How Do We Measure Real Value in the Emergency Department?

Robbin Dick HeadshotEmergency Department Directors measure value in their departments with a number of metrics that are tracked religiously: door-to-provider times, ambulance drop-off times, left without being seen rates, length of stay for discharged patients, diversion hours, and 72-hour returns all come to mind.

These  metrics clearly measure the performance of the Emergency Department, what to they do, if anything, to measure the value of care being provided? These metrics are often presented to hospital administration either monthly or quarterly to demonstrate the performance of the Emergency Department. Emergency physicians in the ER are now the key gatekeeper for nearly half of all hospital administrations, so it makes sense that the hospital leadership would have an interest in what goes on there. Read more ›

Posted in Quality, Efficiency, Utilization

Meet MEP Traveller & Musician Dean Moore

Dean MooreJazz and emergency medicine. You may not think they’re all that alike, but Dr. Dean Moore, an MEP traveller and accomplished jazz musician, sees a lot of parallels, beginning with the role of improvisation.

“It’s the fact that you need to have a lot of information, be alert, and be prepared for anything that might come through the door,” Moore said in a recent interview. Read more ›

Posted in For Residents, Life in the ER

Why Do People Come to the ER? For More Reasons Than You May Think

Mike PerrautIt’s easy to get frustrated in the ER. First, you’re at work. Second, most of your patients don’t want to be there. Third, many (if not most) of your patients don’t need to be there. Finally, by the time you see them, most of your patients are tired of being there.

It’s easy to become jaded when you trudge through this never-ending mire of patient after patient, and indeed ER docs can be known as a jaded lot. We order tests whether they’re needed or not, because, if we don’t, the patient will think that we didn’t do anything. Some react to this enigma by blaming the patient. For a memorable example of that attitude, see Dr. Thomas Doyle’s 2009 article, “Treating a Nation of Anxious Wimps.” Read more ›

Posted in Life in the ER

Congratulations, You’ve Set Up Your Observation Care Unit! – Now What?

Mark Moseley HeadshotEditor’s Note: Dr. Mark Moseley is a featured speaker at Observation Care ’14

Congratulations! You have successfully set up and implemented your ED based observation unit. Now what?

Since you implemented the unit several months ago, the hospital CEO has been asking questions about bed utilization, unit occupancy rates, and staffing productivity for the nurses working in the unit (What is Action O/I and Visionware?). Meanwhile, why has your ED admission percentage suddenly gone down? Read more ›

Posted in Observation Care

MEP To Manage Emergency Care and Observation Care for Union Hospital in Cecil County

Union Hospital Night - EditedMEP is proud to announce that it will assume management of the Emergency Department and Observation Care services at Union Hospital in Cecil County, a 122-bed hospital located in Elkton, Maryland. Union Hospital will become MEP’s eighth hospital partner, and its seventh in Maryland. Read more ›

Posted in MEP News

Should Doctors Work for Hospitals? Tough Question.

Angelo Falcone headshotA physician I have known for many years recently told me about his decision to enter the world of concierge medicine. His reasoning was telling, saying that it came down to a very simple decision on staying independent or becoming a hospital employee. He liked being an independent solo practitioner, and that was his primary motivation – to maintain independence in a time of consolidation.

Richard Gunderman, writing for The Atlantic, tackled this question head on in a recent piece titled, “Should Doctors Work for Hospitals?” The article reflects on the dramatic shift in physicians either seeking or being forced by market pressures to join hospital systems as employees. Read more ›

Posted in Future of Healthcare, Hospital Partnership

Hard data contradicts ACEP survey of emergency physicians

Russell Max Simon HeadshotPatient volumes in Maryland and DC are actually dropping

On Wednesday, national news outlets reported on the results of a survey of 1,845 emergency physicians, conducted by the American College of Emergency Physicians (ACEP). The headlines painted a clear picture: “Emergency docs report higher ER volumes,” wrote ModernHealthcare. “ER Visits Jump As Obamacare Kicks In, Doctors Say,” added HuffPost. The Wall Street Journal proclaimed: “ER Visits Rise Despite Law.”

Of the 1,845 ACEP members who completed the survey, 46 percent reported increases in the volume of patients coming to the emergency room since January 1, when coverage for millions of newly-insured patients took effect. Twenty-seven percent said there had been no change in volumes, while 23 percent said there had been a decline. Read more ›

Posted in Future of Healthcare, MEP News

Video: How Observation Care units are making some ER visits shorter, better, and more profitable.

There is still much debate about how Obamacare, otherwise known as the Affordable Care Act (ACA), will change our hospitals. But early examples of the law’s impact can already be seen in places where hospitals have adapted – and they provide an encouraging glimpse into the future.

Healthcare reform is causing hospitals to shift their focus from billing as much as they can to providing the best healthcare experiences for patients. One adaptation many hospitals are looking at is the implementation of dedicated observation units.

These observation care units help reduce wait times, better ensure positive outcomes, and reduce hospital readmissions. A new video from MEP provides an overview of the impact a dedicated observation care unit can have on patient care. Watch it here:

Read more ›

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Posted in Future of Healthcare, Hospital Partnership, Observation Care, Quality, Efficiency, Utilization

The Noblest Profession in Medicine: An Eternal Thanks to Great Nurses

Angelo Falcone headshotIt’s Nurses Week and there are a lot of adulations being offered on social media and throughout hospitals regarding the appreciation we have for those among us who have chosen to be on the “front lines” of caring for us when ill or injured.

As an emergency physician I could speak about the many times a nurse has grabbed me and pulled me into a room with the words “you have to see this person RIGHT NOW,” and they were always right. I have had nurses question times I was going to discharge a patient because they did not “look right.” And again, they were right. Read more ›

Posted in Life in the ER

High Pay, Job Security, Societal Prestige, & Stimulating Work – So Why is Practicing Medicine the Most Miserable Profession?

Jesse Irwin headshotThere’s a Daily Beast story that’s been going around about how much being a physician sucks. If you’re a doctor or work with doctors, there’s a good chance someone has emailed you the link or posted it to social media.

The story is called “How Being a Doctor Became the Most Miserable Profession,” and it brings together a number of recent trends to paint a pretty sad picture: an increasing number of doctor suicides, rising unhappiness and job dissatisfaction, rising numbers of physicians who choose to be employees rather than have their own practice, more joint MBA programs which allow physicians to move up to management, and more physicians who choose specialties that pay more and allow them to retire and get out of the profession earlier. Read more ›

Posted in For Residents, Life in the ER

The Shift

Hospital Healthcare News & Commentary

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Featured Authors
Angelo Falcone, MD
Chief Executive Officer, MEP
Read posts here.

Robbin Dick, MDRobbin Dick, MD
Director of Observation Services, MEP
Read posts here.

Vipul Kella, MD
Medical Director, Emergency Department, Frederick Memorial Hospital
Read posts here.