How Nurses Can Help Keep Patients Out of the Emergency Department; 3 Tips for Dealing With Poop

Cool Headline, Hospitals and Health Networks!

Emergency department overcrowding is a common conundrum for hospitals, and nurses can play a key role in emptying out those waiting rooms, according to new research in the Annals of Emergency Medicine. Researchers with the Royal Alexandra Hospital in Edmonton, Alberta, found that implementing simple, nurse-driven protocols in the ED — before a patient is treated by a doc or nurse practitioner — helped to drop waiting times dramatically. Those protocols allowed nurses to administer certain treatments early on in the hospital visit, such as giving out acetaminophen to patients in pain or troponin for those experiencing chest pain after a heart attack. Using such protocols allowed the Canadian hospital to drop length of stay for patients by as much as four hours in some cases. While the results are promising, the authors cautioned that they are not a cure-all for ED overcrowding.

Oh, and”poop”:

The nurse just posted a five-minute video to his YouTube channel last week, offering three tips for dealing with poop as a nurse. Those include exposing yourself to these situations, educating yourself on the matter and, most importantly to Liu, tell people when you poop


Emergency Medicine is one of the physician specialties with largest compensation increases in 2016

From Becker’s:

The following 10 specialties experienced the greatest rate of increase in median compensation from 2015 to 2016, according to SullivanCotter’s data. Specialties are ranked in descending order based on rate of increase.

Emergency Medicine — 3.95 percent increase ($335,000)

Press Ganey to be bought by equity firm in $2 billion deal

From Modern Healthcare (hat tip: Dr. Menadue):

Press Ganey, the healthcare consulting firm, announced Tuesday that it will be acquired by EQT Equity in a $2 billion deal.

Under terms of the agreement, the private equity firm will pay $40.50 a share for Press Ganey’s stock. Press Ganey has a market value of $2.35 billion, according to a news release.

New MOON: How hospitals must inform patients of observation status

From Healthcare Business and Technology:

The difference between outpatient observation and inpatient admission has typically been confusing to older hospitalized patients – especially since Medicare only covers portions of outpatient observation stays. In the past, facilities may have given patients quick explanations of the differences, but soon, they’ll be required to do much more. 

177731780Last year, President Obama signed the Notice of Observation Treatment and Implication for Care Eligibility Act (or the NOTICE Act). The new law, which goes into effect Aug. 6, requires hospitals to give patients specific details about their observation status and educate them about what services are usually covered by Medicare.

Under the NOTICE Act, every patient who receives observation services as an outpatient for more than 24 hours must receive an official Medicare Outpatient Observation Notice (MOON). The MOON is a standardized form created by the Centers for Medicare & Medicaid Services (CMS).

What the NOTICE Act means for healthcare organizations

From Becker’s:

Starting August 2016, the NOTICE Act will require hospitals nationwide to inform patients of their inpatient or observation status. (Five states — New York, Connecticut, Maryland, Pennsylvania and Virginia — already require similar disclosures.)

Medicare beneficiaries in the hospital for more than 24 hours must be informed in writing of their status within 36 hours of when they begin receiving medical services as an outpatient. The written notice must clearly explain:

  • that the individual is not an inpatient;
  • the reasons for the person’s observation status; and
  • the implications in terms of increased financial responsibility and lack of eligibility for coverage in a SNF after discharge.

The patient or their representative must sign the notice to acknowledge their understanding.

Hospitals and health systems will be better prepared to comply with the NOTICE Act if they start now to:

  • analyze and update observation programs as appropriate;
  • provide additional patient education about observation status;
  • expand the role of case managers; and
  • deploy follow-up tools as a “safety net” for those patients who are not admitted.

Notice of Observation Treatment and Implication for Care Eligibility Act or the NOTICE Act


(Sec. 2) This bill amends title XVIII (Medicare) of the Social Security Act to require a hospital or critical access hospital with an agreement with the Secretary of Health and Human Services to give each individual who receives observation services as an outpatient for more than 24 hours an adequate oral and written notification within 36 hours after beginning to receive them which:

  • explains the individual’s status as an outpatient and not as an inpatient and the reasons why;
  • explains the implications of that status on services furnished (including those furnished as an inpatient), in particular the implications for cost-sharing requirements and subsequent coverage eligibility for services furnished by a skilled nursing facility;
  • includes appropriate additional information;
  • is written and formatted using plain language and made available in appropriate languages; and
  • is signed by the individual or a person acting on the individual’s behalf (representative) to acknowledge receipt of the notification, or if the individual or representative refuses to sign, the written notification is signed by the hospital staff who presented it.