Transcript EMERGENCY PEDIATRIC GROUP DEPARTMENT MEETING

Division of Pediatric Emergency
Medicine
Faculty Meeting
August 13, 2008
1
Dates
 ECC Faculty and Staff Meeting
• Department of Pediatrics Faculty Meetings
• 5:30p-7p TBA
September 4, 2008
• 5:30p-7p TBA
January 14, 2009
• 5:30p-7p TBA
May 20, 2009
 AAP Boston MA
October 11-14
 ACEP Chicago IL
October 27-30
2
Welcome/ Congratulations
 Welcomes
•
•
•
•
•
Amy Pattishall
urgent care
Peter Strauss
urgent care
Mayuri Patel
nurse practitioner
Tejas Mehta
PRN – urgent care
Michael Greenwald PEM - returns
 0.5 FTE: September
 1.0 FTE: October
 Getting Hitched
• Taryn Holman
3
Announcements
 Career Development Forms
• Access from internal website
• Deadline August 20th, 2008
• Merit increases
 Updated CV’s
• Needed from all by August 20th, 2008
 August Faculty Time Sheets this week
4
Handwashing
 No data
 Just a reminder to continue to wash your hands
before and after each patient contact
 Try to do this in front of the patient so that they are
aware that you did it
 AT EG ADDITIONAL FOAMS IN ROOM
5
EGLESTON ISSUES
6
Miscellaneous
 Staffing
• Lots of new inexperienced staff
 Transfer Center
• All ED calls will be shunted through the transfer center
• Phone tree will change
• More to come
 Using ASCOM phones
• Need team to help develop phone process
 Fast Track opening
• After reviewing data
 Decision: Open fast track rooms w staff at 11am – the
two ED docs will float to see these patients in a timely
manner
7
TAT’s
250
200
150
Md to dispo
aug
md to dispo jul
100
50
0
1
8
2
3
4
5
6
7
8
9
10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
EG and SR Fast Track Times
9
EG Fast Track Issues
 Any problems that affect your ability to meet our
customer service and quality goals should be
logged in the book in FT
 If you are having personnel issues please let me
know
 Continue to be flexible as you all have been, if the
ER is busy and we in FT aren’t it is OK to take a
pink to FT
 Remember that even though that pt TAT doesn’t
count, that it will affect the times of others who wait.
10
Upgrade Ya’!
By Beyonce
 You can upgrade patients if they use more then 1
resource
• X-Ray + Splint = pink
 Important as patients using more than one
resource, take more time
 This affects our overall FT TAT
11
Go to “All”
12
Choose Pink
13
Medicine Reconciliation
 DO IT
 Remind your colleagues
 Remember that is it important to patient care
 Reconcile even when there is “no home
medications”
 Choose “concur – no home medications”
 15% quality bonus based on
• Annual average or
• December score (if there has been progressive
improvement)
14
Med Recon: July
15
75%
AF23
12%
MM46
33%
AK34
95%
MW95
69%
AS72
86%
MZ52
6%
CL94
81%
NK67
17%
DAN4
96%
RP27
0%
SG81
5%
SG95
72%
SJ52
13%
SL39
76%
SS59
36%
TC64
36%
TH33
8%
DG
0%
DG85
24%
DR57
77%
DY10
24%
ED51
90%
HS49
75%
JC9
0%
JG12
33%
JL57
84%
TM20
77%
JS26
21%
TM23
79%
LB19
0%
TN54
0%
MG32
29%
WK93
2%
MM20
0%
ZP70
VS and Med List
16
 Vital signs
• Current process – Patients sorted and if waiting
should get vital signs in a “timely” manner
• This will be reiterated with staff
• If you check HR and RR, do not enter in
flowsheet – put them in physical exam
(constitutional) and do not check triage vital signs
reviewed (since they are not done)
• You can also put an order to check vital signs
 Medication List
• Ask the nurse or put an order to document
medication list – you do not have to populate this
area.
Hughes Spalding Updates
17
Miscellaneous
 Nursing Issues
 Resident Staffing
 Nurse Practitioner Roles
18
Construction Update


Ground Breaking Today
Parking lot scheduled to close August 21
• 2 options

Piedmont Deck (contact Deb)

Auburn Market
–
–

19
Free 8p-6a and all day Sunday
Other days: $7.00
Patients needing “wet” Hazmat decontamination
(showers)
• Will be taken To Grady
• New policy on Careforce
New Ambulance Entrance
(Aug 21)
20
Code Room Update
 Cricothyrotomy kits available
• Stored on top of Braslow cart
 Full set of LMAs
• Stored on top of Braslow cart
 Ongoing project
• Please let Wendy or Angela know of any
suggestions
21
Financial Counseling
 Please don’t forget to flag the chart as soon as you
come out of the room
 Remind the residents and students please
 Continue all of your hard work on this
 Starting soon, we will add this piece to the ED side
– details to follow
22
Double Coverage at HS
 Starting September 1, 2008
• Monday’s & Tuesday’s only
• UC shifts 9a-9p & 5p-1a
• 5p-1a doc takes sign out from 9a-9p doc
• 9a-9p doc becomes a floater between ED and
UC based on volumes and acuity needs
 May send resident back to ED and see patients in
UC if ED doc agrees
 No one leaves early
23
New Toys
• Glidescope Video Laryngoscope
• Micromaxx M Turbo
24
Staffing
 Resident staffing down in July but sl. better
but mismatched w volumes by hour
 Ongoing discussions with Dr Buchter
 There is usually an 11am resident for walkin – they should go to walk-in
 If you want to keep the resident in ED talk
directly with the urgent care attending, do so
in extreme situations only
 Attending staffing in Sept
25
• HS: increases on Mon and Tues – float physician
• EG: 11a UC returns
Incentive Plan
 Semi-annual payment
 ECC incentive to start September 2009
 Data will be sent by mail
26
Semi-Annual Incentive Data
MD TAT
Admissions
Pts/ Hr
RVU's/Pt
(RVU/Hr)
PEM Data
153
19%
1.82
1.90
3.49
UC Data
117
7%
1.96
1.50
3.01
Group Data
142
16%
1.88
1.76
3.32
Compliance Score
PEM Data
98%
UC Data
99%
Group Data
98%
RVU’s/Pt + Goal + Compliance
Goal
TAT
Goal
RVU’s/Hr: 3.61; TAT: 137; Compliance: 93%
RVU’s/Hr: 3.41; TAT: 126; Compliance: 93%
Clinical Productivity =
PEM Goal:
UC Goal:
27
28
29
30
31