Want fries with that? Stanford Hospital experiments with the first drive-thru emergency department. Examining people sitting in their driver’s seat may “keep them from infecting others” but it will also keep doctors from fully examining a patient. Would be interested to see outcomes measures with this idea. If outcomes are similar, what is the big leap between drive up EDs and telephone medicine? After all, you can just ask a patient to put the telephone receiver to their heart for a moment …
Ohio is breaking new ground in its tort reform attempts. According to this article, the legislature is seeking to make it harder to file lawsuits against emergency physicians and against obstetricians (text of bill here). Other states such as Florida and Georgia have already passed such laws. Good idea?
What’s with violence in the EDs lately?
A Washington man walks up to the emergency department doors and shoots himself in the head while ED staff watches on the security camera.
A cop cuffs a stabbing victim to a wheelchair in the ED and then beats him with a sap. Smile, bud, you’re on Candid Camera. That lapse in judgment will get you a few years in the Greybar Motel.
One way to reduce wait times in the ED — order sets. Instead of waiting for the physician to see a patient to order tests, nurses order tests at triage and have the test results ready before the doctor goes into the room. This Canadian hospital reduced wait times by 50% after implementing such a system.
A hospital in the lower Florida Keys used to receive a subsidy to treat indigent patients who were not eligible for Medicaid. Now the subsidy is gone. So is a lot of the care.
UTMB in Galveston is reopening its hurricane-damaged emergency department effective August 1, 2009. Second article here. Previously commented about UTMB’s decision to close its emergency department and open an urgent care clinic, therefore being able to skirt EMTALA requirements. One commenter to the article jokingly wonders whether a forecast for a hurricane to hit the area on August 2, 2009 had any bearing on the opening date.
Another Texas hospital is using a nursing call-in line to direct patients to “the right place to go.” They’re apparently trying to direct non-urgent patients away from the emergency department. But is their idea of doing phone triage on patients already in the emergency department going a little too far?
OK, ACEP and Chicago Tribune, dust off your pitchforks. The nation flipped out about the University of Chicago’s plan to discharge non-urgent patients from its emergency department if the patients could not or would not pay for their medical care. Now HCA, the nation’s largest for-profit hospital chain, is planning to do the exact same thing. In a pilot study at several of its hospitals, HCA noted that 40% of ED visits were classified as non-urgent. When given the opportunity to pay in advance to receive medical care, only 1% of the non-urgent patients decided to do so. Lest you had any doubts … in the article, the Chief Operating Officer of HCA assured everyone: “It isn’t about the cash.”