Perspectives on the Acute Care Continuum

The Acute Care Continuum is the integration of urgent, emergent, inpatient and post-discharge care of patients with acute medical conditions. 

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As Hurricane Katrina bore down on New Orleans in 2005, local authorities and hospital administrators began to implement their disaster plans. Unable to evacuate an entire city, local authorities opened a shelter in what they hoped was a safe structure: the Superdome. Most of us remember the news coverage showing the outcome of that decision.

Hospitals, likewise, found that many of their plans were poorly conceived or inadequate to a disaster of that magnitude. Supplies and vital medications ran out, staffing was often short, patients had to be cared for without electricity and in the stifling heat. Communications were down. Evacuations were delayed and difficult. In at least one case, patients had to be internally evacuated from parts of a hospital that had flooded to its upper floors, leaving patients and staff without working elevators or even ventilators.

1/29/2014 9:28:26 PM | 1 comments

On Jan. 16, 2014, ACEP released the latest version of its National Report Card on the State of Emergency Medicine

The report identified Access to Emergency Care as the area of greatest need. (In fact, the nation earned a D- in this area in both 2009 and 2014.)

Access is the highest-weighted of the five categories, accounting for 40 percent of the overall grade.

So is it true that we've made virtually no progress at improving the average person’s access to emergency care? 

1/28/2014 12:59:25 PM | 0 comments

It makes perfect sense to look around for the best deal on a Toyota Prius or a Vegas vacation package. But in October 2013, the Associated Press reported on an emerging consumer trend: price shopping for healthcare services.

Driven by unpredictable bills and rising deductibles, today's consumers want to know the bottom line before booking an appointment. Physicians' offices have been inundated with phone calls requesting "estimates." New websites allow providers to "bid" on procedures. And employers and insurance companies are leveraging pricing variances by sending patients out-of-state (or even abroad) for procedures. Last week, HealthLeaders magazine editor John Commins summed up the trend in his satirical piece, "A Letter to Healthcare Providers from a Consumer."

So can healthcare really be viewed through the same pricing lens as a car or kitchen remodel? Here to offer their perspectives are Dr. Ellis Weeker, Director of Leadership Development at CEP America, and Dr. Gail Silver, Director of Ambulatory and Urgent Care at CEP America.

1/22/2014 7:13:05 PM | 1 comments

Last year, 2013, was a strange one for healthcare. With full implementation of the Affordable Care Act looming, hospitals across the country were laser-focused on acronyms and numbers. Discussions of TAT-D, LOS and HCAHPS dominated department meetings and huddles. So much was riding on these metrics that some departments took to posting them in the break room — or even the bathrooms — to keep their teams focused on quality goals.

Now don't get me wrong. Better, safer, more affordable healthcare is certainly a worthy aim. But this focus on numbers also comes at a price, because it's been easy to lose sight of why we got into healthcare in the first place. Too often, we've forgotten that behind all these measures and metrics are human beings — patients and families — going through some of the most stressful, painful and profound experiences of their lives.

1/20/2014 8:29:50 PM | 1 comments

The Affordable Care Act was designed to address healthcare spending by eliminating waste and focusing on value. But Obamacare did little to impact one of our major healthcare cost drivers: disproportionate spending on the care of dying patients. Often this involves applying curative approaches to incurable conditions without regard to the patient's dignity or emotional and social needs.

With 30 percent of Medicare dollars being spent during the last 12 months of life, doesn't it make more dollars and sense to rethink how we are spending our limited resources?

1/16/2014 4:31:27 PM | 0 comments
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