Emergency services and trauma care in California are being threatened. Financial pressures, infra-structure requirements and shortages of licensed health care professionals have caused numerous emergency department (ED) and trauma center closures or downgrades.
The willingness of physician specialists to take calls in hospital EDs has also become increasingly problematic for California hospitals.
Special resource toolkit developed by CHA’s EMS/Trauma Committee and the Center for Behavioral Health. Designed to help staff provide support to patients in the ED with psychosis and/or substance abuse disorders, this toolkit provides access to articles, policies, management techniques, assessment tools and more. Click the topic tabs below to access resources and information.
The Centers for Medicare & Medicaid Services (CMS) has published an informational bulletin outlining strategies that states can implement to reduce non-urgent and inappropriate use of emergency department (ED) services, while still delivering appropriate care to Medicaid beneficiaries. Experience and research suggest that broader strategies – such as expanding primary care access, “super-utilizer” programs, and targeting the needs of people with behavioral health and substance abuse issues – appear to have considerable promise for addressing unmet health needs as the underlying causes of high ED utilization. The bulletin also discusses relevant considerations when distinguishing between emergency and non-emergency use of ED services. For detailed information, the CMS bulletin is attached.
The American College of Emergency Physicians (ACEP) has released its state-by-state report card evaluating America’s support for emergency care, ranking each state in key categories and forecasting how the role of emergency medicine will expand under the Affordable Care Act. In ACEP’s last report card, issued in 2009, the U.S. earned an overall grade of C-. This year, the overall national evaluation fell to a D+. California scored a C-, up slightly from its D+ in 2009.
The report card includes 136 measures in five categories: access to emergency care (30 percent of the grade), quality and patient safety (20 percent), medical liability environment (20 percent), public health and injury prevention (15 percent) and disaster preparedness (15 percent). To view the full report, visit www.emreportcard.org.
The Investment in Mental Health Wellness Act of 2013 establishes a new grant program to disburse funds to California counties for the purpose of developing mental health crisis support programs. Specifically, funds will “increase capacity for client assistance and services in crisis intervention, crisis stabilization, crisis residential treatment, rehabilitative mental health services, and mobile crisis support teams.” The grants from the California Health Facilities Financing Authority (CHFFA) will support capital improvement, expansion and limited start-up costs. Counties apply
New research shows that having access to data from a health information exchange (HIE) improved the quality of emergency care and saved more than $1 million in patient charges, or nearly $2,000 per patient. A study presented this week at the annual meeting of the American College of Emergency Physicians focused on 11 emergency departments in South Carolina, and reported on results from 532 patients who had information available in the HIE and for whom the clinicians caring for the patients completed a survey. Findings indicated an average savings of $1,947 per patient, based on Medicare-allowable charges. Also in the study, 80 percent of clinicians reported improved quality of care and time savings with HIE.
The Emergency Medical Services Authority has received a grant from the California Office of Health Information Integrity to prepare emergency medical services (EMS) as part of the effort to implement health information exchange (HIE). The grant objectives include assessment of EMS systems for HIE readiness and identification of gaps; funding for several demonstration projects; and convening an EMS summit of multiple diverse stakeholders to develop a vision for the future of health information exchange in EMS. The summit is scheduled for Nov. 19-20 at the Westin Los Angeles, and hospitals are strongly encouraged to participate. More information and registration details are available in the attached brochure.
The Centers for Disease Control and Prevention (CDC) recently issued a health advisory recommending vigilance by public health agencies, emergency departments and health care providers with patients who develop acute hepatitis or liver failure following the use of OxyELITE Pro, a weight loss and muscle-building nutritional supplement. The initial seven cases were reported by the Hawaii Department of Health. National case-finding efforts have identified several individuals from states outside Hawaii with reported OxyELITE Pro or other weight loss or muscle building dietary supplement use prior to the development of acute hepatitis of unknown cause. CDC, in collaboration with state health departments, is collecting additional clinical and epidemiologic information from these individuals to determine if the outbreak is national in scope. A summary, background, case definition, recommendations and more information can be found at the CDC’s Health Alert Network.
CHA recently completed a Memorandum of Understanding (MOU) with the American Red Cross, establishing a partnership for educating hospitals on releasing protected health information to a “public or private entity authorized by law or by its charter to assist in disaster relief efforts.” Public and private entities include the Red Cross, hospitals, first responders and others.
A copy of the MOU and CHA’s Release of Protected Health Information booklet are available for download at www.calhospitalprepare.org/protected_info. A hard copy of this booklet was also distributed at the CHA Disaster Planning for California Hospitals Conference last month.
The Emergency Medical Services Authority (EMSA) has received a grant from the California Office of Health Information Integrity (CALOHII) to prepare emergency medical services (EMS) as part of the effort to implement health information exchange. The grant objectives include assessment of EMS systems for HIE readiness and identification of gaps; funding for several demonstration projects; and convening an EMS summit of multiple diverse stakeholders to develop a vision for the future of health information exchange in EMS. Contra Costa, Inland Counties and Monterey County EMS agencies will serve as demonstration sites. Areas of focus include the conversion to National EMS Information System 3 data systems, electronic patient care records and transmission of data to hospitals. The summit is scheduled for November 19-20, and hospitals are strongly encouraged to participate.
Whether you are a sending or receiving hospital, many factors must be considered when dealing with a potential EMTALA situation. The patient’s medical condition, screening exams, capacity and capability, and on-call issues are at the top of the list. Learn how to analyze these and other complicated EMTALA situations with confidence.
The EMTALA Manual cuts through the legalese to help you navigate the Emergency Medical Treatment and Active Labor Act — or “patient-dumping” law — that was enacted to ensure patients equal access to emergency services without regard to financial or insurance status. In a question and answer format, the manual provides guidance to hospitals and physicians on how to comply with the Act and clarifies situations to which EMTALA applies.