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Quality Improvement and Patient Safety Section Newsletter - July 2016

Taking Aim


Letter from the Chair: Taking a Triple Aim on Emergency Medicine

Jeff PothofThe year was 2008 when Dr. Donald Berwick and colleagues first published the Triple Aim for healthcare.1 Since that time healthcare has had varying degrees of success on achieving those aims. We don’t often talk about the Triple Aim as emergency physicians. It’s not something that comes up frequently in discussions on shift. Emergency physicians, however, are reminded daily the impact of not achieving the aim, the cracks it leaves in our healthcare system and the toll it takes on our patients.

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Sepsis – 3, a New Definition. Solutions or New Problems?

Sepsis-3Before we can discuss the “Sepsis-3” definitions, we need to look back at the history of Sepsis definitions, and what the rationale was leading the authors to create a new definition. Pictured is a brief, albeit non-exhaustive, timeline that visually represents the essentials of sepsis research and innovation over the past few decades. As you can see illustrated above, there has been an enormous, multi-specialty, multi-national approach to the understanding of sepsis care. Sepsis has been and remains a major cause of mortality and morbidity as well as a significant use of health care spending, costing more than $20 billion in the US alone. The severity of the disease is compounded by an increasing incidence. The reasons for this may be due to an aging population with increasing comorbidities, increased recognition and possibly due to changes in coding practices.

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In Situ Progressive Site Interprofessional Simulation as a Tool for Quality Improvement in Transitions of Care

Transitions of care, particularly involving handoffs between different care teams such as the transfer of a patient from the Emergency Department to the ICU, are inherently risky times in patient care. However, tools available to study these transitions are limited. Simulation is well known as a tool for education, but it can also be utilized to “test” a complex hospital system.

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Make a Difference: Write that Council Resolution -- Deadline July 18, 2016

Many College members introduce new ideas and current issues to ACEP through Council resolutions. This may sound daunting to our newer members, but the good news is that only takes two ACEP members to submit a resolution for Council consideration. In just a few months the ACEP Council will meet and consider numerous resolutions.

ACEP’s Council, the major governing body for the College, considers resolutions annually in conjunction with Scientific Assembly. During this annual meeting, the Council considers many resolutions, ranging from College regulations to major policy initiatives thus directing fund allocation. This year there are 394 councillors representing chapters, sections, AACEM, CORD, EMRA, and SAEM.

The Council meeting is your opportunity to make an impact and influence the agenda for the coming years. If you have a hot topic that you believe the College should address, now is the time to start writing that resolution.

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Letter from the Editor

Just in time for some summer beach reading, here it is—the July, 2016 QIPS Newsletter. By the time of this newsletter’s publication, we will have held our most recent conference call on physician wellness. I hope that many of you were able to join and left with some valuable takeaways, but if you were unable to make it, you can view the webinar here. Also, don’t forget that what happens at QIPS…stays at QIPS?? ACEP Scientific Assembly 2016 in Las Vegas is rapidly approaching. Stay tuned for more details about QIPS section meeting. I hope to see you all there.

In this edition of the QIPS Newsletter, we have some great articles for you to enjoy that take aim at a variety of EM quality and patient safety issues. 

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Challenging Patients in the ED: Part 2

Many people come to the Emergency Department because they have pain. Some of them are people that have never been to our ED before and have obvious causes of their pain like a broken hip or an acute appendicitis. Some, however, are familiar faces and have dental pain or abdominal pain that has been present for months.

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Looking Back While Moving Forward: A History of QIPS and Advances in Emergency Medicine Quality

Members, we would like to put a spotlight on one of the section’s previous newsletter issues. Our issue from December 2015 features outstanding contributions from: 

  • Jeff Pothof, MD FACEP, our new section chair who previews upcoming year for QIPS and quality in Emergency Medicine
  • David L. Meyers, MD, FACEP gives insight into some of the outstanding work done in the IOM’s recent report on diagnostic error. With first of a two part series, he introduces the report’s key themes as well as the conceptual model used to approach this important topic. In the second portion of the article, he will walk us through their 8 subsequent recommendations.
  • David P. John, MD, FACEP, one of the founding members of QIPS, recaps his presentation at the section meeting at Scientific Assembly and shares his thoughts on the history of QIPS, and how this section started to become what it is today
  • Sara Damewood, MD, ACEP's Ultrasound Section Ultrasound Simulation Subcommittee Chair, describes a successful approach to achieving an improvement in faculty credentialing of bedside ultrasonography in the ED
  • Michael Lohmeier, MD and Vanessa Tamas, MD tell us about some exciting work that they are doing to improve the recognition of actively seizing pediatric patients transported by EMS.
  • Joshua Zimmerman MD, Colin McCloseky MD, and Kory Gebhardt MD share their work towards improving sepsis screening that resulted in this year’s ACEP QIPS Resident Quality and Safety Award

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