ED management : the monthly update on emergency department management
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To address declining volumes and suboptimal patient satisfaction in the ED, administrators at North Adams Regional Hospital used lean techniques to eliminate waste and streamline the triage process. A few months into the new approach, administrators say that average daily visits to the ED have increased from 42 to 54, and patient satisfaction scores have jumped 25 points on Press Ganey surveys. Participants also report the approach has resulted in improved cooperation among ED staff and lower noise levels. ⋯ The team also divided the ED into pods so that nurses can be assigned to three or four contiguous rooms. This approach eliminates unnecessary movement and makes it easier for physicians to find a patient's assigned nurse. The hospital is now leveraging the same improvement process to work on ED-to-hospital admissions and a process for handling unexpected patient surges.
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Faculty at Indiana University School of Medicine are set to launch a community paramedicine program aimed at preventing repeat hospital and ED visits for acute exacerbations of asthma in children. Under the program, all children who are treated in the hospital or ED for asthma will receive home visits by specially trained paramedics within a few days of discharge. Paramedics will conduct a comprehensive assessment and make referrals as necessary for followup care. ⋯ The one-time home visits will be comprehensive, enabling EMS providers to initiate stop-gap measures so that if a child is starting to get sick, paramedics can make sure the appropriate medicines are started and that acute care needs are met. Developers will monitor 30-day, 90-day, and one-year readmission metrics among patients who have received home visits. They hope that resulting cost-savings will sustain the program beyond the initial period, which is being funded through a grant from the Department of Health and Human Services.