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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Thinking about this dynamic time around us in The Acute Care Continuum has made me reflect on my years as an attending emergency physician at a hospital in Southern California.  It does not seem so long ago (though it has been 30 years) that I started my career and we had only 27,000 patients coming through our doors each year.  This year that number will reach more than 90,000 with only a modest increase in the available ED space, which was designed 30 years ago for at most 50,000 visits per year.

About a decade ago the ED where I work implemented Rapid Medical Evaluation® (RME).  This has significantly improved our time to provider (TTP) in the ED as well as our patient satisfaction.  Our TTP went down from well over an hour to about 21 minutes, while patient satisfaction scores went up for both our high- and low-acuity patients.  I remember skeptical nurses and some very pleasantly surprised patients, but ultimately the RME process became routine. We developed the concept of “vertical” and “horizontal” patients, streamlined throughput and created ED virtual space to see more patients.

And more patients came year over year over year. With every new surge in patients we redesigned the RME process, learning what worked and what didn't from other practice locations in our organization. Now we are poised to hit 100,000 patients per year in the near future.

4/5/2012 11:57:14 PM | 0 comments

Welcome to our blog. The focus will be on the integration, management, and operational performance of the healthcare providers who are responsible for patient care and experience within acute care hospitals. My goal is for the blog to engage, inform, and serve as a vehicle to share ideas and thoughts among all stakeholders and healthcare professionals about a topic we simply call the "Acute Care Continuum."

In particular we will focus on the physician specialties and hospital departments where care for acutely ill and injured patients is provided – including the emergency department (ED), inpatient services, and post-discharge urgent and ambulatory care (UAC) provided in the 30-day window defined by CMS...

4/3/2012 11:47:18 PM | 0 comments
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