This article explains how a new computer based surveillance tracking system deployed by San Diego’s public safety has reduced the dependence on emergency medical services. All through this country there is an issue with the chronic use of the 911 and emergency medical response system. These chronic individuals usually have issues that are not solved by transport to the emergency department. This article explains how the eRAP is reducing the cost and improving the quality of the care provided by emergency medical services.
The chronic use and abuse of the 911 and emergency medical response system usually encompasses individuals who have social and health disadvantages. “Frequent users typically suffer from combinations of chronic medical diseases, psychiatric disorders, drug and alcohol dependence, in-home difficulties and homelessness” (Jenson, 2013) Theses individuals need specialized social work care and referrals. Prior to the soft ware and surveillance program identifying some of the frequent abuses in large emergency medical response systems was difficult, if not impossible. Reviewing countless medical charts and recognizing these individuals took a great amount time of the social workers.
This new computer system uses information from the medic’s ePCR (electronic patient care reports) and CAD(computer assisted dispatch) system to identify these individuals so that the most appropriate resources may be dispatched. Before an abuser is able to call again for an ambulance , a social worker might be sent along with law enforcement to investigate the underlying circumstance of why this patient is activating the emergency medical response system so often. Once an investigation has been completed the social worker will recommend...
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...e eRAP system seems to be a great asset in the management of chronic users of the emergency medical response system. I foresee this system expanding to every 911 system to mitigate the loss of precious resources, and to provide a more appropriate level of care to patients in the community. The time has come to do away with the old emergency medical service slogan of “You call, we haul, and that’s all”. Our jobs are much more divers now as the increase of abuse of the system occurs. For the sake of the community, we have to be more proficient in the management of emergency medical services, and the eRAP system is one of the tools that may be employed to combat the ever worsening abuse.
Works Cited
Jenson A.M., & Dunford J. (2013). EMS-based surveillance and case management system reduces dependence on EMS. Journal of Emergency Medical Services. 01(13). P.50-51
De Tar Hospital should ensure that EMTALA compliance is monitored regularly through internal auditing of emergency department records. Issues identified should be examined against existing policies and procedures to determine whether the problem is an isolated error which may be corrected through education and discipline, or if there is a more systemic problem that calls for major modification of existing policies and procedures. For example transfer records executed by Dr. Burditt and other physicians should be reviewed see if there is a pattern of inappropriate transfers by other physicians or if this is just an isolated incident. Such a proactive approach to addressing EMTALA compliance issues should significantly reduce the hospital’s liability for violation.
The challenges that all acute care hospitals and facilities faces are the demand for highly specialized services has increased. The US population is constantly aging and the elderly tend to need more acute care services. Because many people lack health insurance, they tend to use emergency rooms in the hospitals as their source of care. The increase demand in acute care prompted hospitals to expand their facility
I found your post interesting, having worked in an emergency department during my paramedic years. In my career as a nurse working in a clinic on occasion we must send a patient to the emergency department. I always call to speak with the charge nurse to provide report prior to just sending the patient, often I am on hold for greater than 15 minutes. This often results in the patient arriving at the ER before I can give report. Adding to this the charge nurse on more than one occasion is calling me on another line to ask why the patient it there! However, from past experience I do know how busy the ER can be at any given time.
Thathamkulam led the initiative to revise and wrote Telecare’s Computer Downtime Policy (Memorandum 118-Tele-015). He has further contributed to minimizing costs to the Houston MEDVAMC, as he has developed documentation protocols to ensure quality documentation for SI/HI callers who called from the After Hour off Site Call Centers. He served as a preceptor to new RN staff, he emphasized the importance of RNs including the Financial Disclaimer in all symptom calls received to help control cost due to negligence by failure to inform Veterans in regards to the disclaimer and failure to address the disclaimer in documentation. As a chair person in one of the Performance Improvement projects for Abandonment Rate Committee, he identified that the Telecare unit was experiencing a high rate (36.7%) of caller abandonment according to 2014 abandonment rate data. This was a problem that had been occurring for the last few years. In collaboration with Pharmacy team, IT team and mental health team, he decided to cut short the documentation policy for Telecare nurses, who are receiving symptom calls including suicidal calls. One suicidal call usually takes approximately 30 minutes to one hour, that back up other patients’ calls in the queue. It automatically resulted in increasing the abandonment rate for the incoming calls. He initiated and created a committee to resolve this issue. The committee meets on a monthly basis to evaluate the situation, and he initiated a plan of action that recommended management to hire additional staff and alert to revisit the documentation policy in order to reduce the current abandonment rates. Mr. Thathamkulams’ vast experiences in Mental Health, he was managed to convinced the Telecare management team and suicidal prevention team by eliminating some of the unnecessary suicidal protocol, which helped to reduced the call handling time to 25minitus per each suicidal call. He also monitored about calling procedures of staff to make sure that
There are pros and cons. Some medical people believe that the EMTALA legislation creates some problems for hospitals. Knowing that hospitals must take care of every person, people may use the ED for routine doctor visit situations. These people believe this contributes to the sometime overcrowding of ED’s. Another problem is that EMTALA legislation mandates caring for everyone no matter what. The hospital therefore, may not get paid. “According to the American College of Emergency Physicians, 55 percent of emergency care goes
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On account of theses limits other tools that are more efficient, objective and accurate are necessary to enhance acute hospital care. The National Institute for Health and Clinical Excellence (NICE 2007) have highlighted the importance of a systemic approach and advocated the use of EWS to efficiently identify and response to pa...
Healthcare professionals associated with medical billing and coding know the progress the technology has made so far. In the last few decades, medical billing and coding has switched from being a paper-based system to a computerized format. Under HIPAA laws, medical practitioners had to develop new software in order to send out electronic bills. With the advent of electronic medical records (EMR), with one touch of a button, doctors, Nurse Practitioners and PAs can gain access to all the care a patient has ever received from every healthcare facility the patients visited previously and can figure out possible illnesses. This enables statistical documentation of the population as a whole as well. EMR can also make the healthcare system more transparent and allow integration with reimbursement data. As the healthcare system changes, this will prevent unnecessary costs and make it easier to get the reimbursements needed to treat a patient.
The emergency department (ED) is an essential component of the health care system, and its potential impact continues to grow as more individuals seek care and are admitted to the hospital through the ED. Invasive procedures such as central lines are placed with increased frequency
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The term “failure to rescue” refers to a clinical scenario where hospital doctors, nurses, or caregivers fail to recognize symptoms. Responders do not respond adequately to clinical signs that would prevent harm (Morse, 2008, p.2). Dr. Jeffery H. Silber, Director of the Center for Health Outcomes and Policy Research, first coined the term “failure to rescue” in the 1990’s. He characterized the matrix of institutional and individual errors that contribute to patient deaths as “failure to rescue” (Aleccia, 2008). Since 1990, it has been well documented patients usually exhibit signs and symptoms of impending cardiac or respiratory arrest 6-8 hours before an arrest (Schein, Hazday, Pena, Ruben, & Spring, 1990). Buist, Bernard, Nguyen, Moore, and Anderson’s (2004) research reported similar findings. They found patients had documented clinically abnormal signs and symptom prior to arrest (Buist, et al., 2004). When certain abnormal signs and symptoms are identified early, critical bedside consultat...
Emergency Medical Technicians work with law enforcement and firemen in many different environments on 911 calls involving the need for emergency medical services. The modern EMT started as just “the good samaritan that would help the careless traveler bandage up his leg in 1500 B.C.” and has evolved throughout the years to what we all know for them to be today ("Emergency Medical Services"). This career has changed quite a bit over the years from “instituting the first ambulance in 1865, to using a helicopter for medical evacuations during the Korean War in 1951, to the New York City EMS being absorbed by the FDNY in 1996” ("Emergency Medical Services"). In this day and age, Emergency Medical Technicians work
Meredith, J.W (2008, May). The Lack Of Hospital Emergency Surge Capacity: Will The Administration's Medicaid Regulations Make It Worse? Presented at The House Committee On Oversight And Government Reform. Retrieved March 2014, from