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 Winter 2010 Volume 8, Issue 1  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 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 January, 2010 column, Reducing Pediatric Medical Legal Risk in your Urgent Care Center (.pdf). For archives of previous articles, click here. |
Consultant's Corner 
Emory Petrack, MD, FAAP, FACEP
Like many emergency departments and urgent care centers across the country, we are in physician recruitment mode. We have implemented various processes to facilitate our recruitment efforts, including using recruiters and asking other physicians and some of our nurses to help identify potential candidates. While the process we use is critical, in the end we need the overall effort to be successful so we can expand hours and fill additional gaps.
This need for success got me thinking more about the other tasks and challenges we all face in our daily organizational lives. How do we look at the work we do (inputs or processes) versus our actual accomplishments (outputs or outcomes)? We'll explore the issue and its potential impact on the success of your projects in this month's feature article.
Feature Article
Input vs. Outcomes: Which is More Important to Your Mission?
Much of what we do revolves around process. Take, for example, our efforts to improve quality of care, specifically, for asthma. One of our departments put a process in place that would 1) classify asthma (intermittent, mild, moderate, severe), 2) identify certain triggers, and 3) identify a home treatment plan. Several months after a form was created to document these data elements, hospital administration noted that the data collection rate was still low, even after several attempts to improve it.
New Articles/Abstracts
Brief summary of recent new articles and abstracts from http://www.PetrackConsulting.com/articles.html
Menchine, M. D., Wiechmann, W.Rudkin, S.
This study looked at specific parameters related to the expansion of midlevel provider (MLP) practice in U.S. emergency departments. Data were analyzed using the National Hospital Ambulatory Medical Care Survey (NHAMCS). The number of patients seen by MLPs increased sharply, from 5.2 million in 1997 (5.5% of all ED cases) to 15.2 million in 2006 (12.7% of all ED cases). In addition, the number of EDs reporting use of MLPs increased from 28.3% in 1997 to 77.2% in 2006.
Sullivan, A. F., Ginde, A. A., Espinola, J. A. et al.
These authors used a model to estimate supply and demand of emergency physicians by state, based on 2005 data. Overall, the supply of emergency medicine board-certfied physicians was 58% of required FTEs to staff all EDs, ranging by state from 10% to 104%. The overall picture quantifies significantly more demand than supply.
Many emergency departments are looking at the Lean methodology to improve their processes. These authors describe the effects of using Lean on quality of care in 4 EDs. One year after using Lean, 3 out of 4 EDs had reduced length of stay, despite an increase in volume, with concomitant increase in patient satisfaction. Both leadership and front line commitment to the process were critical to success.
This joint policy statement on pediatric care in EDs was issued by the American Academy of Pediatrics, the American College of Emergency Physicians, and the Emergency Nurses Association. It focuses on the unique needs of children, and should be required reading for any emergency department rendering care to children. There is some great information that is applicable to pediatric care in urgent care centers as well.
Upcoming Meetings
February 17-21, 2010, Emergency Nurses Association, Leadership Conference, Chicago, IL. 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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