Access to acute and emergency care is essential when we are ill or injured, but the costs are significant. How can we make services more efficient and effective? This thought-provoking text provides twenty case studies detailing successful innovations to enhance value, includingtelehealth, observation medicine, high utilizer programs and the use of informatics to improve clinical decision support. A detailed history of system developments over the last fifty years in the US and internationally is provided, and subjects including measurement and qualityimprovement, volume versus value based care, and emergency department crowding are discussed. An ideal way for emergency physicians and healthcare managers to explore new ideas and enhance the quality of care in their area.
- Examples of best practice are studied and described, providing advice to help improve acute and emergency care in the US and internationally
- The future of acute and emergency care in a value based world is outlined, and the potential for integrated care is described
- Case studies are reviewed by academic experts, placing each innovation in context
1. Fiftyyears of transformation of acute and emergencycareBenjaminEaster
2. Measuring and improving quality of care Jesse M. Pines, Mark S. Zocchi, C. Noelle Dietrich and Molly Benoit
3. Fragmentation in acute and emergency care: causes, consequences and solutions Benjamin Easter and Arjun Venkatesh
4. Alternative payment models in acute, episodic care: moving from volume to value Nir J. Harish and Jesse M. Pines
5. Improving timeliness and access of acute and emergency care: the science of improving emergency department crowding Olan A. Soremekun
6. Bringing the patient-voice into emergency care Marc A. Probst and Erik P. Hess
Case study 1. Expanding the role of observation care Christopher W. Baugh, Christopher Caspers and Anthony M. Napoli
Case study 2. An innovative strategy to streamline care for behavioral health in the emergency department Michael Turturro, Leslie Zun and Jack Rozel
Case study 3. The geriatric emergency department Ula Hwang and Christopher R. Carpenter
Case study 4. How UK responded to the 4-hour rule Suzanne Mason and Michael J. Schull
Case study 5. High-cost users: using information technology to streamline care plans Dawn Williamson and Jody A. Vogel
Case study 6. Emergency care in an integrated healthcare delivery system: the Kaiser experience Dana R. Sax, Jeffrey S. Selevan and Wm. Wesley Fields
Case study 7. Urgent care centers: an alternative to unscheduled primary care and emergency department care Judd E. Hollander and Jesse M. Pines
Case study 8. The 'no-wait' emergency department Chris McStay and Jody Crane
Case study 9. Transforming care delivery through telemedicine Judd E. Hollander and Brendan G. Carr
Case study 10. Coordinating emergency care through telemedicine Sarah A. Sterling, Kristi Henderson and Alan E. Jones
Case study 11. Bringing diagnostic testing to the bedside: point of care testing Benjamin Easter and Kelly Bookman
Case study 12. Regionalization of care M. Kit Delgado, Fred Lin and Brendan G. Carr
Case study 13. Clinical decision support tools Kelly Bookman and Ali S. Raja
Case study 14. Automated patient follow-up program Tom Scaletta, Kristin L. Rising and Megan Ranney
Case study 15. Using data on patient experience to improve clinical care Seth Glickman and Abhi Mehrotra
Case study 16. Community paramedicine: the Geisinger experience Manish N. Shah and David J. Schoenwetter
Case study 17. Initiating palliative care in the emergency department Christian Jacobus and Tammie E. Quest
Case study 18. Streamlining patient flow in the emergency department with discrete event simulation Eric J. Goldlust, T. Eugene Day and Nathan R. Hoot
Case study 19. Using emergency department community health workers as a bridge to ongoing care for frequent ED users Roberta Capp and Richard Zane
Case study 20. Big data: use of analytics for operations management Joe Guarisco and James Langabeer II.
Jennifer L. Wiler, University of Colorado School of Medicine
Jennifer L. Wiler MD, MBA, FACEP is a board certified emergency physician, Executive Vice Chair of the Department of Emergency Medicine at the University of Colorado School of Medicine, Co-Founder and Director of the University of Colorado CARE Innovation CenterTM, and Associate Professor at the University of Colorado School of Business. She has been appointed to numerous national committees including the American Medical Association RBRVS Updates Committee (RUC), is Past Chair of the American College of Emergency Physicians (ACEP) EM Practice Committee, and past Board member of the Colorado Medical Society. She is a national expert who has authored a number of publications on healthcare policy, access, payment policy and quality.
Jesse M. Pines, George Washington University, Washington DC
Jesse M. Pines, MD, MBA, MSCE is a board-certified emergency physician, the Director of the Center for Healthcare Innovation and Policy Research and a Professor of Emergency Medicine and Health Policy and Management at the George Washington University, Washington DC. He is a national thought leader in emergency care and health policy and leads Urgent Matters (www.urgentmatters.org), a program that disseminates best practices in acute and emergency care. He is author of over 240 peer-reviewed publications in journals such as the Journal of the American Medical Association, Health Affairs, Circulation, and Annals of Emergency Medicine and has contributed to TIME magazine, Slate, and the Wall Street Journal.
Michael J. Ward, Vanderbilt University Medical Center, Tennessee
Michael J. Ward, MD, MBA is a board-certified emergency physician and Assistant Professor in the Department of Emergency Medicine at the Vanderbilt University Medical Center and a PhD candidate in Operations Management from the University of Cincinnati. Dr Ward is a recipient of grant funding from the National Institutes of Health, studying the intersection of operational challenges and the delivery of high quality emergency care for patients with time-sensitive emergencies.