National Emergency Care Enterprise Advancing Care Through Collaboration: Workshop Summary (2009) / Chapter Skim
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7 Federal Partners Roundtable
7 Federal Partners Roundtable
Pages 73-82
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From page 73... ...
reports, and to suggest concrete ideas and thoughts regarding how the federal emergency care enterprise can most immediately and significantly advance emergency care in the United States. The session chairs began by describing what they considered to be the high points of their sessions.
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From page 74... ...
He recalled trauma surgeon William Schwab's statement that in P ennsylvania, the percentage of patients on which trauma hospitals lose money varies between 20 percent and 65 percent. Some hospitals are "operating on air." Clifton said his panel's discussion highlighted longstanding distortions in the Medicare Resource-Based Relative Value Scale (RBRVS)
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From page 75... ...
[I] t is absolutely amazing to see this coalition developing around the emergency care enterprise with such a great deal of momentum, both inside and outside the federal government." Drew Dawson, director of the Office of EMS at the National Highway Traffic Safety Administration, said the key messages he would highlight have to do with the importance of collaboration and coordination, and how important both are in exercising leadership.
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From page 76... ...
He endorses the notion of a moratorium on creating emergency care research agendas. Roger Lewis, an emergency physician from Los Angeles, recently identified 19 emergency care research agendas that had been produced over the past 10 years.
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Wilkerson believes that figuring out how to address the boarding problem has the potential to have a huge impact on quality and patient safety in the United States. All five federal agencies are impacted by this problem, through disaster preparedness, metrics, young people, traffic crash victims, or other ways.
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From page 78... ...
Kellermann suggested that a Presidential order be communicated that every hospital that receives Medicare funding adopt and begin gaining experience with the use of a "full-capacity protocol" -- a recommendation recently tendered by ACEP. It requires each inpatient unit to temporarily hold one or more admitted patients in their hallways whenever the ED reaches a critical level of crowding.
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Emergency physician Lewis suggested that the ECCC use the participants attending this workshop as an advisory group. Handrigan responded that the emergency care enterprise covers the entire spectrum of emergency care activities and agreed that the federal government should not act in a vacuum.
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Rapp cautioned that presidential directives sound appealing, but there are not too many areas in health care where even the President has complete authority. There are more than 4,000 hospitals in the United States, and most are run by various private entities.
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From page 81... ...
If overcrowding and boarding are issues this group wants the federal government to tackle, he said, it will be important to maintain continued engagement in the process. "When you try to push things one way," he said, "somebody will think it's great, but somebody else is going to think it's terrible.
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