In this Issue:

• Best Practices: Improving Patient Flow by Redesigning Care Management
• Innovations: Helping Frequent Users of Emergency Departments Find Their Medical Home
• Perspectives: Changing the Paradigm: Measuring Patient Flow Instead of Emergency Department Crowding
• In the News: CDC & Center for Health Workforce Studies Reports
• Webinar Resources: Strategies to Improve Patient Flow and Reduce ED Crowding

Best Practices
Improving Patient Flow by Redesigning Care Management

As health care leaders understand more about how hospital-wide discharge processes affect crowding in the emergency department, many hospital leaders are counting on care managers to be more efficient. That is why Philadelphias Albert Einstein Medical Center redesigned the Care Management Department by establishing a Resource Center, going paperless and adopting a speed dating approach to rounds.

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Innovations
Helping Frequent Users of Emergency Departments Find Their Medical Home

Three years ago, an assessment of Lincoln, Nebraskas health care safety net showed that ways to link safety net patients with community providers was lacking, and that 35 percent of visits to BryanLGH Medical Centers emergency department were non-emergent. Today, BryanLGH is working with its chief competitor to help vulnerable people in the community find their medical home.

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Perspectives
Changing the Paradigm: Measuring Patient Flow Instead of Emergency Department Crowding

Brent R. Asplin, M.D., M.P.H., of Regions Hospital and HealthPartners Research Foundation and the University of Minnesota Medical School in Minneapolis, comments on how the term emergency department crowding lets the rest of the hospital off the hook, so to speak. Dr. Asplin explains why it is time for health care researchers to stop trying to measure crowding and start measuring patient flow.

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In the News
CDC & Center for Health Workforce Studies Reports

Staffing, Capacity, and Ambulance Diversion in Emergency Departments: United States, 2003-04
In September 2006 the Centers for Disease Control and Prevention released a report, Staffing, Capacity, and Ambulance Diversion in Emergency Departments: United States, 2003-04. The report describes the growth of hospital emergency medical services and decline in the number of emergency departments. It also summarizes staffing and capacity; the availability of specialized services; the effect of demand and capacity on the ability to provide services; and variability among EDs in areas that are metropolitan and not metropolitan.

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The Emergency Care Workforce in the United States
In August 2006 the Center for Health Workforce Studies released a report, The Emergency Care Workforce in the United States which describes ED personnel across the country. The report illustrates the emergency medical care workforce including physicians, RNs, physician assistants, EMTs and paramedics and emergency medical dispatchers. It also highlights geographic trends in staffing rates as well as projected shortages for several professions.

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Webinar Resources
Strategies to Improve Patient Flow and Reduce ED Crowding

All materials from the October 2006 Webinar are now archived and available to download for free. Materials include audio recording, presentation slides, and several tools provided by Debra Foshee.

The Webinar presentations include:

1. Creating and Using Process Improvement Teams to Reduce ED Crowding
   o Debra Foshee, RN, Vice President, Quality and Medical Staff Services, Shady Grove Adventist Hospital, Rockville, MD
   
2. The 24-Hour ED Cycle
   o Shari Welch, MD, FACEP, QI Director, Emergency Department, LDS Hospital, Salt Lake City, UT

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