ED management : the monthly update on emergency department management
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A hospital-wide improvement effort has enabled Robert Wood Johnson University Hospital in Hamilton, NJ, to reinstitute a guarantee that patients arriving at the ED for care will be evaluated within 15 minutes and receive a medical examination within 30 minutes. Administrators used a team approach to identify bottlenecks and implement solutions, and they divided the ED into four zones, with provider teams responsible for each zone. ⋯ The zoning system in the ED has improved patient throughput and fostered accountability within the care teams responsible for each zone, say administrators. Overall care provider satisfaction has risen from the 75th percentile in 2010 to the 80th percentile in 2011, according to Press Ganey surveys.
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Clinical pharmacists with EM training slash medication errors, help to optimize therapies in the ED.
Pharmacists who specialize in emergency medicine are taking a place at the bedside in a small but growing number of EDs. Studies show the approach can make a big dent in medication errors and can quickly guide physicians toward optimal therapies with respect to trauma patients and other complex cases. Experts say clinical pharmacists provide an extra safeguard that is commonly missed in the fast-paced ED setting. ⋯ Pharmacists serve on trauma teams, review medication orders, assist with medication titration, and act as a communication bridge between the ED and the inpatient pharmacy. Recent studies suggest pharmacists capture significantly more medication errors than other personnel, and that they help to speed patients with ST-elevation myocardial infarctions from the ED to the cardiac catheterization laboratory. Nurse and physician buy-in are critical to the success of a clinical pharmacist program in the ED.