Waiting to Be Seen: Where EM Policy Meets Practice is a new EM Cases blog series, authored by Dr. Howard Ovens, a veteran Emergency Department Director, whose main purpose is to share ideas and generate discussion on the role that public policy and administrative practices play in creating the conditions that help front line emergency providers achieve better patient outcomes.

waiting to be seen

WTBS 5 Emergency Physician Speed Part 2 – Solutions to Physician Productivity

In Emergency Physician Speed How Fast is Fast Enough – Part I, Dr. David Petrie addressed the issue of physician productivity (patients per hour, or PPH), the many factors that influence how quickly emergency physicians can process patients, and some of the tradeoffs between speed and quality. He also discussed the processing rate of the entire ED and introduced the concepts of surge capacity and the effect of crowding on safety if the ED can’t keep up. In this follow-up blog, Dr. Petrie expands on the departmental aspects of throughput and safety, and calls on policy-makers to recognize the need to include surge capacity in planning efforts. He also makes some powerful arguments about the related issues of so-called 'inappropriate visits' and the changing role of the ED. In this post - Emergency Physician Speed Part 2 - Solutions to Physician Productivity , he also brilliantly dismantles some common myths about ED visits — and drivers of costs.

WTBS 4 – Emergency Physician Speed: How Fast is Fast Enough?

Racing legend Mario Andretti famously said, “If everything seems under control, you’re just not going fast enough.” He was talking about cars, but to many beleaguered emergency physicians trying to keep up with the patient queue, emergency medicine often seems this way. This guest blog on emergency physician productivity began as a question to our national association, the Canadian Association of Emergency Physicians (CAEP): Are there any national standards with respect to emergency physician productivity, i.e., expected number of patients assessed per hour? The question was referred to the CAEP Public Affairs Committee and triggered a lively email discussion among our members....

Health Equity, Trust and Data Collection in the Emergency Department

I view the emergency department as a safe refuge, a modern-day secular sanctuary. We are the one health-care service that never turns anyone away; we provide shelter to the homeless on cold winter nights, safety for battered women, and food for the hungry. I have always felt this “sanctuary” role was part of the core mission of the ED, one with a great potential for improving lives, or at least providing comfort.

Funding FOAMed

  Funding and freeing the future of learning that is FOAMed Longtime followers of EM Cases will have noticed a progressively prominent display on its website of the logo and inclusion of the name of the Schwartz/Reisman Emergency Medicine Institute — or SREMI —over the past two years. Some of you may have wondered what an Emergency Medicine Institute is, and what this one has to do with EM Cases. It's about funding FOAMed. What is SREMI? SREMI was established in November 2013 by a founding gift from our patrons, Gerald Schwartz and Heather Reisman. It is a partnership of Mount Sinai Hospital (now part of the Sinai Health System) and North York General Hospital in Toronto. Our vision is to advance the discipline of emergency medicine through the development of new knowledge — research and translating that knowledge into practice — as well as advocating for system improvement through better public policy. The partnership brought together two hospitals that already knew each other well and collaborated extensively; Mount Sinai brought strength in research and education including simulation, North York added its national reputation in continuing medical education. Dr. Anton Helman, the founder of EM Cases, [...]

By |2017-02-03T11:50:18-05:00May 14th, 2015|Categories: Waiting to be Seen|Tags: , , |1 Comment

Why Recording Time to Initial Assessment is Worthwhile

As both an emergency director and a practising emergency physician, I believe it is the job of administrators to make the challenges of front line staff easier, not vice-versa. Clinicians are too busy taking care of patients to perform purely administrative chores. But one task that I would ask all emergency doctors to adopt is the step of recording the time of Physician Initial Assessment, or PIA times. The time from arrival until they first see a physician is what most patients consider their ED wait time, and it is an important metric to report. Yes, it means one more small box to fill out in your charting, but it can be of huge benefit to doctors. Allow me to explain why....

By |2019-11-11T17:08:10-05:00April 23rd, 2015|Categories: Waiting to be Seen|Tags: , , |0 Comments
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