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David Callaway, MD, MPA - Team Rubicon's Chief Medical Officer - is an ER doctor's ER doctor. Dr. Callaway boldly leads his teams to deliver excellent and compassionate patient care, whether in Charlotte or in war zones. #BAFERD From ACEPNow's interview, "This Emergency Physician Leads Next Generation Through Service", by Dr. Aisha Terry (formerly Liferidge): Dr. Callaway: Emergency physicians are uniquely suited to be leaders. First, we get a lot of practice. On a daily basis, we are placed in situations where we must direct multidisciplinary teams to care for patients, often in high-stress situations. Quickly understanding people’s strengths, weaknesses, and needs becomes second nature to most of us. Second, we are action-oriented. And this piece is important for ACEP—our members are passionate, committed, and want to get stuff done. Nothing builds resilience like action and progress. Finally, we are on the front lines of nearly every major issue facing our country. So naturally people become vested in trying to find solutions—to homelessness, firearm violence, climate change, human trafficking. ACEP can harness this passion for great things. ... I truly believe that being an emergency physician is one of the greatest jobs in the world, and with it comes an even greater responsibility. I’ve always been driven toward opportunities to use health care to build bridges and create stability in unstable areas. Whether it’s clinical and operational, such as directing COVID response for a large health system, or it’s civic minded, like our efforts to ensure safety in voting through an initiative called Healthy Democracy for All. Or when its advocacy informed by science, on topics like climate change and health equity. It all comes back to skills and passions I developed through emergency medicine. Look, my wife euphemistically says I have a “healthy distaste for the status quo.” That is shorthand for being a pain in the butt. But I find crisis response is the ultimate time for innovation—the barriers are down. I’m an optimist; I think that whatever we are doing, we can do it better. #emergencymedicine American College of Emergency Physicians Society for Academic Emergency Medicine American Academy of Emergency Medicine (AAEM) Emergency Medicine Residents' Association (EMRA) Society of Emergency Medicine Physician Assistants (SEMPA) Society of Physician Entrepreneurs Beth Israel Deaconess Medical Center, Atrium Health

On increased risk in A&E minors: 🩼🤕 In my NHSE role I meet with operations teams regularly. A consistent comment relates to increased risk observed in the A&E minors area. 🩼😵 Why this observation? To understand this, we need to first understand A&E scope and workflow. The primary scope of Emergency Medicine (EM) requires the type of clinical work space found in A&E majors & resus (M&R) areas. 🩺😷 It is EM's equivalent of specialty clinic, theatre or cath lab, and without it EM is less effective. (Minor injury/ illness is secondary scope) When patients attend A&E, the process of triage assigns them priority. This process also determines who is better suited to be cared for in M&R. Triage takes place for ambulance and walk-in attendance. 🩼🚑 Patients who require M&R, is reliant on there being space in M&R. But presently EM competes with other specialties for M&R space. 🩼🚑 vs 🏥 This has the same effect as specialties competing for say specialty clinic, theatre or cath lab space: 🤚Some who require that specialised space will not be able to access it in a timely way. 👉 This increases risk. Patients with high risk attendance (heart attack or stroke) attend mainly by ambulance, but also by the walk-in route. They always have, this is not new. Low capacity in M&R space means risk is pooled in the area the patient attends to: ambulance or the waiting room. 🩼🚑 As an emergency physician, the balance between assigning risk to M&R from either the ambulance or waiting room queue is conflicting. 🩺🤔 There are tremendous pressure to offload ambulances. Too often some end up in the waiting room. 🚑...👉🩼 The result is more risk pooled in the part of A&E with the lowest staffing, beds & monitoring per patient. 😷 vs 🩼🩼🩼🩼🩼🚑😵 Understanding M&R capacity is crucial to A&E workflow. This requires knowledge of M&R occupancy & flow *by specialty*, to attribute accountability. The simplest way to do this is measure EM & specialty caseload separately: 👉Use referral time/ CRtP as end point for EM, & starting point for specialties in realtime metrics. 👉Measure mean time to disposition. 👉(& if you can) Measure time to first specialty clinician. 📝 Summary: 🩼Increased risk in minors exists mainly due to non-EM M&R crowding. 🩼Individualise delay in M&R in realtime, by specialty, to improve transparency. ❗Sites with weak internal professional values are likely to struggle operationalising the latter❗ Royal College of Emergency Medicine Getting It Right First Time (GIRFT) Emergency Care Improvement Support Team

#DoctorsDay may be over, but we are grateful for our incredible physicians every single day of the year! Today we're spotlighting Benjamin Webster, MD, an emergency medical specialist with Emergency Resources Group at #BaptistJax. Q: When did you begin practicing medicine & how long have you been affiliated with Baptist Health? A: I graduated from the University of Pittsburgh School of Medicine in 2008 & completed my residency at Vanderbilt University Medical Center in 2011. I worked for a year in the Cleveland area before moving to Jacksonville to join Baptist Health & Emergency Resources Group in 2012. Q: How would you describe your specific field of practice? A: I can see a patient of any age, with any problem at any time. We are trained to deal with any emergent or urgent condition, to stabilize your illness/injury & provide definitive treatment or get you into the hands of someone who can. We also provide a great deal of primary care to those who don't otherwise have access to health care. Q: What drove your passion for medicine and led you to become a doctor? A: Growing up, I was always drawn to the life sciences & enjoyed interacting with people. Medicine was the perfect combination. I never really considered anything else. Q: What do you enjoy most about being a physician? A: I enjoy meeting people from every walk of life & the variety that every day in the emergency department brings. I like the fast-paced nature & the ability to see the care I provide make an immediate impact. Q: What is the most significant thing you've learned about caring for patients & the impact you have on their health? A: The biggest thing I've learned is to sit down & be quiet. I've learned that even on my busiest shift, I have 5 minutes to sit down & listen. I find it often leads to less testing because I truly understand the patient's concerns and can allay those fears more efficiently. Q: What does being a physician mean to you and have your feelings about this evolved over the years? A: After being a father and husband, being a physician is the greatest honor in my life. Complete strangers entrust me to care for them or their loved ones, often in their greatest time of need. Q: What would you like others to better understand about your role as a physician? A: My role & efforts extend beyond the bedside. When not directly seeing patients, I & many other physicians work hard to create best-practice guidelines, provide education to other team members, and work to improve the coordination of care between the inpatient and outpatient world. Q: What do you like to do outside of work? A: My wife & I have four wonderful children that keep us running all the time. We spend a lot of our time supporting them at the Apex Theater and the Davis Park baseball/softball fields. I'm currently coaching my son's 6-year-old T-ball team, a true test of patience. I'm a diehard Pittsburgh sports fan, desperate for a winning Pirates team in my lifetime! #BaptistProud

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#DoctorsDay may be over, but we are grateful for our incredible physicians every single day of the year! Today we're spotlighting Benjamin Webster, MD, an emergency medical specialist with Emergency Resources Group at #BaptistJax. Q: When did you begin practicing medicine & how long have you been affiliated with Baptist Health? A: I graduated from the University of Pittsburgh School of Medicine in 2008 & completed my residency at Vanderbilt University Medical Center in 2011. I worked for a year in the Cleveland area before moving to Jacksonville to join Baptist Health & Emergency Resources Group in 2012. Q: How would you describe your specific field of practice? A: I can see a patient of any age, with any problem at any time. We are trained to deal with any emergent or urgent condition, to stabilize your illness/injury & provide definitive treatment or get you into the hands of someone who can. We also provide a great deal of primary care to those who don't otherwise have access to health care. Q: What drove your passion for medicine and led you to become a doctor? A: Growing up, I was always drawn to the life sciences & enjoyed interacting with people. Medicine was the perfect combination. I never really considered anything else. Q: What do you enjoy most about being a physician? A: I enjoy meeting people from every walk of life & the variety that every day in the emergency department brings. I like the fast-paced nature & the ability to see the care I provide make an immediate impact. Q: What is the most significant thing you've learned about caring for patients & the impact you have on their health? A: The biggest thing I've learned is to sit down & be quiet. I've learned that even on my busiest shift, I have 5 minutes to sit down & listen. I find it often leads to less testing because I truly understand the patient's concerns and can allay those fears more efficiently. Q: What does being a physician mean to you and have your feelings about this evolved over the years? A: After being a father and husband, being a physician is the greatest honor in my life. Complete strangers entrust me to care for them or their loved ones, often in their greatest time of need. Q: What would you like others to better understand about your role as a physician? A: My role & efforts extend beyond the bedside. When not directly seeing patients, I & many other physicians work hard to create best-practice guidelines, provide education to other team members, and work to improve the coordination of care between the inpatient and outpatient world. Q: What do you like to do outside of work? A: My wife & I have four wonderful children that keep us running all the time. We spend a lot of our time supporting them at the Apex Theater and the Davis Park baseball/softball fields. I'm currently coaching my son's 6-year-old T-ball team, a true test of patience. I'm a diehard Pittsburgh sports fan, desperate for a winning Pirates team in my lifetime! #BaptistProud

Setting the standard for #PatientSafety with "A" Grade Leapfrog Ratings across an entire health system! As we continue to celebrate Patient Safety Awareness Week, let's recognize Hartford HealthCare for an incredible achievement of earning an "A" Safety Rating from the Leapfrog Group! Pressure injury reduction was cited as a key metric for their "A" grades, so how'd they do it? ✅ Empowered their "Skin Champions" to identify new solutions. ✅ Standardized ICU admission process w/ thermal imaging. ✅ Leveraged anatomy-specific data for early, targeted interventions. ✅ Created a nursing council to provide education on pressure injuries. Check out the full impact story here: https://bit.ly/3TwRIBO #PSAW2024 #PressureInjuryPrevention #woundcare #wocn

"A union for doctors? Physicians at Salem Hospital just created one" - Boston Globe Media Emergency physicians, along with their hospital-based colleagues, voted to form the Salem Physicians Union within Mass General Brigham, Massachusetts' largest healthcare system. From the article: Like many union workers, the doctors in Salem are fighting for a greater voice, but, they say, they are also fighting for something bigger: the ability to push back against corporate power and "take back medicine," as one physician put it. "This is not an MGB problem. This is not a Boston or a Massachusetts problem. This is a nationwide healthcare system problem," said Sean Codier, an emergency room physician at Salem Hospital. "This is something that a local group of physicians can do to try to reassert their voice and reassert our stake in our patient's care." ... The number of physicians who are no longer their own bosses has also risen sharply in recent years. In 2012, less than 6 percent of physicians worked directly for hospitals, according to the American Medical Association. But by 2022, following a surge in acquisitions of physician-owned practices, that share had soared to more than half, with another 22 percent employed by corporate entities such as insurers or private equity firms, according to a Physicians Advocacy Institute study. ... "Physicians need to run their house, but that house has been taken away from us," said ER physician Kelley A. Wittbold, MD, MHCM. "No matter how talented our individual nurses or doctors are, none of us can operate and provide the care that patients really need if we don't create a comprehensive system where it really works for everyone." ... Doctors have become "cogs in a machine designed to maximize return in a field fundamentally designed to alleviate illness," as Sameer Shah, a pulmonary and critical care specialist at Salem Hospital put it. "We are using our voice here to try to advocate for patients to get the care that they deserve on a more systemic level," Shah said. ... #emergencymedicine American College of Emergency Physicians American Academy of Emergency Medicine (AAEM) Society of Emergency Medicine Physician Assistants (SEMPA) Emergency Medicine Residents' Association (EMRA)

🚨Telemetry technicians tasked with monitoring 80 patients at one time 🫀🚨 . A telemetry monitor is a critically important device that continuously monitors the electrical conduction of a patient’s heart. . The device is able to track a patient’s heart rhythm and rate, amongst other things, and can detect any significant changes or abnormal patterns or that represent a threat to patient health. . Telemetry monitors are observed closely by trained healthcare professionals who then sound alarms and notify nursing staff promptly when they visualize unusual or dangerous changes in a patient’s heart rhythm or rate. . Healthcare workers at HCA hospitals report telemetry technicians being responsible for monitoring up to 80 patients at one single time. . This puts patient safety at risk as changes in heart rhythm on the monitoring machine may not be picked up in a timely fashion, simply due to professionals having way too many patients to monitor at one time. . One such tragic example is of patient T.D. who was cared for at HCA’s Wichita, Kansas hospital. . T.D. was on telemetry as he was admitted for a brain bleed. Just prior to discharge to a rehab facility, a sudden turn of events took place. . In the wee hours of the morning, a nurse walking by his room and heard T.D. choking and that he had a weak thready pulse. . When the nurse called the telemetry monitoring room for a cardiac reading, she was told “there is no heart rhythm/rate”, yet no alarms sounded nor none of the nurses were alerted to the fatal change, as would be typical. . CPR (cardiopulmonary resuscitation) was started and a Code Blue called. After 4 minutes of resuscitated efforts, T.D. Was pronounced dead. . The records received from the hospital did not contain the telemetry records from the hours before the event, which is unusual. . With over 180 hospitals across the country, HCA has been cited for similar telemetry-related deaths at hospitals nationwide and many events have been cited in federal and state issued deficiency reports. . As staffing shortages in healthcare deepen and trained and skilled professionals are tasked with caring for patients in unsafe numbers, tragic and potentially avoidable events such as these will occur on a more regular basis. . Our patient’s lives hang in the balance. . (Source: NBC News). . #heart #cardiac #monitoring #patientsafety #nursesonlinkedin _________________________________ Next Level Nurse Consulting, LLC: Providing medical information and valuable healthcare expertise to attorney clients nationwide. 📧 [email protected] 📞 (858) 250-0570 . https://lnkd.in/gWkXGbCN

Nurses in intensive care units may hear as many as 400 alarms per patient daily. Because most are false alarms, there’s a risk they may stop responding to the warnings, jeopardizing patient safety. This “cry wolf effect” can lead to danger, or death, for patients — in at least one reported case, a patient died because some of their alarms had been deactivated. Our own Hossein Piri, assistant professor of operations and supply chain management, recently published a study in Operations Research alongside his colleagues Dr. Woonghee Tim Huh and Dr. Steven Shechter of UBC Sauder School of Business and Dr. Darren Hudson, an ICU physician at the Department of Critical Care Medicine, University of Alberta that presents an algorithm to solve alarm fatigue. The algorithm, embedded into smart alarm systems, personalizes patient alarms, making them more accurate and reducing the frequency of false alarms. Read more about his research and the need to promote patient safety and nurses' well-being: https://ow.ly/5apZ50PM6Ln #HaskayneResearch #research #innovation #businessschool #yyc

This is another example of putting profits over patient safety. It’s a tragic outcome that is predictable and preventable. Healthcare professionals cannot be overburdened and overwhelmed. It takes time and attention to nurture and protect a vulnerable person as they heal. When you are providing healthcare, nurses and those who support nursing are resources you invest - not expenses that you trim.