Physician Continuity is Key after Emergency Room Visit for Heart Failure

From Healthcare Professionals Network:

Heart failure patients who follow up with a familiar physician after release from the emergency department have better outcomes, according to research published online July 9 in the Journal of the American College of Cardiology: Heart Failure. 

The researchers found that heart failure patients receiving follow-up from a familiar versus unfamiliar physician after discharge from the emergency department were less likely to experience hospitalization or death at three months (adjusted hazard ratio [aHR], 0.79; 95% confidence interval [CI], 0.71 to 0.89), at six months (aHR, 0.86; 95 percent CI, 0.77 to 0.95), and at 12 months (aHR, 0.87; 95% CI, 0.80 to 0.96). Follow-up care with any physician within 30 days of discharge from the emergency department was associated with reduced risk of repeat emergency department visit or death at six months.

Speak Your Piece: A Rural Hospital Crisis

From the Daily Yonder (hat tip: Tyler Wallace):

The number of patients admitted to small, rural hospitals is dropping rapidly, creating big changes in the economics of rural healthcare.

From 1996 to 2012, the average number of acutely ill inpatients at “critical access hospitals” fell by half, from an average of 8.7 to 4.35 per hospital per day.

If the current rate of decline continues, most of the inpatient business at these hospitals will be gone in the next decade.

Inpatient care accounts for a third or less of the revenue of critical access hospitals. But it’s a vital stream of money for institutions that operate in the black by only 1% of their budgets, on average.

Why are patient admissions declining, and how should we respond?


Redesigning EDs for patient experience

From Healthcare Finance News:

At a time when emergency care is increasingly viewed as inconvenient, overcrowded and overpriced, and possibly losing ground to urgent care clinics, some health systems are trying to make their ERs a place where people actually want to go and spend their time and money.

Aria Health, a three-hospital network in north Philadelphia, has opened a new $37 million emergency department at its Torresdale campus, on the northern city-suburb border. It’s an investment for growth and in a new approach to emergency care trying to put the patient experience front and center.

On the front lines of health reform: It’s still hard to gauge health law’s impact on emergency rooms

From Insurance News:

As patients, doctors and health analysts look to see how the Affordable Care Act plays out, the emergency room is one of the closely watched stages.

Nationwide, emergency rooms have seen a jump in patients who are newly insured under the law, drawing speculation and debate about whether the law is working as it should.

But seven months after new health insurance options, Chattanooga-area hospital officials say they are still unable to gauge the law’s impact on their emergency rooms.

They are all seeing an increase, but it’s nothing out of the ordinary, they say.

More notable, they say, is the shifting role the emergency department is playing as an access point to more regular care — especially as emergency room care is one of the 10 essential health benefits required by new individual insurance plans under the law.

Resuscitation in the ED: Beyond the ABCs

From MedPage Today:

Approaching a critically ill patient can be nerve-racking, and when your nerves are racked it can be hard to remember what to do. However, when you remember what to do, your nerves get less racked. So, I’m going to present a top-down approach to resuscitation that uses an expanded ABC’s mnemonic to jog your memory and unrack your nerves:

10 Body Parts You Could Do Without

From Mental Floss:


ER holding its own amid epidemic of violence

From the Southtown Star:

It’s just another weekend, and despite the shift’s two gunshot victims, four car-crash patients and one circular saw injury, it is somewhat slow considering what usually comes in on a summer Saturday night.

“You should have seen last night,” a nurse says. “GSW [gunshot wound] after GSW, all night.”

As the only Level 1 trauma center to service Region 7 in Illinois, a geographic area that is as diverse as it is broad, Christ is always busy, but even more so on the weekends in summer, when just about everything from traffic accidents to gun violence escalates.


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