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[Editor's note: This is the first in a two-part series. This month we examine the performance improvements that one hospital achieved after placing a pharmacist in the ED. We also discuss how a pharmacist's recommendations to dispense a medication orally enabled the ED to save money and improve patient safety. In the August issue, we'll look at additional benefits these pharmacists offer, from the perspective of ED nurses and physicians.]
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As the ED staff at Valley Medical Center in Renton, WA, was preparing to move into its new "digs," emergency services manager Kayett Asuquo, RN, BSN, MBA, CES, recognized that it was important that they do more than just take a walking tour of the new facilities. They needed to see how it would function as an environment for treating patients.
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Getting stuck with a needle is frightening. Most health care workers are frightened and imagine they will become HIV positive. When prophylaxis is indicated, it needs to be started as soon as possible, so it falls to the ED provider to determine the risk and start the right medications to prevent the development of disease.
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[Editor's note: This is the second in what is now scheduled to be a three-part series on reducing violence in the ED, due to breaking news. In last month's article, our experts discussed the importance of a "zero tolerance" policy. In this article, we outline key steps recommended for reducing violence and discuss the importance of having clear procedures when it comes to dealing with patients and their families. Next month we will examine the Sentinel Event Alert just published by The Joint Commission that discusses why the ED is particularly susceptible to episodes of violence, outlines leading causal factors, and provides additional guidance for violence prevention.]
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[Editor's note: This article is the first in an ongoing series reviewing the latest findings of the Emergency Department Benchmarking Alliance (EDBA) and how ED managers are addressing the challenges that members have identified. This first article discusses how ED managers are combating steadily increasing volume. The EDBA for 2009 shows increases of 5%-10%. The EDBA findings are significant because they represent feedback from 376 high performing EDs serving 14.8 million patients in the calendar year 2009.]
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Unless your ED is planning an expansion, the amount of space you have to work with is finite. However, as the leadership team at Jersey City (NJ) Medical Center has shown, creative use of that space can significantly improve your department's capacity and help slash wait times and the number of patients who leave without being seen. In less than a year, average wait times went from 3-4 hours to 30 minutes, and the left without being seen (LWBS) rate went from 6% to 1.5%.
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In the first phase of a two-phase process, paramedics with Grady Emergency Medical Services in Atlanta now have the option of transporting patients with less-urgent ailments to Grady Health System clinics instead of the ED. Emergency leaders believe this strategy will provide the most appropriate care for these patients and help alleviate some ED crowding.
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Difficult intubations are usually the result of a difficult airway, sometimes anticipated and sometimes not.
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This study sought to determine whether the coagulo-pathy associated with chronic liver disease specifically the elevated International Normalized Ratio (INR) frequently present in patients with advanced disease is protective against venous thromboembolism (VTE) in hospitalized patients.
