how the law can attempt to impute responsibility on health care organizations and/or other health care workers for the alleged negligence of another.
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Burn injuries frequently present to the emergency department. In the majority of cases, the burns are minor, yet they require a careful assessment, cleaning, dressing, and careful follow-up. Patients with more severe burn injuries, especially those associated with house fires or explosions, should be assessed carefully for multiple trauma, and care should be taken to protect the spine until injury can be excluded clinically or radiographically. The authors review the diagnosis, classification, and management of patients with sustained burns.
