New hospital protocols make EDs more efficient, safe

A series of new protocols and initiatives make hospital emergency departments across the country more efficient, cost effective and safe.

Washington saved more than $30 million in healthcare costs after instituting an initiative to make the ED more efficient and cost-effective, according to a report from the Washington State Health Care Authority (HCA).

The HCA partnered with Washington State Hospital Association, the Washington State Medical Association and others to create the "Seven Best Practices" to redirect care to the most appropriate setting, reduce low acuity and reduce preventable Medicaid ED visits.

They are:

  1. Track emergency room visits to reduce "ED shopping"

  2. Implement patient education efforts to re-direct care to the most appropriate setting

  3. Institute an extensive case management program to reduce inappropriate ED utilization by frequent users

  4. Reduce inappropriate ED visits by collaborative use of prompt (72 hour) visits to primary care physicians and improved access to care

  5. Implement narcotic guidelines that will discourage narcotic-seeking behavior

  6. Track data on patients' prescribed controlled substances by widespread participation in the state's Prescription Monitoring Program

  7. Track progress of the plan to make sure steps work

ED visits dropped 10 percent in fiscal 2013, according to report, while "frequent flyer" visits decreased along with the rate of visits resulting in a scheduled drug prescription.

"This program is a great example of the success public/private partnerships can have in applying evidence-based solutions to problems," acting HCA Director MaryAnne Lindeblad said in a statement. "Through shared best practices and cooperation, we all win."

Meanwhile, two dozen hospitals pledged to implement a bedside introduction approach to minimize miscommunication resulting in medical errors after patient handoffs in its ER, according to MarketWatch.

The "Safer Sign Out" program, piloted by Christopher Beach, chief of emergency medicine at Northwestern Lake Forest Hospital near Chicago, requires that:

  • Incoming and outgoing doctors chat in person

  • Doctors visit the patient in person

  • Physicians go over a checklist of important symptoms to watch regarding each patient

A December study in the Journal of the American Medical Association discovered that after Boston Children's Hospital implemented a structured handoff tool, there were fewer omissions or miscommunications about important data during handoffs and medical errors decreased 45.8 percent, FierceHealthcare previously reported

To learn more:
- here's the Washington State report
- read the statement
- check out the MarketWatch article

 

 

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