Urgent Care Siphons Off Emergency Patients

Urgent Care Siphons Off Emergency Patients

From 2008 to 2015, low acuity care in commercially insured patients has dropped 36% in EDs and increased 140% in non-ED settings, dominated by an increase in urgent care but also, less so, by increases in retail clinic and telemedicine utilization.

Why SEP-1 CMS "Quality" Metrics Are Dumb

Why SEP-1 CMS "Quality" Metrics Are Dumb

Sepsis bundles like the CMS SEP-1 guidelines are too restrictive, requiring an all-or-nothing approach to achieve compliance. These bundles fail to prioritize the most important bundle components while penalizing providers for meaningless omissions that have no impact on mortality.

Sign-Out Bombs and Resident Productivity

Sign-Out Bombs and Resident Productivity

With ED boarding, the burden of sign-out patients is greater than ever. This study shows just what I expected.  All of these sign-out patients negatively affects how many new cases each resident is able to see on each shift.

Door to tPA Under 20 Minutes - Impressive or Dangerous?

Door to tPA Under 20 Minutes - Impressive or Dangerous?

A door-to-tPA in under 20 minute protocol at this center with 1015 stroke alerts resulted in a misdiagnosis rate of 14.8% and 8 people being harmed.  The authors concluded this was safe.  I'm not so sure about that.

Start Strong, Finish Weak - Attending Shift Productivity

Start Strong, Finish Weak - Attending Shift Productivity

Attending physician productivity peaks at the beginning of the shift, starting with about 3 new patients in the first hour and decreases as the shift progresses.  This has important implications for staffing models.  Assuming a simple, uniform average over the shift won't work.

Member Login
Welcome, (First Name)!

Forgot? Show
Log In
Enter Member Area
My Profile Sign up to get full access. Log Out