Tag: er

Observation Medicine Playing Bigger Role in the ER

April 20th, 2012
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Traditional observation units often focus on chest pain and a few other diagnosis. But as the health care market continues to change, so has the need to decrease length of stay, decrease re-admissions, and streamline patent care. Accordingly, our Observation Services at Western Maryland Health System continues to grow. We have physically expanded from ten to […]

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Posted in Future of Healthcare, Observation Care

The Decline and Fall of Triage in the ER

April 13th, 2012
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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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Posted in Quality Efficiency Utilization

Medicaid Rule for Emergency Departments Used a Hammer to Tighten a Screw

April 4th, 2012
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There are a thousand places to look for cost savings in healthcare, but this week in Washington State officials grappled with one of the most visible of those: emergency care. Thankfully, Washington Governor Christine Gregoire has suspended implementation of a rule that would have denied emergency rooms payment from Medicaid if the patient was diagnosed […]

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Posted in Future of Healthcare

5 Strategies To Head Off Malpractice Claims in the ER

March 27th, 2012
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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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Posted in Leadership, Quality Efficiency Utilization

Leadership in the ED: Being a Floor General for Your Team

March 20th, 2012
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In sports, the most successful athletes are not necessarily those that have had the best individual statistics, but are those that have managed to make their teammates better around them: Magic Johnson, Isaiah Thomas, or to use a hot new name – Jeremy Lin.  These athletes epitomize selfless leadership on the court. While their own […]

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Posted in Life in the ER

When Are ER Docs Hunting the Snark?

March 5th, 2012
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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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Posted in Life in the ER, Quality Efficiency Utilization

Addiction and Pain: Who Gets a Script?

February 27th, 2012
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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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Posted in Quality Efficiency Utilization

We Want Our Healthcare Like We Want our Fast Food

February 24th, 2012
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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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Posted in Quality Efficiency Utilization

After 20 Years in Emergency Medicine, The Worries and Tools I Take to a New ER

January 24th, 2012
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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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Posted in Life in the ER, Quality Efficiency Utilization

When an Emergency Room Gets New Management, Relationships Come First

January 20th, 2012
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It’s no big surprise that there is anxiety when a new management group takes over an Emergency Department. The question is, what can our group do to effectively confront that anxiety? At midnight on December 31st, 2011, our group took over management of the emergency room at Bristol Hospital. The previous group had managed the ER there […]

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Posted in Hospital Partnership, Leadership, Life in the ER