Indiana Health Information Exchange stresses value in ED alert pilot program

From Fierce Healthcare:

Providing near-real-time notice when patients visit the emergency room might be more useful and cost-effective initially than a full-fledged health information exchange, according to a case study presented by the Agency for Healthcare Research and Quality.

The Indiana Health Information Exchange (IHIE), one of the nation’s largest, provides health plans and Medicare-chartered accountable care organizations with alerts within 24 hours when a member visits the emergency room or is admitted to the hospital. In a pilot test of near real-time collection of admission, discharge, transfer (ADT) messages, a managed health plan was able to reduce non-urgent emergency department visits, replacing them with lower cost primary care visits–saving money while providing more coordinated care.

Proposing “The Burns Suite” as a Novel Simulation Tool for Advancing the Delivery of Burns Education

From the Journal of Burn Care & Research:

Educational theory highlights the importance of contextualized simulation for effective learning. We explored this concept in a burns scenario in a novel, low-cost, high-fidelity, portable, immersive simulation environment (referred to as distributed simulation). This contextualized simulation/distributed simulation combination was named “The Burns Suite” (TBS). A pediatric burn resuscitation scenario was selected after high trainee demand. It was designed on Advanced Trauma and Life Support and Emergency Management of Severe Burns principles and refined using expert opinion through cognitive task analysis. TBS contained “realism” props, briefed nurses, and a simulated patient. Novices and experts were recruited. Five-point Likert-type questionnaires were developed for face and content validity. Cronbach’s α was calculated for scale reliability. Semistructured interviews captured responses for qualitative thematic analysis allowing for data triangulation. Twelve participants completed TBS scenario. Mean face and content validity ratings were high (4.6 and 4.5, respectively; range, 4–5). The internal consistency of questions was high. Qualitative data analysis revealed that participants felt 1) the experience was “real” and they were “able to behave as if in a real resuscitation environment,” and 2) TBS “addressed what Advanced Trauma and Life Support and Emergency Management of Severe Burns didn’t” (including the efficacy of incorporating nontechnical skills). TBS provides a novel, effective simulation tool to significantly advance the delivery of burns education. Recreating clinical challenge is crucial to optimize simulation training. This low-cost approach also has major implications for surgical education, particularly during increasing financial austerity. Alternative scenarios and/or procedures can be recreated within TBS, providing a diverse educational immersive simulation experience.

Health Information Exchange reduces repeat imaging in the ER

From Healthcare IT News:

The benefits of reduced imaging from the use of health information exchange have largely been the stuff of anecdote and theory, until now.

In one of the first large-scale empirical studies on the links between HIE participation and imaging in hospital emergency departments, researchers from Mathematica Policy and the University of Michigan found redundant CT scans, X-rays and ultrasounds decreased fairly significantly — with savings in the millions of dollars.

Minnesota Plans for Emergency, Prepares for Pandemic Response

From JEMS:

Forty people from Minnesota’s Northeast Healthcare Preparedness Coalition (NHPC) recently attended the Pandemic Planning and Preparedness (P3) course at FEMA’s Center for Domestic Preparedness (CDP). Students represented 20 partnering agencies including: healthcare facilities, local and tribal public health; public safety; emergency management; the Minnesota Air National Guard; and regional healthcare, public health, and emergency management coordinators.

According to Marilyn Cluka, Public Health Preparedness Consultant with the Minnesota Department of Health, “Although this course focused on a pandemic response, the training can be applied to any disaster. We gained a better understanding of the Incident Command System and how we work together with different organizations within an Emergency Operations Center.”

Doctor Braves Snowstorm, Walks 6 Miles to Perform Emergency Surgery

From Gawker:

Dr. Zenko Hrynkiw was working at Brookwood Medical Center in Birmingham on Tuesday when he received word that a patient requiring emergency brain surgery had arrived at Trinity Medical Center, located more than six miles away. But because of Tuesday’s storm, which effectively shut down transportation across the Southeast, Hrynkiw was able to drive only three blocks before traffic stopped. He quickly called the hospital.

“The cell service was bad so we were fading in and out,” Steve Davis, charge nurse in the neuro intensive care unit at Trinity, told “At one point, I heard him say, ‘I’m walking.'”

Several hours went by before Hrynkiw’s calls got through. “He finally called me and said, ‘Where’s the patient? What’s the status?'” Davis said.

Not long after, Hrynkiw finally arrived at the hospital, met with the patient’s family, and performed the surgery. The patient, who would’ve died without the procedure, is doing well and is expected to recover.

No more “code blue” for Missourui hospitals?

From Fierce Healthcare:

The Missouri Hospital Association wants organizations to use more transparent phrases like “bomb threat” or “active shooter” rather than code phrases, according to the St. Louis Post-Dispatch. Pain language alerts and warnings will heighten patient safety and response time, Leslie Porth, vice president of health planning at the Missouri Hospital Association, told the newspaper.

Study Shows Decline in Emergency Services Use Among Newly Insured

From California Healthline:

The UCLA Center for Health Policy Research yesterday released a study that lends credence to one of the primary contentions of health care reform — providing health care coverage can reduce expensive emergency department use.

“Once you provide coverage to a population and provide preventive services, particularly for chronic conditions, you can expect a decline in emergency room visits over time,” said Nadereh Pourat, the center’s director of research and lead author of the study.

ER Briefs: Why I Disagree With ACEP’s tPA Guidelines

From MedPage Today:

We reached out to Anand Swaminathan, MD, MPH, assistant residency director and assistant professor of emergency medicine NYU/Bellevue Emergency Department, for his take on the American College of Emergency Physicians (ACEP) tPA guideline debate.

Overall, I think making a Level A recommendation based on the NINDS study is fraught with issues. Although other research was considered in this recommendation, NINDS was the only randomized, controlled trial (RCT) that played into the recommendation. Making such a strong recommendation based on a single RCT is problematic. Typically, Level A is accorded to recommendations with multiple studies backing it up.

ED Briefs: Open Season on ACEP tPA Guidelines

From MedPage Today:

Some medical guidelines arrive barely noticed, but others — say, last fall’s new AHA/ACC guidelines for managing cholesterol — lead to a ruckus. That’s what happened with a 2013 guideline from the American College of Emergency Physicians (ACEP) that all but backed intravenous clot buster thrombolytics for acute ischemic stroke.

And last week, ACEP responded by declaring open season on those guidelines, launching a 60-day member comment period.

Colorado Helicopter Crash Claims Experienced Rescue Pilot

From JEMS:

 Time after time, pilot Doug Sheffer set down his helicopter atop Colorado peaks, allowing rescuers to reach stranded hikers or mountaineers.

“There’s a number of people today who wouldn’t be alive had it not been for his skill and experience,” Jeff Edelson, a firefighter, paramedic and president of the volunteer Mountain Rescue Aspen group, said in an interview Tuesday.

A day earlier, Sheffer was killed on a more routine mission, helping a utility company survey power lines in western Colorado near his hometown of Rifle. The two other men aboard also were killed.