Fifty Years of Modern EMS: Looking Back at the Paper That Started It All

From EMS World:

Download your copy of the original White Paper here.

September marks the 50th anniversary of EMS’ landmark document, Accidental Death and Disability: The Neglected Disease of Modern Society, more commonly known as the “white paper.” While the white paper is sometimes viewed as a relic from the past, its findings and recommendations deserve a review to understand how they’ve influenced EMS. It may be a surprise how relevant the white paper still is today.

A look at the growing specialty of hospitalist

From the Tribune:

The number of hospitalists has increased from the few hundred doctors practicing in 1996 to more than 50,000 working today in the United States, according to the Society of Hospital Medicine. Nine out of 10 hospitals with more than 200 beds are staffed with hospitalists. While no board certification exists for those in this field of medicine, most hospitalists are trained and board certified in internal medicine.

Mass. hospital improves ER flow by prioritizing morning discharges

From Fierce Healthcare:

Lahey Hospital and Medical Center in Burlington developed a multidisciplinary task force to address ED compression through an early morning discharge initiative, which had a goal of discharging 20 patients by 10 a.m. across the facility, according to Hospitals & Health Networks. Despite its clear-cut goal, there were numerous barriers, including an existing culture of late-afternoon discharges within the hospital; the communications gap among the various staff involved in the discharge process; and lack of incentive among staff to prioritize discharge among providers with numerous other items on their itineraries.

To address these issues and successfully implement the program, Lahey’s task force developed several strategies, including:

  • Regular updates about progress and best practices for frontline staff
  • Promoting multidisciplinary rounds to strengthen communication throughout the continuum of care
  • Incentivizing discharge by providing gift cards for nurses who led the unit in discharges by 10 a.m.
  • Enlisting the help of family members who patients rely on for transportation by offering free parking and breakfast vouchers
  • Share results with floor units and department heads to promote data transparency and accountability
  • Deploying “social marketing,” making sure to communicate that the initiative aims for improved patient safety and satisfaction rather than merely freeing up beds

 

Research from Columbia Business School Reveals How to Shorten Emergency Room Wait Time

Press Release:

According to the U.S. Department of Health and Human Services, demand for emergency health care services is rapidly increasing, causing over-crowding and long wait-times in emergency rooms nationwide.  New research from Columbia Business School shows that predictive analytics – that is, using data about ER demand to predict future demand – could help hospitals reduce wait times and improve care by diverting patients away from emergency rooms before they become overcrowded.

Hospital diversions are intended to help patients get care faster by directing them away from overcrowded ERs and toward facilities that can care for them more appropriately and quickly. In current practice, diversion decisions are typically made based solely on information about current congestion — i.e. if a maximum threshold is reached, then new patients will be diverted.  However, the researchers suggest that by using predictions of when patient congestion is likely to build, hospitals could substantially reduce the wait times of patients seeking medical care from an ER.

“Patients on their way to the emergency room want to know that their emergency is going to be handled as expeditiously as possible,” said Professor Carri Chan, co-author of the study and Sidney Taurel Associate Professor of Business at Columbia Business School. “By using predictive modeling to develop more effective diversion policies, hospitals can reduce wait times for patients by up to 15 percent, improving care and customer satisfaction while at the same time saving time and money.”

The study, titled Using Future Information to Reduce Waiting Times in the Emergency Department via Diversion, co-authored by Chan and Kuang Xu of Stanford University, proposes a new algorithm to predict future emergency arrivals.  This algorithm can be then be applied to make decisions about diverting incoming patients.

Chan concluded: “Using predictive analytics is a step towards eliminating the over-crowding and long wait times that plague may of today’s emergency rooms, ensuring patients receive the care they need when they need it.”

To learn more about the cutting-edge research being conducted at Columbia Business School, please visitwww.gsb.columbia.edu.

About Columbia Business School
Columbia Business School is the only world–class, Ivy League business school that delivers a learning experience where academic excellence meets with real–time exposure to the pulse of global business. Led by Dean Glenn Hubbard, the School’s transformative curriculum bridges academic theory with unparalleled exposure to real–world business practice, equipping students with an entrepreneurial mindset that allows them to recognize, capture, and create opportunity in any business environment. The thought leadership of the School’s faculty and staff, combined with the accomplishments of its distinguished alumni and position in the center of global business, means that the School’s efforts have an immediate, measurable impact on the forces shaping business every day. To learn more about Columbia Business School’s position at the very center of business, please visit www.gsb.columbia.edu.

How to derive real value from “smarter” connected health products

From ReadWrite:

When a sick person – particularly a sick child – is in a moment of need, the first thing that person or those concerned parents look for isn’t simply an answer to “how high is my temperature?” What they really want are answers around what that number means and what they should do next — What is it? Should I call a doctor? How can I/he/she get better?

With smart devices that can respond to the onset of illness in real-time, we finally have the ability to deliver those answers to that person in their time of need, helping them detect illness sooner, get care faster and prevent their illness from spreading.

New reversal agent for anticoagulants

From Reuters:

An experimental drug designed to quickly counteract blood-thinning medicines has demonstrated effectiveness, according to preliminary results of a new trial done under real-world conditions.

The drug is Portola Pharmaceuticals’ AndexXa, known generically as andexanet alfa. Earlier this month, the U.S. Food and Drug Administration decided not to approve this so-called reversal agent without more data. The new test, reported on Tuesday at a European Society of Cardiology Congress in Rome and released by the New England Journal of Medicine, offers more evidence. Portola financed the study.

The drug reversed episodes of major bleeding that couldn’t be stopped because the patients were on drugs such as apixaban and rivaroxaban, which inhibit the body’s natural blood clotting chemical known as factor Xa.

Illinois emergency room visits increased after Obamacare

From the Tribune:

Hospital emergency department visits increased in Illinois after the Affordable Care Act took effect — the opposite of what many hoped would happen under the landmark health care law, according to a new study.

“Emergency departments are already overcrowded, and bringing more patients in will continue to make that worse,” said Dr. Scott Dresden, an assistant professor of emergency medicine at Northwestern University Feinberg School of Medicine, and the lead author of the study.

Emergency visits in Illinois increased 5.7 percent, or by more than 14,000 visits a month on average, in 2014 and 2015 compared with 2011 through 2013, according to the study, published online in Annals of Emergency Medicine, a peer-reviewed journal.