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Mission Critical: Moving Outside the Four Walls of the Emergency Department
 
Health care in the United States is delivered through a fragmented and complex system than can be difficult to navigate in the best of times. While the purpose of the emergency department (ED) is treat and stabilize in instances of acute episodic care, in reality the ED does a lot more than treat and release patients. The Follow-Up Office at Stony Brook Medical Center is an example of how one ED is collaborating with the local community to improve the health of its citizens.
 
A decrease in the number of health care facilities combined with an increase in the number of Americans without health insurance and an aging population have contributed to a significant increase in the number of people receiving health care through the emergency department (ED). The Medical College of Georgia is using telemedicine to keep nursing homes residents from visiting the ED unnecessarily.
In recent years, there has been a major push to better integrate the efforts of the wide variety of federal agencies that do similar work, the Emergency Care Coordination Center was established to examine and explore ways to regionalize the delivery of emergency care.

Quality as always been an important element in health care, and in the era of health reform there has been a renewed interest in the process of quality improvement and related techniques.  There are numerous quality improvement techniques, processes, and methodologies being used in the health care industry today.  An increasing number of providers are utilizing a process called Lean, a methodology associated primarily with Toyota and manufacturing industries.  It is used to improve quality, reduce waste, and create more efficient and effective processes improving overall patient outcomes. 
 
 Lean is a set of principles and methods that can be applied to any team of people working in an organized process.  Lean methodology is being used to examine process flow, identify barriers, and reallocate resources to improve patient outcomes and the overall quality of care provided.  This issue of the Urgent Matters E-Newsletter examines the use of Lean methodology as quality improvement technique in the emergency department and features an interview with one of the leading experts in the field of health care quality, Dr. Dale Bratzler, DO, MPH, chief executive officer, Oklahoma Foundation for Medical Quality; president, American Health Quality Association. 

 

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