National Emergency Care Enterprise Advancing Care Through Collaboration: Workshop Summary (2009) / Chapter Skim
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2 How Federal Policy Affects Emergency Care at the Community Level
2 How Federal Policy Affects Emergency Care at the Community Level
Pages 15-24
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From page 15... ...
-level estimates from the 2007 National Hospital Ambulatory Medical Care Survey. This survey provides nationally representative estimates on ED visits and EDs on an annual basis.
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From page 16... ...
As a result, the NCHS cannot determine whether diversions are increasing or decreasing in frequency. GENERAL AUDIENCE DISCUSSION Following the opening presentation, Mary Jagim, client engagement manager for Intelligent InSites and 2006 IOM committee member, facilitated a general discussion of how federal policy affects emergency care at the community level.
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From page 17... ...
In an effort to fill the gap, the ACS increased efforts and became what he described as "a surrogate for any sort of national coordination of injury care." He said that ACS-COT fielded questions from state agencies, counties, cities, individual hospitals, and even individual practitioners, nurses, and prehospital personnel. The ACS instituted verification programming, professional standard setting, quality projects, and the development of quality-based metrics using trauma registry, similar to what the United Network for Organ Sharing does for transplants.
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From page 18... ...
Sanddal said many of the problems confronting emergency care systems need to be fixed at a regional level with state leadership. Nedza added, "This really is about communities, especially when you talk about regionalization." Ron Anderson, president and chief executive officer at Parkland Health & Hospital System in Dallas, said, "Frankly, when you talk about the national trauma anything, I am a little suspect, because most of this is local.
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From page 19... ...
The concepts of regionalizing care, coordination of call, and sharing resources will be driven by hospitals, he said. Ricardo Martinez, former administrator of the National Highway Traffic Safety Administration and now executive vice president of The Schumacher Group, has worked with more than 100 hospitals in rural areas and bigger cities.
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From page 20... ...
Rather than allowing matters to reach the point where the safety net hospital might refuse to accept these patients, the local private hospitals pooled their resources to fund a "detox unit," staffed by a nurse practitioner or a physician assistant. Intoxicated patients spend up to 8 hours there, and if they remain sick, they are taken to the emergency room.
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From page 21... ...
Hospitals in England operate under a funding mechanism that specifies that the patient must be out of the ED within 4 hours. He said that the Centers for Medicare & Medicaid Services could drive improvements by requiring hospitals to keep track of how long people wait in the ED and by decreasing reimbursements in cases when the wait times are too long.
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From page 22... ...
You do whatever you need to do to take care of the patient in front of you." This year, for the second year in a row, despite overwhelming public support, overwhelming votes in both chambers, and the putative support of the state's leadership, Georgia's General Assembly failed to pass a bill to fund a trauma care network in the state, Kellermann said. "Basically, they dared the hospitals and the existing system to fall apart, which it will not do, because we will suck it up the best we can." The Congressman Kellermann quoted had praised the political will of a handful of orthopedic surgeons in Las Vegas.
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From page 23... ...
"As a discipline, we have been codependent and enabling, and we have allowed people to push us around, thereby permitting bad care to be given to our patients," Fildes said. Roger Lewis of Harbor–UCLA Medical Center noted the close association between trauma care and general emergency care in the public's perception.
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