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In a move that emergency medicine experts hope will provide at least partial relief to the call coverage challenge, the Centers for Medicare & Medicaid Services (CMS) has proposed a new regulation that would allow hospitals to establish community call arrangements at a regional level to satisfy their Emergency Medical Treatment and Labor Act (EMTALA) on-call physician requirements.
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At first glance, it sounds like only good news for ED managers who are frustrated at their inability to have specialty services adequately covered.
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ED managers should be pleased with the proposed increases in ambulatory payment classifications (APCs) for fiscal year 2009, says Dennis Beck, MD, FACEP, CEO of Beacon Medical Services in Denver and chair of the quality and performance committee of the American College of Emergency Physicians (ACEP).
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In the wake of a flash flood in June that forced the closing of Columbus (IN) Regional Hospital, the ED reopened about two weeks later in a mobile unit called the Carolinas Mobile Emergency Department-1 (MED-1).
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With The Joint Commission's 2009 National Patient Safety Goals focusing on hospital-acquired infections (HAIs), ED managers say the key to compliance remains one of the most basic but difficult to implement strategies of all: hand washing.
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Involving the patient in their own care, an important component of the National Patient Safety Goals for several years, including 2009, also can be a big help for EDs looking to control hospital-acquired infections (HAIs), says Christopher Beach, MD, vice chair, Department of Emergency Medicine, at the Northwestern University Feinberg School of Medicine and Northwestern Memorial Hospital in Evanston, IL. So can education, he adds.
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In anticipation of unannounced survey visits by The Joint Commission, the ED at St. Jude's Medical Center in Fullerton, CA, created a "Code JUDE," or Joint Commission Unannounced Disruption Event, drill to help it prepare.
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In response to several high-profile incidents of homeless patients being discharged in a less-than-dignified manner, the city of Los Angeles has enacted a new law that requires obtaining written consent to transport a patient anywhere other than his or her legal residence. Violating the law could result in a misdemeanor conviction.
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A protocol built around the use of rapid response teams (RRTs) has reduced incidences of preventable codes among pediatric patients by 20% at a group of hospitals in Ohio, one of the best demonstrations yet of the success of that approach in improving patient safety. One hospital even saw a drop of 40%.
