Emergency Department Administration

Role of Point-of-Care Testing in Reducing Time to Treatment Decision-Making in Urgency Patients: A Randomized Controlled Trial

Chaisirin, MD, et al.

Shortening emergency department (ED) visit time can reduce ED crowding, morbidity and mortality, and improve patient satisfaction. Point-of-care testing (POCT) has the potential to decrease laboratory turnaround time, possibly leading to shorter time to decision-making and ED length of stay (LOS). We aimed to determine whether the implementation of POCT could reduce time to decision-making and ED LOS.

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New Clarification About Observation Billing May Improve Care for Behavioral Health Patients

Osborne, MD, et al.

Emergency Physicians provide ongoing care to psychiatric patients beyond the confines of a standard emergency room visit. Often, when we identify patients who need specialty psychiatric care, patients board in the emergency department awaiting acceptance and transfer to an outside facility. Even in cases where it has taken multiple days to complete the transfer, it has been unclear how to properly obtain reimbursement for this care. We discuss a new coding clarification that may provide a pathway to improve part of this situation.

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Time Cost of Standardized Nursing Screens in the Emergency Department

Migdal, MD, et al.

Various policies require that screening questions be asked of all patients who present to the emergency department (ED). No studies have previously examined the potential time costs of standardized screens. Our objective was to analyze the time nursing spent conducting standardized nursing screens and calculate the corresponding time cost.

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Increased Computed Tomography Utilization in the Emergency Department and Its Association with Hospital Admission

Bellolio, MD, MS, et al.

Our goal was to investigate trends in computed tomography (CT) utilization in emergency departments (EDs) and its association with hospitalization. We conducted an analysis of an administrative claims database of U.S. privately insured and Medicare Advantage enrollees. We identified ED visits from 2005 through 2013 and assessed for CT use, associated factors, and hospitalization after CT, along with patient demographics.

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Emergency Department Operations

Physician Quality Reporting System Program Updates and the Impact on Emergency Medicine Practice

Volume 17, Issue 2, March 2016.
Jennifer L. Wiler, MD, MBA, et al.

In 2007, the Centers for Medicaid and Medicare Services (CMS) created a novel payment program to
create incentives for physician’s to focus on quality of care measures and report quality performance
for the first time. Initially termed “The Physician Voluntary Reporting Program,” various Congressional
actions, including the Tax Relief and Health Care Act of 2006 (TRHCA) and Medicare Improvements
for Patients and Providers Act of 2008 (MIPPA) further strengthened and ensconced this program,
eventually leading to the quality program termed today as the Physician Quality Reporting System
(PQRS). As a result of passage of the Affordable Care Act of 2010, the PQRS program has expanded
to include both the “traditional PQRS” reporting program and the newer “Value Modifier” program
(VM). For the first time, these programs were designed to include pay-for-performance incentives for
all physicians providing care to Medicare beneficiaries and to measure the cost of care. The recent
passage of the Medicare Access and Children’s Health Insurance Program (CHIP) Reauthorization Act
in March of 2015 includes changes to these payment programs that will have an even more profound
impact on emergency care providers. We describe the implications of these important federal policy
changes for emergency physicians.

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Emergency Medicine Clerkship Directors: Current Workforce

Volume 15, Issue 4, July 2014
David A. Wald, DO et al.

The emergency medicine clerkship director serves an important role in the education of medical students. The authors sought to update the demographic and academic profile of the emergency medicine clerkship director.

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Contact Information

WestJEM/ Department of Emergency Medicine
UC Irvine Health

333 The City Blvd. West, Rt 128-01
Suite 640
Orange, CA 92868, USA
Phone: 1-714-456-6389
Email: editor@westjem.org

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WestJEM
ISSN: 1936-900X
e-ISSN: 1936-9018

CPC-EM
ISSN: 2474-252X

Our Philosophy

Emergency Medicine is a specialty which closely reflects societal challenges and consequences of public policy decisions. The emergency department specifically deals with social injustice, health and economic disparities, violence, substance abuse, and disaster preparedness and response. This journal focuses on how emergency care affects the health of the community and population, and conversely, how these societal challenges affect the composition of the patient population who seek care in the emergency department. The development of better systems to provide emergency care, including technology solutions, is critical to enhancing population health.