Urgent Matters

Today’s topic brings together a novel approach of linking emergency medical service teams with a state health information exchange.

Speaking with us today is Richard Lewis, the EMS bureau chief of the Denver-area South Metro Fire Rescue Authority.  Rick teamed up with Emergency Physician, Dr. Mark Pranther, to create what is essentially described as “an urgent care clinic on wheels.”

Today’s topic brings together a novel approach of linking emergency medical service teams with a state health information exchange.

Speaking with us today is Richard Lewis, the EMS bureau chief of the Denver-area South Metro Fire Rescue Authority.  Rick teamed up with Emergency Physician, Dr. Mark Pranther, to create what is essentially described as “an urgent care clinic on wheels.”

The Heart Hospital Baylor Plano created Code STEMI, an interprofessional team to expedite treatment to patients presenting with a STEMI, a type of heart attack, and improve door to balloon time. The Code STEMI team approach aims to provide continuity of care from arrival to discharge. Two members of the Baylor team, Kerstin Duncan, the Clinical Nurse Manager of the Emergency Department and Non-Invasive Nursing and Kim Nguyen, the Director of Nursing, discuss the results of the Code STEMI team. Dr. Jesse Pines is the Director of the George Washington University Office for Clinical Practice Innovation and a Professor of Emergency Medicine and Health Policy. Visit our website for more information about Urgent Matters.

Congratulations to winners of the 2015 Emergency Care Innovation of the Year Award, the Geisinger Wyoming Valley Medical Center! Their Mobile Health Paramedic program focuses on patient needs in the community and works to keep patients in their home, rather than at unnecessary ED or clinic visits. Dr. David Schoenwetter of Geisinger discusses the features of this program, as well as the successes they've seen thus far. Dr. Jesse Pines is the Director of the George Washington Univeristy Office for Clinical Practice Innovation and a Professor of Emergency Medicine and Health Policy. Visit our website for more information about Urgent Matters.

With the limited number of toxicologists currently practicing in the United States, innovation is necessary to spread their knowledge to the greatest number of patients. The proliferation of telemedicine and the public availability of Google Glass spurred an innovative teletoxicology study to determine the acceptability and feasibility of using Google Glass at the bedside in the emergency department for toxicology consults. Dr. Peter Chai, an Emergency Medicine physician and Medical Toxicology Fellow at the University of Massachusetts Medical School, joins us to discuss the findings and the implications for medical consults. Dr. Jesse Pines is the Director of the George Washington University Office for Clinical Practice Innovation and Urgent Matters and is a Professor of Emergency Medicine and Health Policy. Visit our website for more information about Urgent Matters.

The potentially devestating consequences of adverse cardiac events translate to many patients who are seen urgently in the emergency department during an episode of chest pain. A recent study investigated the short-term risk of an adverse cardiac event for patients presenting in the ED with chest pain. The results showed that for patients with a negative workup (normal blood work, good vital signs, normal EKG), adverse cardiac events were rare, suggesting that inpatient admission may not be the most beneficial for these patients. Dr. Michael Weinstock, the Emergency Department Chairman and Director of Medical Education at Mt. Carmel St. Ann's and a Professor of Emergency Medicine, Adjunct, at The Ohio State University College of Medicine, discusses this study and its implications for cardiac patients in the ED. Dr. Jesse Pines is the Director of the George Washington University Office for Clinical Practice Innovation and Urgent Matters and is a Professor of Emergency Medicine and Health Policy. Visit our website for more information about Urgent Matters.

David Gillinson, Chief Data Scientist at StaffSked, talks to Dr. Jesse Pines, the Director of Urgent Matters and a Professor of Health Policy and Emergency Medicine at The George Washington University. StaffSked is trying to utilize new software and techniques for optimizing the various levels of staffing in emergency departments. ED utilization is inconsistent, so overstaffing will be costly for the hospital, while understaffing could be a disaster for patient care. By utilizing modeling software and other engineering theories, StaffSked is able to reduce a hospital's staffing costs while still making sure they are adequately prepared to handle the patient load. 

For more information, visit www.StaffSked.com 

Urgent Matters is housed in The George Washington University Office for Clinical Practice Innovation. Our goal is to promote new innovations in the delivery of emergency care across the spectrum of providers, administrators, and policymakers. To subscribe to Urgent Matters free newsletters and webinars, visit www.urgentmatters.org and follow on twitter and facebook twitter.com/Urgent_Matters

Do you love the Urgent Matters Podcast?! Then you will also love the Clinical Practice Innovations Podcast as well. Search "Clinical Practice Innovations" in the podcast section of iTunes to hear biweekly interviews with innovators throughout the healthcare industry.

In the United States, everyone knows that if you call 911, someone will come help you. It's a great system, but anyone who has worked in it knows that not everyone who calls needs the level of emergency care it was intended for. So what should be done with patients who many would label as "abusing" the system? 

The city of Houston has taken a novel approach to finding an alternative means of handling these patients so that patients receive the care they need and expensive resources are conserved. It's called ETHAN or Emergency TeleHealth And Navigation. With this, EMTs responding to a 911 call, are able to connect less acute patients with an Emergency Medicine physician via video over the tablets they already carry. The physician then confirms that the patient would be better served with a next-day appointment somewhere other than the hospital's ED, and is able to arrange everything right then. This saves EMS from needing to transport the patient, it saves the ED from needing to treat the patient, and it connects the patient with a better alternative for their care with a clinic or primary care physician's office. 

Talking with us about this project is the program's director, Dr. Michael Gonzalez of the Houston Fire Department. Interviewing Dr. Gonzalez is Dr. Jesse Pines, the Director of The George Washington University Office for Clinical Practice Innovation and Professor of Emergency Medicine and Health Policy. 

For more information about Urgent Matters, visit our website at www.urgentmatters.org and follow us on Facebook and Twitter @Urgent_Matters

Patients presenting in the emergency department with mental health issues can wait extremely long times for a psychiatric consult due to a lack of psychiatrists and overwhelming demand at some hospitals. Hospitals throughout North Carolina have teamed up with East Carolina University, to implement a telepsychiatry program whereby patients are seen remotely in the emergency department by available psychiatrists throughout the community. 

The Director of the North Carolina Statewide Telepsychiatry Program (NC-STEP) is Dr. Sy Saeed, who also serves as a Professor and Chairman of the Department of Psychiatry and Behavioral Medicine in the Brody School of Medicine at East Carolina University. Interviewing him is Dr. Jesse Pines, a Professor of Emergency Medicine and Health Policy, and Director of the Office for Clinical Practice Innovation at The George Washington University. 

Urgent Matters is a platform for disseminating new ideas and strategies for the delivery of emergency medical care. In addition to our podcasts, Urgent Matters offers free webinars, newsletters, and issue briefs. These materials and more can be found at www.urgentmatters.org  or to sign up for emails, text URGENTMATTERS to 22828. 

Urgent Matters is housed in The Office for Clinical Practice Innovation at The George Washington University. For more innovations, check out the "Clinical Practice Innovations" podcast and follow Urgent Matters on twitter @Urgent_Matters

Electronic Medical Records. They're still evolving and designers are working to improve the ease with which they integrate into a clinician's workflow rather than create extra hurdles. Dr. Carlo Reyes founded Health-E-Medrecord because he wanted to design a medical record system that was centered around the patient's need for provider collaboration. He's here today to talk with Dr. Jesse Pines of The George Washington University's Office for Clinical Practice Innovation about his new system. For more information, visit: www.health-e-medrecord.com 

Urgent Matters is a communication platform for strategies on emergency department patient flow and quality. For more of our free products, visit www.urgentmatters.org , or text URGENTMATTERS to 22828 to sign up for our quarterly newsletters and webinars! 

Don't forget to subscribe to Urgent Matters on iTunes so that you never miss an episode. Want more podcast interviews? Check out "Clinical Practice Innovations" for more interviews with leaders throughout the healthcare industry.