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Division of Pediatric Emergency MedicineFaculty Meeting

August 13, 2008

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Dates

ECC Faculty and Staff Meeting• Department of Pediatrics Faculty Meetings• 5:30p-7p TBA September 4, 2008• 5:30p-7p TBA January 14, 2009• 5:30p-7p TBA May 20, 2009

AAP Boston MA October 11-14 ACEP Chicago IL October 27-30

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Welcome/ Congratulations

Welcomes• Amy Pattishall urgent care• Peter Strauss urgent care• Mayuri Patel nurse practitioner• Tejas Mehta PRN – urgent care• Michael Greenwald PEM - returns

0.5 FTE: September 1.0 FTE: October

Getting Hitched• Taryn Holman

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Announcements

Career Development Forms• Access from internal website• Deadline August 20th, 2008• Merit increases

Updated CV’s• Needed from all by August 20th, 2008

August Faculty Time Sheets this week

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Handwashing

No data Just a reminder to continue to wash your hands

before and after each patient contact Try to do this in front of the patient so that they are

aware that you did it AT EG ADDITIONAL FOAMS IN ROOM

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EGLESTON ISSUES

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Miscellaneous

Staffing• Lots of new inexperienced staff

Transfer Center• All ED calls will be shunted through the transfer center• Phone tree will change• More to come

Using ASCOM phones• Need team to help develop phone process

Fast Track opening• After reviewing data

Decision: Open fast track rooms w staff at 11am – the two ED docs will float to see these patients in a timely manner

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TAT’s

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EG and SR Fast Track Times

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EG Fast Track Issues

Any problems that affect your ability to meet our customer service and quality goals should be logged in the book in FT

If you are having personnel issues please let me know

Continue to be flexible as you all have been, if the ER is busy and we in FT aren’t it is OK to take a pink to FT

Remember that even though that pt TAT doesn’t count, that it will affect the times of others who wait.

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Upgrade Ya’!By Beyonce

You can upgrade patients if they use more then 1 resource• X-Ray + Splint = pink

Important as patients using more than one resource, take more time

This affects our overall FT TAT

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Go to “All”

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Choose Pink

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Medicine Reconciliation

DO IT Remind your colleagues Remember that is it important to patient care Reconcile even when there is “no home

medications” Choose “concur – no home medications” 15% quality bonus based on

• Annual average or• December score (if there has been progressive

improvement)

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Med Recon: July

75% AF23

33% AK34

69% AS72

6% CL94

17% DAN4

8% DG

0% DG85

24% DR57

77% DY10

24% ED51

90% HS49

75% JC9

0% JG12

33% JL57

77% JS26

79% LB19

0% MG32

2% MM20

12% MM46

95% MW95

86% MZ52

81% NK67

96% RP27

0% SG81

5% SG95

72% SJ52

13% SL39

76% SS59

36% TC64

36% TH33

84% TM20

21% TM23

0% TN54

29% WK93

0% ZP70

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VS and Med List

Vital signs• Current process – Patients sorted and if waiting

should get vital signs in a “timely” manner• This will be reiterated with staff• If you check HR and RR, do not enter in

flowsheet – put them in physical exam (constitutional) and do not check triage vital signs reviewed (since they are not done)

• You can also put an order to check vital signs Medication List

• Ask the nurse or put an order to document medication list – you do not have to populate this area.

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Hughes Spalding Updates

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Miscellaneous

Nursing Issues Resident Staffing Nurse Practitioner Roles

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Construction Update

Ground Breaking Today Parking lot scheduled to close August 21

• 2 options Piedmont Deck (contact Deb) Auburn Market

– Free 8p-6a and all day Sunday– Other days: $7.00

Patients needing “wet” Hazmat decontamination (showers)

• Will be taken To Grady• New policy on Careforce

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New Ambulance Entrance (Aug 21)

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Code Room Update

Cricothyrotomy kits available• Stored on top of Braslow cart

Full set of LMAs• Stored on top of Braslow cart

Ongoing project• Please let Wendy or Angela know of any

suggestions

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Financial Counseling

Please don’t forget to flag the chart as soon as you come out of the room

Remind the residents and students please Continue all of your hard work on this

Starting soon, we will add this piece to the ED side – details to follow

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Double Coverage at HS

Starting September 1, 2008• Monday’s & Tuesday’s only• UC shifts 9a-9p & 5p-1a • 5p-1a doc takes sign out from 9a-9p doc• 9a-9p doc becomes a floater between ED and

UC based on volumes and acuity needs May send resident back to ED and see patients in

UC if ED doc agrees No one leaves early

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New Toys

• Glidescope Video Laryngoscope• Micromaxx M Turbo

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Staffing

Resident staffing down in July but sl. better but mismatched w volumes by hour

Ongoing discussions with Dr Buchter There is usually an 11am resident for walk-

in – they should go to walk-in If you want to keep the resident in ED talk

directly with the urgent care attending, do so in extreme situations only

Attending staffing in Sept• HS: increases on Mon and Tues – float physician• EG: 11a UC returns

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Incentive Plan

Semi-annual payment ECC incentive to start September 2009 Data will be sent by mail

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Semi-Annual Incentive Data

MD TAT Admissions Pts/ Hr RVU's/Pt (RVU/Hr)

PEM Data

UC Data

Group Data

PEM Data

UC Data

Group Data

Clinical Productivity = RVU’s/Pt + Goal + Compliance Goal TAT Goal

PEM Goal: RVU’s/Hr: 3.61; TAT: 137; Compliance: 93%UC Goal: RVU’s/Hr: 3.41; TAT: 126; Compliance: 93%

153 19% 1.82 1.90 3.49

117 7% 1.96 1.50 3.01

142 16% 1.88 1.76 3.32

98% 

99%

98%

Compliance Score

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