Category Archives: Emergency Medicine

WVSOM regional assistant dean: Medical students must learn to connect with patients – The Steubenville Herald-Star

Contributed ALWAYS TEACHING Dr. Jane Daugherty-Luck, a native of Colliers, helps students connect in her role as an assistant dean with the West Virginia School of Osteopathic Medicine.

LEWISBURG For nearly three decades, Dr. Jane Daugherty-Luck was an emergency medicine physician, where quick decisions can restore the health of a sick or injured patient.

Today, in her role as one of eight regional assistant deans serving the West Virginia School of Osteopathic Medicines Statewide Campus, shes responsible for another type of transformation helping third- and fourth-year medical students navigate their latter years of medical school.

Medical students dont realize all the little things they dont know, Daugherty-Luck said. Guiding them along that path is great. Its a gradual climb for a while, and then all of a sudden they hit a peak and soar straight up. Its nice to watch them succeed.

Daugherty-Luck, a graduate of WVSOMs Class of 1991, oversees students in the schools Northern Region, which encompasses West Virginias Brooke, Hancock, Marshall, Ohio, Tyler and Wetzel counties. Born and raised in Colliers, she developed an interest in science during her childhood and said medicine was one of the only professions that seemed suitable for smart girls at the time.

I cant remember not thinking about medicine. It just seemed the thing for me, she said. I liked solving mysteries and puzzles, and I liked the idea of hearing peoples stories. I liked that you get to hear interesting accounts of how something happened or how someone came to be diagnosed.

After earning a bachelors degree in chemistry from Alderson Broaddus College in Philippi, W.Va., Daugherty-Luck interviewed with two of West Virginias medical schools. She was influenced to consider WVSOM by her grandfather, whose beloved primary care physician was a doctor of osteopathic medicine, but her choice ultimately came down to the school she believed was a better fit for her personality.

On my other interviews, I didnt like the people I was interviewing with. They seemed dull and stuffy. At WVSOM, I interviewed with friendly people I felt I would enjoy hanging out and studying with. They would talk about other things in their life besides their career, and thats what made them interesting, she said.

Daugherty-Luck discovered her future specialty during an internship, noting that she fell into it accidentally.

At that time we had to do a one-year rotating internship, and the only rotation I liked was emergency medicine, because that was where I felt people actually wanted to teach me, she said. I remember a nurse coming to me, saying, This lady is in atrial fibrillation, and I said, Really? Shes here for finger pain. The nurse said, I took her pulse, and its really fast. Thats how I learned that vital signs could point you to the actual diagnosis. It turned out that the finger pain was referred from her heart.

After completing a residency at Clevelands Brentwood Hospital (now known as South Pointe Hospital), Daugherty-Luck worked as an emergency medicine physician in nearby Richmond Heights for two years before relocating to northwestern Kansas, where she would spend the next 12 years as assistant director of emergency medicine at Hays Medical Center.

It was during this period that she developed an interest in niche topics that she has continued to lecture on during her time at WVSOM. Following the Sept. 11, 2001, terrorist attacks, Daugherty-Luck assembled informational lectures to help emergency department staff learn about disaster planning and decontamination. She subsequently attended an incident response to terrorist bombings class presented by the U.S. Department of Homeland Security.

The class was a great experience. I learned about different types of explosive materials and the unique problems associated with these situations. A bomb that goes off in an open square, in a crowd of people, will create a different pattern of injuries than a bomb that goes off in a confined space or in water, and injury patterns are important to emergency medicine, she said.

Daugherty-Luck returned to West Virginia in 2009, working at Ohio Valley Medical Center in Wheeling and East Ohio Regional Hospital in Martins Ferry, and acting as an associate faculty member in the two hospitals emergency medicine residency program.

She also served as a preceptor, providing clinical training and mentoring to students in a variety of health care fields, and delivered lectures on terrorism and bombing response to WVSOM students during a popular wilderness medicine rotation established by former faculty member Dr. Lisa Hrutkay. It was only natural that when the opportunity came in 2022 to become a regional assistant dean, she would return to her alma mater full time.

Today, Daugherty-Luck works to ensure that medical students on clinical rotations feel supported, are in effective learning environments and stay on track to graduate. But the best guidance she can offer students has nothing to do with the classroom or the clinic, she said.

Her advice?

Know that theres more to life than medical school. Students need to get out and go to the movies, read books, do things that have nothing to do with medicine. Theyll say they dont have time, but if I were in their situation, I would find a way. It makes you relatable. It makes you interesting. It makes you a person. If youre only talking doctor stuff to a patient, its hard to make a connection. But if you can say, I read that book thats in your bag, or, I saw that movie too, thats how you connect.

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WVSOM regional assistant dean: Medical students must learn to connect with patients - The Steubenville Herald-Star

Long emergency department wait times are perilous. Fix this stat! – The Boston Globe

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As Kowalczyk points out, medical patients are also affected, as is anyone experiencing a true emergency in a department with its beds occupied by boarders.

Boarding is visible in emergency departments, but it is not an ER problem. It is a problem of hospital throughput. Emergency physicians look forward to collaborating at all levels of the health care system, from hospitals and insurers to elected officials, to identify immediate and longer-term solutions to the nations urgent boarding crisis.

Dr. Joseph Tennyson

Northborough

The writer is president of the Massachusetts College of Emergency Physicians, director of clinical operations and chief of emergency medicine at the UMass Memorial Health Alliance-Clinton Hospital Emergency Department, and an associate professor of emergency medicine at the UMass Chan Medical School.

As an occupational therapy student at Boston University, I was intrigued by the article Waits longer than ever in area ERs.

The reporter cites how increased wait times in emergency departments are unacceptable for hospital staff and could lead to medical errors for patients but does not mention the potential long-term effects of delayed care and hospital overcrowding on patient health and the overall health care system.

Delayed provision of emergency care for example, for strokes or cardiac events can lead to increased severity of medical events and a greater risk of further hospitalization or rehabilitation. Many rehab facilities and nursing homes are also understaffed and overcrowded, so these increased ER wait times would lead to an increased burden on an already-strained system and decrease the quality of patient care. This in turn could affect the available length of stay for patients as they recover, sending some home sooner than advised.

Bringing more attention to the greater and potentially widespread impact of ER wait times could motivate legislators and heads of hospitals to urgently address this issue.

Natalie Schmidt

Allston

Many of the observers cited in the Globes article focused on process interventions such as improved utilization of observation beds or transfers of patients to inpatient units to shorten emergency department wait times. My colleagues and I published a study in the Journal of Emergency Nursing investigating a range of hospital characteristics associated with how much time it took for a patient to be diagnostically evaluated in 67 Massachusetts emergency departments. Our research demonstrated that this wait significantly increased when emergency nurses cared for higher numbers of patients.

Importantly, while 17 other potential process factors were included in the statistical analysis, such as hospital occupancy, staffed hospital beds, ICU beds, Medicare case mix, observational beds, and profit and loss figures, the most important factor affecting wait times in Massachusetts ERs was nurse-to-patient ratios.

If Massachusetts hospitals want to lower these wait times, the evidence seems clear: Hire and staff more registered nurses.

Judith Shindul-Rothschild

Sherborn

The writer is a registered nurse and is a research professor at William F. Connell School of Nursing at Boston College. She holds a masters degree in psychiatric nursing and a doctoral degree in social economy and social policy.

Liz Kowalczyks story on ER wait times highlighted a distressing reality at a fragile time for American health care. Heres what patients should know as our state addresses these challenges.

First, the root causes: About 19,000 hospital job vacancies in Massachusetts have led to fewer overall care beds. More than 1,000 beds are unavailable on any given day simply because hospitals cannot move patients to lower-level facilities. Patients are experiencing longer stays. Community-based care is constrained. Virus seasons are intensifying. This perfect storm of factors has come together to create the delays many patients are experiencing today.

Second, the solutions: Just as they did throughout the COVID-19 pandemic, health care organizations are working with the state and one another to balance out care demand and share available resources. It is a daily, round-the-clock effort centered around treating the sickest patients immediately. As the pandemic showed, cutting back on planned procedures leads to greater illness and contributes to the capacity crisis we are experiencing now. It would be a mistake to dismiss the importance these procedures have on patients long-term health.

Most of all, patients should know that hospitals have their backs, and they should not hesitate to seek care when they need it. Patients can help local providers by visiting urgent care centers and primary care doctors when they are not in an emergency, keeping up with medical appointments, and treating caregivers with the respect they deserve.

Patricia Noga

Vice president, clinical affairs

Massachusetts Health & Hospital Association

Burlington

The writer is a registered nurse.

One major reason for such overuse of emergency departments is the collapse of outpatient care. Try to get in touch with an outpatient provider. You might get to leave a phone message (after wading through a complicated list of options).

Some people wont, or cant, wait weeks or months to see a provider. Emergency departments are always open, and one can be seen immediately (so to speak) and expect to get good care. So thats what people opt to do rather than see an outpatient provider. Urgent care centers are a good option, but they usually close in the evening.

The care systems are broken. Its helpful to report on pieces of the problem, but Id like to see a report on the fragmented system of health care itself.

Dr. George Sigel

Norwood

The long waits in emergency departments are just another symptom of a much bigger problem. When an industry is led by those without the proper training, the probability of failure is high. The day-to-day workflow of hospitals has increasingly been managed by risk managers, data analysts, and business graduates. However, medicine is a service industry with unanticipated consequences, not a commodity with neatly drawn revenue projections. Corporate models dont apply. Yet it has devolved into a series of billable events governed not by clinical judgment but by insurance company protocols and stakeholder margins. Lets try putting those with a license to practice medicine back in charge of medical care so that we can start to clean up the mess. Its not that complicated to take good care of a patient.

Dr. Paula Muto

Andover

The writer, a practicing surgeon, is the founder and CEO of the technology platform Uberdoc, which promotes access and price transparency.

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Long emergency department wait times are perilous. Fix this stat! - The Boston Globe

Here’s how fix E.R. wait times in Md.: Cut hospital executive salaries. A lot. | GUEST COMMENTARY – Baltimore Sun

Maryland leads the nation in Emergency Room extended wait times. As directors of E.R.s at Maryland hospitals, we faced this more than 30 years ago. Although steps have been taken to ease the problem, over the years its gotten worse. Much worse.

Heres whats going on. For the typical community hospital, E.R.s are the source of 50% to 80% of hospital admissions. When admitted E.R. patients cant move to an in-patient bed, they stay in the E.R. Its not unusual to have half of E.R. beds taken by patients awaiting transfer, for hours or even days. Because these are the sickest patients, they require continuing attention, while new patients continue to arrive with no place to go. Thus, ever-increasing wait times.

These delays affect all patients those with medical and surgical problems as well as those with behavioral disorders, especially children and adolescents who have been reported to spend as much as a week or more in E.R.s awaiting placement. The stress of these delays hits patients and their families, but also caregivers who face burnout from working harder with fewer colleagues and resources.

While inadequate bed space is a factor, the lack of staff at every level is even more significant: nurses, physicians, physician assistants, social workers, pharmacists, skilled technicians (lab, imaging, respiratory), housekeepers, transporters, security, unit clerks, dietary and many others. The new CEO of the Maryland Hospital Association, Melony Griffith, noted that roughly one in five nursing positions in the state is unfilled, and the shortage could get much worse without urgent, aggressive action.

Simply put, the key to fixing this requires better pay for more front-line staff.Where would this money come from?

Two prominent leaders recently addressed financial issues in business. Robert Reich, a U.C. Berkeley Professor and former Secretary of Labor under Bill Clinton cited dramatic increases in compensation of American corporate CEOs: In 1965, CEOs earned roughly an average of 20 times the typical workers pay. As of 2021, the CEO-to-median-worker pay ratio had grown to 399 to 1. Since the 1970s, CEO pay has risen 1,200%, while the pay of the average American worker went up just 18%.

Donald Berwick, a lecturer at Harvard Medical School and former administrator of the Centers for Medicare and Medicaid Services, wrote last year in an opinion piece in the Journal of the American Medical Association entitled Salve Lucrum: The Existential Threat of Greed in US Health Care that the grip of financial self-interest in U.S. health care is becoming a stranglehold, with dangerous and pervasive consequences. No sector of US health care is immune from the immoderate pursuit of profit.

We looked at Maryland hospital executive compensation on a public website (HSCRC.maryland.gov/Pages/hospital-irs-990.aspx). There, one can see CEO and executive compensation for every Maryland hospital, all of which are nonprofit. Generous six- and seven-figure incomes are common, with one exec making over $15 million per year. These incomes then drive retirement and other benefits. Further, Maryland hospital executives make far more than their counterparts at non-health-care nonprofits.

In 2004, salaries for state workers were frozen due to financial shortfalls, and legislators voluntarily imposed the same freeze on themselves as was done to state employees. A similar approach should apply to hospital executives.

Heres a proposal for hospital governing boards: Cap hospital executives compensation at $500,000 per year, a more-than-comfortable wage in Maryland. By our estimate, that would free up over $100 million annually to be used to recruit and retain thousands of much-needed frontline workers for our hospitals. That could help reduce E.R. wait times while improving other services.

The executives may object, arguing that their high salaries are needed to attract and retain the best and brightest for these challenging positions. But $500,000 per year is more than adequate for work in the nonprofit sector, which is heavily subsidized by citizens through taxes and charitable giving in exchange for the benefits these institutions are to provide to their communities.

Almost everyone else in health care makes less, far less, and they do so with dedication, professionalism and sacrifice. We should expect the same of those leading these organizations. Regardless, as administrators, theirs is the ultimate responsibility for E.R. wait times and other operational shortfalls, including those where quality and safety standards are not met.

Our proposal is a start, but it does not solve the myriad of problems affecting Americas health and health care, including our poor ranking in health measures compared to other developed nations, falling life expectancy, rising infant and maternal mortality, profiteering pharmaceutical companies, medical debt now being the most frequent cause of personal bankruptcies our lack universal health coverage, in which we are alone among modern nations.

Dont let anyone tell you that we dont have the money to do better. We do. The money is there. Its just not going to where its needed: to those whoperform the front-line work of patient care and for preventive services andpublic health.

Dr. David Meyers (dm0015@comcast.net) has been Chief of Emergency Medicine at numerous hospitals and trauma centers, a physician executive, patient advocate and ethicist. Dr. Dan Morhaim (danmorhaim@gmail.com) served in the Maryland House of Delegates from 1995 to 2019; he is the author of Preparing for a Better End (Johns Hopkins Press).

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Here's how fix E.R. wait times in Md.: Cut hospital executive salaries. A lot. | GUEST COMMENTARY - Baltimore Sun

Yale Global Health Insights Podcast < Yale Institute for Global Health – Yale School of Medicine

The Yale Institute for Global Health is excited to announce the launch of the Yale Global Health Insights podcast, hosted Dr. Sharon Chekijian, Associate Professor of Emergency Medicine, managed by Alyssa Cruz, Associate Communications Officer, and produced by Mike DeMatteo. The podcast explores and uncovers the personal stories and insights of global health faculty at Yale and their partners worldwide. In each episode, Dr. Chekijian reveals their paths, the moments that ignited their interest in global health, the challenges they faced, their triumphs, and the triumphs forces that keep them moving forward.

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Yale Global Health Insights Podcast < Yale Institute for Global Health - Yale School of Medicine

Why emergency services are vital in rural health care – SiouxFalls.Business

Feb. 6, 2024

This paid piece is sponsored by Avera.

The rural lifestyle offers independence, self-sufficiency, fresh air and being miles away from the noise and traffic of the city. Yet just as in an urban setting, the unexpected can happen requiring a fast response to save a life or prevent a serious outcome.

Emergency rooms are so important in rural communities because often its about time. Its about how quickly we can provide lifesaving or life-stabilizing measures until we can get that patient into the right bed at the right facility across the system, said Dr. Kevin Post, Avera chief medical officer.

Avera has 39 24-hour emergency departments across a 72,000-square-mile footprint in portions of South Dakota, Nebraska, Iowa and Minnesota. Almost 90 percent of those EDs are in non-urban settings: small communities and rural towns.

Emergency medicine goes hand in hand with the mission of Avera Health, said Dr. Jared Friedman, clinical vice president of the Avera Emergency Medicine Service Line. We know that the people in these communities deserve high-quality health care. We are there to take care of people at their worst moment. Were there to step in and guide them, whatever they may be going through.

Local emergency room teams must be ready for anything: traumatic injury because of a car accident, farm accident or ATV rollover. Injuries occurring while handling livestock. Stroke or heart attack. Snakebite. Frostbite. Heat exhaustion. Pregnancy and childbirth complications.

At Avera, local emergency teams have the support of the Avera system.

In a region with a large, widely scattered rural population, rapid emergency air transport is essential. Careflight brings state-of-the-art technology to people throughout the region from its base locations in Sioux Falls, Aberdeen and Pierre.

Careflight is a world-class air ambulance system that we are fortunate to have they provide a flying intensive care unit that can take patients to the appropriate care they need, Friedman said.

Helicopters are used for shorter distances because they can land at helipads at rural hospitals or near an accident scene. Fixed-wing planes are used for distances greater than 150 miles or if helicopter transport is limited by weather. Ground ambulances offer critical care during transport to and between medical facilities.

We know that outcomes and peoples lives depend on getting them to a tertiary care center, said Anna Vanden Bosch, assistant vice president of emergency and Careflight for Avera McKennan Hospital & University Health Center. If we can help decrease that out-of-hospital time or provide that level of care they need to bridge that gap, its something thats crucial for our health care system.

In the past year, Careflight provided over 2,600 transports with over 310,000 miles flown.

That feeling of handing them off to a trauma surgeon, ER physician or ICU and knowing you made an impact is what were all about in health care. Theres no better feeling than when youre called to do that, Vanden Bosch added.

The Avera Transfer Center is a centralized hub, serving as a resource for facilities that need to transfer patients to other facilities within the Avera footprint. The transfer center finds the best possible placement for each patient, depending on several factors, including level of care needed for their condition, proximity to home and loved ones, and availability.

We give that patient all the care we can do locally while simultaneously arranging for them to be transported to a higher level of care as needed to get the more advanced procedure, medication or therapy or whatever that need may be, said Lucas VanOeveren, medical director of the Avera Transfer Center.

We like to say that were going to deliver the same care to any patient that comes into any of our Avera emergency departments across the footprint, VanOeveren said. And yet we understand that theres not a neurosurgeon in Britton, South Dakota; theres not a cardiologist in De Smet, South Dakota.

Thats when resources like telemedicine, Careflight or the Avera Transfer Center play a key role in a patients care plan.

What is great about the Avera system is that when a patient or their family walk into one of our rural emergency departments, they should feel the full support of the entire system, Friedman said.

The grit, the heart, the integrity it is incredible how everybody pulls together to make sure we serve that patient well, Vanden Bosch said.

Learn more about Averas commitment to rural health.

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Why emergency services are vital in rural health care - SiouxFalls.Business

Keystone Healthcare Partners Establishes Partnership with Trinity Medical to Expand Emergency Medicine Footprint … – PR Newswire

MEMPHIS, Tenn., Feb. 2, 2024 /PRNewswire/ -- Keystone Healthcare Partners (Keystone Healthcare), a leading provider of emergency medicine, hospital medicine, critical care medicine, andtelehealth staffing and management services, as well as revenue cycle management, recently announced that it has formed a partnership with Trinity Medical in Ferriday, Louisiana. Keystone's delivery of emergency medicine services at Trinity Medical will commence on February 1, 2024.

This contract represents an exciting expansion of Keystone's regional influence into Louisiana; the company has managed contracts in Mississippi for decades. Glenn Adams, Keystone's CEO & Co-founder, notes, "We are excited to kick off another partnership with a client where we see opportunity for real impact. We've hit the ground running to shore up areas of frustration for the client and bring value-add and innovative solutions, such as Keystone Connect AI technology to the emergency medicine program."

While the healthcare landscape has been challenging for rural and critical access hospitals, the two entities share a patient-centered ethos that will be paramount to the partnership. The two entities share a community- and patient-focus that is embodied by Trinity's motto, "People you know, caring for people you love."

"We are very excited to start our partnership with Keystone Healthcare," states Keisha Smith, CEO of Trinity. "My goal for Trinity Medical has always been to provide our patients with the best healthcare and customer service possible in the Miss-Lou area. We feel that Keystone shares the same goals that we have and will be a true asset to our hospital. Henry Ford stated, 'Coming together is a beginning, staying together is progress, and working together is success.' We are looking forward to a long lasting, successful partnership with Keystone Healthcare."

Trinity Medical, a 23-bed licensed facility, continues to grow and upgrade their services and facilities in addition to recruiting physicians to meet the growing needs of their expanding community.

About Keystone Healthcare

Keystone Healthcare is a leading provider of Emergency Medicine, Hospital Medicine, Critical Care Medicine and Telehealth clinical management services and staffing solutions for hospitals. We efficiently deliver high-quality, patient-centered care through strong physician leadership and involved management that drive our innovative and integrated business model.

About Trinity Medical

Trinity Medical is operated by Concordia Parish Hospital Service District No. 1. Trinity Medical, formerly Riverland Medical Center, opened in 1964 as Concordia Parish Hospital and has continuously served the residents of the area for more than 55 years.

In addition to emergency and acute care, Trinity Medical offers surgical services, diagnostic imaging, infusion center, cardio-respiratory care, gastroenterology, lab services, otolaryngology, urology, and an in-hospital rehabilitation service as well as an extensive range of out-patient services, both diagnostic and for treatment.

Media Contact: (901) 795-3600, [emailprotected].:

SOURCE Keystone Healthcare Partners

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Keystone Healthcare Partners Establishes Partnership with Trinity Medical to Expand Emergency Medicine Footprint ... - PR Newswire

Assessing Medical Emergency E-referral Request Acceptance Patterns and Trends: A Comprehensive Analysis of … – Cureus

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Assessing Medical Emergency E-referral Request Acceptance Patterns and Trends: A Comprehensive Analysis of ... - Cureus

Patient Outcomes in Helicopter Emergency Medical Service Documentaries and on Air Ambulance Websites – Cureus

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Please choose I'm not a medical professional. Allergy and Immunology Anatomy Anesthesiology Cardiac/Thoracic/Vascular Surgery Cardiology Critical Care Dentistry Dermatology Diabetes and Endocrinology Emergency Medicine Epidemiology and Public Health Family Medicine Forensic Medicine Gastroenterology General Practice Genetics Geriatrics Health Policy Hematology HIV/AIDS Hospital-based Medicine I'm not a medical professional. Infectious Disease Integrative/Complementary Medicine Internal Medicine Internal Medicine-Pediatrics Medical Education and Simulation Medical Physics Medical Student Nephrology Neurological Surgery Neurology Nuclear Medicine Nutrition Obstetrics and Gynecology Occupational Health Oncology Ophthalmology Optometry Oral Medicine Orthopaedics Osteopathic Medicine Otolaryngology Pain Management Palliative Care Pathology Pediatrics Pediatric Surgery Physical Medicine and Rehabilitation Plastic Surgery Podiatry Preventive Medicine Psychiatry Psychology Pulmonology Radiation Oncology Radiology Rheumatology Substance Use and Addiction Surgery Therapeutics Trauma Urology Miscellaneous

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Patient Outcomes in Helicopter Emergency Medical Service Documentaries and on Air Ambulance Websites - Cureus