Question: I could not attend the ACEP Scientific Assembly this year. What were your impressions of the exhibits? What’s the latest buzz? Answer: According to the College, the 2010 attendance broke all records (5900 registered). All I knew was that the corridors, meeting rooms, and the exhibit hall were crammed. I suspect the lure of ...

Question: Recently, the Hospital’s CEO and the Emergency Department Nurse Management have been totally consumed by their disappointment with the ED’s key performance metrics. As Emergency Department Medical Director (EDMD) and President of the Emergency Medicine Practice, I want to help achieve the needed improvements and have some ideas about what needs to be done. ...

Question: Our Hospitalists and Emergency Physicians are feuding over the appropriateness of admissions from the ER.  How can we get them to work together better? Answer: As a consultant, I’m frequently asked to offer insight on improving the working relationships between these two practices. The nexus of their interaction is the phone call regarding a ...

In part two of this response, I focus on the systemic issues involved when considering the replacement of a medical director in the emergency department and what to do about them. Part Two: Removing the Obstacles When considering whether to replace the EDMD, look for procedural, financial or organizational impediments to leadership performance. What historical ...

Question: Our Emergency Department Medical Director (EDMD) is one of the original members of our Emergency Medicine Practice. He’s primary care trained like most of our Emergency Physicians and is Emergency Medicine Board Certified but not by the American Board of Emergency Medicine. He’s practiced clinically here for years and has been the EDMD for ...

Question: Recently, the Baltimore Sun published the article “Hospitals Try to Improve Emergency Wait Times” detailing efforts undertaken by hospitals in Maryland and Virginia to reduce waiting times in their emergency departments. The article focused mostly on the activities hospitals used to advertise their improved performance. There were few specifics regarding process improvements themselves. What’s ...

Question: Several years ago our local Emergency Medicine Group faced a crisis.  After considerable investigation and evaluation, it was concluded that the best means of retaining the Emergency Physicians was for the Hospital to employ them. All of the doctors became employees at the same time so all of the employment contracts have the same expiration ...

Question: Our emergency department personnel and the emergency physicians have tried various process improvement projects to upgrade the ER’s productivity and performance. They’ve made significant improvements but with the continuing growth in the department and the resulting pressures on the staff from the ancillaries and the in-patient areas we seem to be losing momentum. What else ...