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If it seems youre seeing more patients with mental illnesses recently, youre not imagining it. The number of people with mental illness seeking care in the ED has surged recently, and the increase is taking a toll on other ED care, says J. Brian Hancock, MD, president of the American College of Emergency Physicians (ACEP) in Irving, TX.
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Hsu J, Reed M, Brand R, et al. Cost sharing: Patient knowledge and effects on seeking emergency department care. Med Care 2004; 42:290-296. Saketkhoo DD, Bhargavan M, Sunshine JH, et al. Emergency department image interpretation services at private community hospitals. Radiology 2004; 231:190-197. Lyons MS, Lindsell CJ, Trott AT. Emergency department pelvic examination and Pap testing: Addressing patient misperceptions. Acad Emerg Med 2004; 11:405-408.
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In addition to increased numbers of mentally ill patients, emergency departments (EDs) are seeing more uninsured patients than in the past, and the numbers could grow, warns Brian Hancock, MD, president of the American College of Emergency Physicians (ACEP) in Irving, TX. Your budget planning should factor in more uninsured patients, not just the same level you have coped with for years.
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An analysis tool commonly used for investigating adverse events and other process errors in health care can prove useful in the ED as well, say experts who have seen it used to address long wait times and similar problems. The technique is called root-cause analysis (RCA), and chances are youve heard the term tossed around, but its not as likely that youve actually employed it in the ED.
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A root-cause analysis (RCA) is a complex tool that requires professional training, but an ED manager can utilize it with the help of an expert, says Kenneth A. Hirsch, MD, PhD, a practicing psychiatrist and director of Medical Risk Management Associates, a consulting firm in Honolulu.
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In addition to increased numbers of mentally ill patients, EDs are seeing more uninsured patients than in the past, and the numbers could grow, warns Brian Hancock, MD, president of the American College of Emergency Physicians (ACEP) in Irving, TX. Your budget planning should factor in more uninsured patients, not just the same level you have coped with for years.
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Question: How do we avoid patient hoarding, in which nurses or physicians intentionally delay moving a patient out to delay the next patient and give themselves a breather? Weve already warned that hoarding wont be tolerated, but it still happens and thwarts our efforts to improve patient flow through and decrease waiting time.
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Question: Should we have a plan for responding to patients on the hospital property, but not in the ED area, when they need or request emergency care? The final rule seems to make clear that we are not obligated to rush out of the ED to provide care for anyone who does not come to a dedicated emergency department, but were not clear on what should happen when that person is elsewhere on the campus.
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As an ED manager, you may be accustomed to handling the brunt of responsibility for accreditation surveys. But under the new Shared Visions New Pathways process from the Joint Commission on Accreditation of Healthcare Organizations, surveyors will be talking with your staff and your patients. How on earth can you prepare for that?
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Many ED managers are unsure of how to prepare for unannounced surveys from the Joint Commission of Accreditation of Healthcare Organizations, which began for all facilities on Jan. 1. Here are insights from those who have had firsthand experience with the process.
