Emergency medicine clinics of North America
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Emerg. Med. Clin. North Am. · Feb 2004
ReviewThe business of emergency medicine: a model for success.
Today's EPOs and their physicians face an array of daunting challenges. Falling reimbursement, rising malpractice costs. ED and hospital crowding,and demands for improving ED efficiency and patient satisfaction all contribute to the challenging and sometimes threatening environment of EM practice. ⋯ They can demonstrate performance history and targeted future performance to differentiate themselves from competitors and to stem efforts to impose unbalanced metrics that do not serve well the hospital, the EPO, and ultimately, patients. The power of such measurement systems, internal and external to the organization, strongly point to the need for consistently defined measures across the industry. Ultimately when faced with changes in the environment,the entire industry will be better equipped to respond in specific ways and to communicate its progress to communities or government authorities.
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Information system planning for the ED is complex and new to emergency medicine, despite being used in other industries for many years. It has been estimated that less than 15% of EDs have comprehensive EDIS currently in place. The manner in which administration is approached in large part determines the success in obtaining appropriate institutional support for an EDIS. ⋯ Finally, good clinical content is key to virtually every aspect of the EDIS. Much of this content is yet to be developed and what is available still needs to be adapted to the EDIS environment. Daunting as it may be, an EDIS implementation properly accomplished results in better patient care, improved staff productivity, and a satisfying work environment (Box 3).
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The purpose of this article is to explore some of the tools and technologies available in operations management in health care in general and in emergency medicine in particular. The intent is to stimulate the reader to explore some of these approaches and tools in further detail. Various theories are noted, but the intent of this article is to be eclectic so as to give the reader a feel for the rich variety of approaches available.
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Although emergency departments (ED's) vary in shape, size, and technology, similarities in responsibilities exist. The primary responsibility is to provide quality health care to the communities served. ⋯ The ED nurse manager must have an understanding of how outside influences affect the operational aspect of the ED. Having this body of knowledge enhances the viability of the department and positively affects the quality of care.
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Patient satisfaction is not merely a "smile and be nice" set of behaviors. It is a philosophy that is founded in the concept that the patient's experience of care is important and ultimately translates into their actual response to care. The improved response to care that patients exhibit makes patient satisfaction important from a clinical vantage point. ⋯ One major difference between a successful customer service initiative and an unsuccessful one is the level of sincerity the hospital and its staff have about the care they express for their patients. If the whole process is merely an exercise to improve scores, the success will be limited and without deep roots. If the push is to establish an atmosphere of genuine care and interest for patients, however, the results are more meaningful, longer lasting, and more appreciated by patients and staff.