Doctors, Federal Health Officials Search for Solutions to Emergency Room Crowding

From ABC News

On Friday, June 22, nearly a year after the Institute of Medicine issued three reports chronicling a rise in numbers of emergency patients and a decline in the number of emergency facilities nationwide, the House Committee on Oversight and Government Reform listened to testimony from five physicians in a hearing titled “The Government’s Response to the Nation’s Emergency Room Crisis.”

Study: Iowa quickest in US on ER visits

From Yahoo News:

Iowans may want to think twice before complaining about long waits in the emergency room. According to a national study, Iowa is the quickest place in the country to get emergency medical attention — the average visit lasting two hours, 18 minutes.

The national average is three hours, 42 minutes, according to a study from Press Ganey Associates Inc., a South Bend, Ind.-based company that measures patient satisfaction.

The study, which was published this month, rated hospitals’ performances last year. Nebraska rated second fastest in the nation at two hours, 26 minutes, followed by South Dakota (2:28), Vermont (2:32) and Wisconsin (2:34).

The longest average visits were in Arizona (4:57), Maryland (4:07), Utah (4:04), New York (3:58) and Florida (3:57).

Scott McIntyre, spokesman for the Iowa Hospital Association, said Iowa’s rural landscape could be one reason why ER visits are shorter here.

“We have a lot of small hospitals that don’t have a lot of emergency room traffic,” he said. “The pressure on the ERs here is not comparable to ERs in, say, Los Angeles.”

In addition, McIntyre said more Iowans have primary physicians, regular health care and insurance than people in other states, which leads to less time in the emergency room.

Update on Standard MM 4.10 in the Emergency Department (ED)

From the Joint Commission:

Effective April 6, 2007, the interim action was suspended for Standard MM.4.10, Element of Performance 1 that required a retrospective review of all medication orders in the Emergency Department (ED) by a pharmacist when a prospective review was not conducted. The interim action was implemented on January 1, 2007 for EDs in hospitals and critical access hospitals.

The decision to suspend the interim action was based on several concerns cited by the field, including the lack of prior hospital pharmacist involvement in the ED setting, the costs to hospitals of providing additional pharmacist manpower to support medication review of any type in the ED, and the frequent unavailability of pharmacists because of the long-standing pharmacist shortage.

The 1000 lb Ambulance

From Medgadget:

Obese folks living within the Calgary region of O’Canada now have access to an ambulance that is designed for patients up to 1000 lbs (450 kg) in weight. According to the article, obesity is not only a problem in Canada, but in the rest of North America as well.

The upgrades to the ambulance include a specially designed air mattress that is inflated beneath the patient, making transfer to a widened stretcher easier and safer. A remote lift system then gently raises the stretcher into the ambulance.

Physicians who talk about themselves cut into visit’s valuable time


Too much personal talk by doctors can be bad medicine, according to a study published on Monday in which U.S. researchers sent actors posing as new patients to see doctors in secretly recorded visits.

Doctors often wasted time in what already may have been short visits and stifled the flow of information from patients by gabbing about themselves, their own health problems, their families and their political beliefs, the study found.

The doctors engaged in such “personal disclosures” in 34 percent of visits tracked by the researchers. The personal talk may have been well-intentioned — to deepen a doctor-patient relationship — but yielded little of value to patients and sometimes was counterproductive, the researchers said.

Standard of Care Remains a Moving Target in Medical Malpractice Cases

From MedPage Today:

Courts in 21 states adhere to a local or community standard of care in medical malpractice cases, slowing implementation of evidence-based, resource-based, nationwide standards.

So said Michelle Huckaby Lewis, M.D., J.D., of Johns Hopkins and Georgetown University, and colleagues in a commentary in the June 20 issue of the Journal of the American Medical Association.

The locality rule was a 19th century concept intended to protect rural physicians from being held to the same standards as physicians working in urban areas or at academic institutions, the authors said.

But, they note, modern communication has removed barriers to standardization — no place is more than a phone call or a mouse click away from the latest evidence-based findings.

As a result, a rule originally intended as a protection now “imposes additional duties and legal risk on physicians. Not only must they remain aware of advances in their own specialty, physicians must also be aware of the standard of care in their locality, whether or not that standard is considered substandard at the national level,” the authors wrote.

List compares hospitals’ heart-related death rates

From USA Today:

In a bid to improve hospital performance, the federal government on Thursday posted online its first comparison of heart attack and heart failure death rates from more than 4,000 hospitals nationwide.

Hospital’s ‘scribes’ help them focus more on patients, less on paperwork

From SignOnSanDiego:

Doctors struggling to keep pace with the growing volume of patients who pass through Tri-City Medical Center’s emergency room are getting help from an unlikely source: college students.

The Oceanside hospital has hired undergraduate pre-med students and recent graduates as “scribes” to document physician notes and orders in the emergency room – work that doctors usually do themselves.

That change gives doctors at one of the busiest emergency rooms in San Diego County more time to spend with their patients and provides the students with real-world medical experience they normally wouldn’t get until later in medical school

TabletKiosk™ Greets Patients in ER

From Medgadget:

When a patient arrives at Parkland Memorial Hospital in Dallas, he or she is now greeted by a computer, The Dallas Morning News is reporting. This electronic processing of patients at Parkland was implemented by the hospital’s own IT department with the help of Sand Dune Ventures Inc., a Torrance, CA maker of TabletKiosk™.

The company is specializing in touch screen tablet PCs, mobile computers, and “custom hardware solutions and kiosk encasements.” They serve different industries, but health care solutions is what interests us.

Doctors urged to make good first impression

From Reuters:

Doctors should know that when meeting a new patient for the first time there is no second chance to make a good first impression, researchers said on Monday.

Almost all patients want to be greeted by name when seeing a doctor for the first time and want to shake hands, a survey of patients found. But while handshakes are common, doctors often never utter the patient’s name, the researchers said.

“Greetings are just a small slice of the visit, but they can have a lasting impact,” study leader Gregory Makoul of Northwestern University Feinberg School of Medicine said in a telephone interview.

It’s the first impression that can really set the tone for the rest of the encounter and for the doctor-patient relationship.”

Not only that — manners can prevent mistakes.

“It’s not only a feel-good exercise,” said Dr. Sheldon Horowitz of the American Board of Medical Specialties, whose 24 member boards certify U.S. physicians.

“There is some correlation between good communication between the physician and patient and actually good outcomes in patient care.”