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Dr. Petrack will speak at the Urgent Care Association of America annual conference, to be held April 29- May 2 in New Orleans (see the Upcoming Meetings section for details).

His topic will be "Focus on pediatric procedures: improving the experience for children and providers alike."

Peer-reviewed article featured in Journal of Urgent Care Medicine

As a Spotlight reader, you already know my passion for improving family-centered care in emergency departments and urgent care centers. What you might not know, however, (shameless plug time!) is that we - our child life specialist, pediatric nursing educator and myself - recently had an article, Integration of Pharmacologic and Non-pharmacologic Techniques to Enhance Pediatric Minor Procedures, published as the February cover piece for the Journal of Urgent Care Medicine (click here to see the pdf version). In this peer-reviewed article, we discuss techniques that, in essence, can lead to a major upgrade in family-centered care for your institution.


Implement family-friendly techniques in your organization -
at a significantly reduced price

You also might not realize that you can easily implement the techniques mentioned in the article using our CalmerKids Training Module. This 45-minute DVD course equips staff to help children and families cope better with their experiences in emergency and urgent care settings. The module includes one hour of CE credit for your entire department, a year of support and, once you've completed the training, the CalmerKids Certified designation. Nationwide feedback from emergency departments and urgent care centers using the course has been great. And now you can benefit from recent updates to the module, including a significantly lower price. For more information, click here.

Everyone talks about patient-centered care. It's practically a holy mantra in our field. For the next week, I challenge you not to do this. Instead, practice family-centered care.

Family-centered care is a term commonly used when talking about "child-friendly" emergency departments or urgent care centers. However, in lecturing to physicians and nurses around the country, I find that many are not familiar with this term at all.

At the heart of family-centered care is the core notion of collaboration. The patient, his or her family and the care provider work in partnership to ensure that patient needs are truly met. This approach is appropriate for patients of all ages and is relevant to all healthcare settings.

For this approach to be effective, physicians, nurses and others who interact with the patient need to honor family perspectives and needs. Open communication, with the intention to understand differing concerns of family and staff, is essential. Through good communication and collaboration, the patient is fully supported.

The family-centered care approach requires deliberate time and energy. Staff may sometimes resist expanding their horizons to include family perspectives. Practicing family-centered care might mean encouraging a parent to remain with their child during a difficult procedure, and supporting that parent to help position and distract the child while the procedure is performed. It may mean listening more closely to the adult child of an elderly patient to ensure that patient's needs are met in an emergency situation.

Even if the approach occasionally takes more time, the respect and understanding offered frequently lead to improved patient satisfaction- not to mention enhanced patient safety with fewer medical errors. And yes: I know that patient-centered and family-centered approaches to care are not mutually exclusive. But, focusing on family-centered care is an approach we should all work to incorporate into our way of practice. For additional information, see www.familycenteredcare.org and www.newhealthpartnerships.org.

U.S. Healthcare Quality Measures Only Edging Up, Medpagetoday.com, March, 2008.

Report: Patients' emotional needs unmet, United Press International, March, 2008.

Shortage of primary care threatens health care system, USA Today (Opinion), March, 2008.

Hospitals go greener to improve bottom line, SeattlePI.com, March, 2008.

Bonus bucks in medicine, San Diego Union-Tribune, February, 2008.

Emergency Room Wait Times Getting Longer, Boston Globe, January, 2008.

Time-strapped patients feeding growth of urgent care centers, STLtoday.com, January, 2008.

Brief summary of recent new articles and abstracts from http://www.PetrackConsulting.com/articles.html

Hsia RY, MacIsaac D, Baker LC.
Decreasing reimbursements for outpatient emergency department visits across payer groups from 1996 to 2004.
Ann Emerg Med. 2008 Mar; 51(3):265-74

There continues to be concern that decreases in payments to emergency departments will adversely affect overall operations. Using the Medical Expenditure Panel Survey data from 1996-2004, these authors examined charges and payments across insurance. Overall, the mean charge for an outpatient ED visit increased from $713 in 1996 to $1,390 in 2004. The mean payment increased from $410 (57% of charge) in 1996 to $592 (42% of charge) in 2004. The proportion of charges paid in 2004 varied from 56% for privately insured visits to 33% for Medicaid visits. The authors conclude that the persistent declines in payments may threaten the survival of EDs and their role as safety nets in the health system.


Petrack E, Perry LS, Vehar K.
Integration of pharmacologic and non pharmacologic techniques to enhance pediatric minor procedures.
Jrnl Urgent Care Med. 2008 Feb; 2(5):11-16.

Children frequently require minor procedures, such as blood draws, IV catheter placement, suturing, and abscess drainage. Although "minor," these procedures can highlight safety concerns and create significant anxiety for the child, family and even staff. This article discusses how to gain trust, and give children and families a sense of control. Specific techniques are offered to position children for procedures to maximize safety and reduce restraint. The authors discuss how to use appropriate language, prepare, and then distract children during the procedure. The integration of pharmacologic and non-pharmacologic techniques is emphasized.


Zisk RY, Grey M, Medoff-Cooper B, MacLaren JE, Kain ZN.
The squeaky wheel gets the grease: parental pain management of children treated for bone fractures.
Pediatr Emerg Care. 2008 Feb;24(2):89-96.

This study looked at parental attitudes towards pharmacologic and non-pharmacologic pain management after extremity fractures. Fifty parents of children 5-10 years old with extremity fractures were studied. On the day following the fracture, 20% received no analgesia, and 44% received only 1 dose. Most children received analgesia based on active, loud behaviors such as crying; yet, children exhibited quiet behaviors more frequently than crying. Although this is a small number of patients, the authors raise the concern that recognizing behaviors that correlate with pain is difficult, and that quiet behaviors may also reflect pain and need for analgesia.

April 29- May 2, 2008, Urgent Care Association of America, National Conference, New Orleans, LA
Conference Information

May 29- June 1, 2008, Society for Academic Emergency Medicine, Annual Meeting, Washington, DC
Conference Information

Sept 24-27, 2008, Emergency Nurses Association, Annual Meeting, Minneapolis, MN
Conference Information

About Our Organization

Created in 2003, Petrack Consulting is dedicated to helping physician and hospital leadership bring excellence to emergency services. We work collaboratively to fully understand our client's needs, and then address programmatic initiatives with measurable outcomes. Our unique background in emergency medicine, administrative medicine, and organization development allows us to create uniquely effective solutions for enhancing emergency services.

Website: http://www.PetrackConsulting.com
Email: epetrack@PetrackConsulting.com


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