Quality Efficiency Utilization
Saving Time in the ER, Even When It’s Not Life and Death
May 14th, 2012by: Dr. Josh Muyderman
In the ER, we celebrate small improvements. After all, we work in a place where a few minutes saved could mean the difference between life and death. In other cases, shaving a few minutes off a process here or a protocol there may result in somewhat less dramatic payoff. Take our recent Kaizen project at […]
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The Decline and Fall of Triage in the ER
April 13th, 2012by: Dr. Vipul Kella
The national trend toward overcrowding in emergency rooms is having an interesting effect on a process that was conceived to handle a large number of injured patients: triage. One might expect that as more and more patients flow into the ER, the process of triage would become even more central to the smooth flow and […]
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5 Strategies To Head Off Malpractice Claims in the ER
March 27th, 2012by: Dr. Jonathan Wenk
I have always had an interest in risk management in the ER, a world in which it is a statistical inevitability that there will be bad outcomes. This interest stems from my fundamental belief that Emergency Physicians are well-intentioned, morally upright individuals. And so it frustrates me when some bad outcomes lead to malpractice litigation. […]
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When Are ER Docs Hunting the Snark?
March 5th, 2012by: Dr. Mike Perraut
The old saying about the doctor who tells a patient to “take two of these and call me in the morning” is losing its meaning in today’s modern healthcare system. Today, doctors are weary of sending their patients home without something more, usually an expensive test that either confirms or (less commonly) contradicts their diagnosis. […]
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Addiction and Pain: Who Gets a Script?
February 27th, 2012by: Dr. Julian Orenstein
As if we as ER docs didn’t have enough on our plates already with proliferating drug shortages, adapting to the Affordable Care Act, the capriciousness of a new and very temperamental EMR, and my teenage daughter’s mood swings (wait, how did that get in there?), we also find ourselves under the microscope for our treatment […]
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We Want Our Healthcare Like We Want our Fast Food
February 24th, 2012by: Dr. Angelo Falcone
With due respect to those patient souls among us, America is, in general, an impatient nation. That includes how we think about our healthcare. This is why I read with some interest, and some amusement, stories like “A real ‘doc fix,’” published this week in the New York Times. Basically it says we need to […]
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Sometimes the Best Emergency Medicine is No Medicine at All
February 3rd, 2012by: Dr. Angelo Falcone
I was recently reminded by a patient experience that the best medicine sometimes is no medicine at all. I cared for a young woman who had been seen the last few nights complaining of shortness of breath. When it was obvious that she had normal breath sounds, no wheezing and normal oxygen level I started […]
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After 20 Years in Emergency Medicine, The Worries and Tools I Take to a New ER
January 24th, 2012by: Dr. Angelo Falcone
When I completed my training nearly 20 years ago, I always wondered what type of emergency department I would work in. Two decades later I can say I’ve worked in a lot of different emergency departments, seven of them to be specific. They range from bustling suburban hospitals to small rural facilities to busy trauma […]
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The Expanding Role and Bright Future of Advanced Practice Practitioners in the Emergency Department
October 26th, 2011by: Dr. Mike Perraut
Advanced Practice Practitioners see a wide variety of patients at our hospital sites, from those with chest pain to those with minor lacerations and everything in between. This practice is not limited to us. Nationally, it is estimated that Physician Assistants (PA’s) see 10 percent of emergency room patients in the United States, and a 2009 […]
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Madness, Death, and the Real Solution to Over-Prescribing Prescription Narcotics
October 21st, 2011by: Dr. Angelo Falcone
Last month, the LA Times chronicled the stunning rise of deaths attributed to prescription drug overdose, particularly narcotics meant to manage pain. The push to control or manage all pain regardless of the legitimacy of the pain has made overdose from prescription drugs a bigger killer than heroin and cocaine combined, the story reported. Incidentally, […]
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