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Quality Improvement & Patient Safety Section Newsletter - March 2012

Chair’s Letter

Heather Farley

Killing the Pain without Killing Our Patients

Did you know that prescription opioids kill more people than heroin and cocaine combined1?  In some states, drug related deaths even outnumber traffic fatalities. What is your ED doing to manage its role in the growing prescription drug abuse epidemic? 

In a November 2011 publication on this topic, CDC researchers reported that opioid analgesics were involved in 73.8% of prescription-drug overdose deaths in 2008, a per capita rate almost 4 times that recorded in 19991.   Check out where your state stands on overdoses of prescription opioid medicines at: ).   

A 2010 study reported that nearly 5% of the U.S. population ≥ 12 years old have used opioid pain relievers for non-medical reasons2.  In addition to fueling addiction and subsequent overdoses, the rise in prescription opioid use has led to startling increases in pharmacy thefts and other related drug-fueled crimes. It’s no wonder- a typical bottle of 100 oxycodone 30 mg pills might cost patients with insurance only $15 at the pharmacy. On the street, the bottle is worth upward of $2,000, with individual pills sold for as much as $50 each.

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Editor’s Note


In this edition of the QIPS Newsletter we include a number of relevant issues facing ED quality and safety leaders. 

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Thoughts and Commentary on the OP-19 Throughput Measure

A recent thread of emails was shared regarding the new CMS requirements for ED patients who are discharged: OP-19: Transition Record with Specified Elements Received by Discharged Patients.  These emails have been made anonymous, annotated from first to last, and included in this newsletter for other readers to consider.

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QIPS TIPS # 12: Cueing

Dr. Dickson CheungShari Welch

An ED visit consists of a series of critical healthcare encounters and events. Each encounter or event involves the placement of the patient into a waiting line or queue.

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Consulting for Dummies

Consult : To seek another's disapproval of a course already decided on.
Ambrose Bierce, The Devil's Dictionary, 1881  

When did you learn how to call a consult?  Think hard…Was it in medical school?  Residency?  Maybe it was as a junior attending.  I’ll be honest-- I do not think I ever formally learned.  I just watched others do it, used my intuition, and picked up the phone.  Listening to a good consult is kind of like recognizing that patient that is about to crash--you don’t know why or how, but you just know.  And just as sure as that patient is going to crump as soon as you walk into the room, a bad consultation will leave you feeling dark and lonely for the rest of your shift.

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Every Cloud Has a Silver Lining

You know the old adage…every cloud has a silver lining.  Sometimes that can be true.  In an effort to improve our laboratory processes, a new system was recently installed at our institution.

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EMPSF 2nd Annual Emergency Care Patient Safety Summit

Please plan to attend the EMPSF 2nd Annual Emergency Care Patient Safety Summit: From Insights to Outcomes – Getting Results! March 22-23, 2012 at the Marriott Riverwalk Hotel in San Antonio, TX.

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Quality and Safety Articles


Here is a selected list of recent articles for your interest. These are distributed by AHRQ PSNet.

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