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.
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.
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.
A cross-sectional, web-based survey was emailed to medical directors and/or nurse managers of the 135 hospital-based EDs in Michigan. Questions included presence of clinical pathways, services to reduce admissions, and barriers to connecting patients to outpatient services.
Healthcare organizes doctors and patients into a system where that relationship can be financially exploited and as much money extracted as often as possible by hospitals, clinics, health insurers, the pharmaceutical industry, and medical device manufacturers.
The effect of nurse staffing on emergency department (ED) efficiency remains a significant area of interest to administrators, physicians, and nurses. We believe that decreased nursing staffing adversely affects key ED throughput metrics.
This was a retrospective analysis of data collected from electronic, patient-care, timestamp events and from a prospective Code Help registry for consecutive adult patients admitted from the ED at a single academic center during a 15-month period.
Case management is an effective, short-term means to reduce emergency department (ED) visits in frequent users of the ED. This study sought to determine the effectiveness of case management on frequent ED users, in terms of reducing ED and hospital length of stay (LOS), accrued costs, and utilization of diagnostic tests.
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.
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.
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.