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 Fall 2009 Volume 7, Issue 4  Consultant's Corner
Feature Article
Quote of the Month
New Articles / Abstracts
In the News
Upcoming Meetings
For free articles, abstracts, Emergency Care Briefs, and more, visit our Resource Center at PetrackConsulting.com...
New, revised CalmerKids Training Module! Get a new low price, plus become CalmerKids Certified when training is complete. Show me...
Dr. Petrack and Lisa Perry, our child-life specialist, will be at the Emergency Nurses Association annual meeting in Baltimore, MD, from October 8-10. We will have information about our consulting and training services, as well as discounts for our CalmerKids Training Module. If you're at the conference, stop by Booth 1007 and say hello!
Dr. Petrack continues his new quarterly column, Pediatric Urgent Care, in the Journal of Urgent Care Medicine. This column focuses on both the clinical and business aspects of urgent care medicine, as they relate to care for children and families. Check out the October, 2009 column, Good First Impressions Set the Tone for Good Clinical Care (.pdf). For archives of previous articles, click here. |
Consultant's Corner 
Emory Petrack, MD, FAAP, FACEP
Like many of you, I have a lot going on these days: many projects, kids in school (including starting a new college!), and various other irons in the fire.
My wife and I just received the third communication in 10 days from our son's school. I opened the large envelope and, to my dismay, found among the other "inserts" a three-page, single-spaced cover letter, detailing the school's "purpose, promise and principles."
I tossed it aside for now.
Feature Article
Those "Important" Details are Sometimes Too Much!
I, you, we... are simply deluged with information these days, much of it unnecessary. And the very task of sorting out which pieces among these "bombardments" of information are important can be daunting.
You might have noticed a shift in website design over the last three to four years. It used to be that a website's home page provided lots and lots of information about a product or service. Knowledgeable website developers, however, have shifted to a new paradigm.
Rather than flood the reader with information, a well-built, modern website presents relatively little information on the home page. Instead, it shares the "bullet points" - the major divisions of information that help the reader focus on what he or she is looking for. These major divisions help the reader drill down into the site, and more easily and quickly get to the kernel of information sought.
How do these realities and communication challenges apply to our work? I suggest the following:
New Articles/Abstracts
Brief summary of recent new articles and abstracts from http://www.PetrackConsulting.com/articles.html
Travers, D.A., Waller, A.E., Katznelson J. et al.
The Emergency Severity Index (ESI) triage scoring system is being increasingly used in emergency departments, but its use in the pediatric population has not been well studied. These authors assessed the reliability and validity of ESI for pediatric triage at 5 sites. Inconsistencies in triage were noted for the most acute and least acute patients, as well as those less than 1 year of age, as well as those with medical (vs trauma) chief complaints. Nurses from dedicated pediatric EDs were 31% less likely to undertriage patients than nurses in general EDs. They conclude that reliability of ESI for pediatric triage is moderate, with several areas in which nurses have difficulty triaging pediatric patients consistently.
This study documents what many who practice emergency care already perceive, that length of stay (LOS) is increasing. This was a retrospective study of the NHAMCS database, from 2001-2005. Median LOS increased 3.5% per year, from 132 minutes in 2001 to 154 minutes in 2005. For critically ill patients, which require significantly more resources to manage, LOS increased 7.0% per year, from 185 minutes to 254 minutes. ED LOS was persistently longer for African-American and Hispanic patients, and did not improve over this period.
For optimal care, rapid access to emergency services is essential. The National Emergency Department Inventories-USA was used to identify location, volume and teaching status of EDs in the US. Overall, 71% of the US population has access to an ED within 30 minutes, and 98% has access within 60 minutes.
Upcoming Meetings
October 5-8, 2009, American College of Emergency Physicians Scientific Assembly, Boston, MA 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 |
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