September 18, 2019

What's “ED Throughput” Got to do With It?

To paraphrase the iconic singer, Tina Turner, what’s “ED Throughput” got to do with it?

This is a case where the CEDR measure, ED throughput and my personal life intersected two weeks ago at the end of this long and brutal Midwest winter.

An unanticipated fall during my routine morning dog walk with my wife resulted not only in a visit to my local emergency department (I refused to take an ambulance) but also a tri-malleolar right ankle fracture and multiple screws and plate. Even lying there helpless on the gurney, sedated by hydromorphone, I was acutely aware of the organized chaos, sounds, voices, rhythms, lack of privacy- the quintessential grittiness of the ED.

I found myself flipping back and forth between my patient and physician selves during my hours’ long experience in the ED and several day post-surgery hospital sojourn. Acute pain, dependency, lack of privacy, nursing communication, insurance hassles, discharge issues… these were all things I pondered between vital signs, IV checks, and other care routines in the emergency department and hospital.

So there can be a personal connection between CEDR and one’s personal health and life.

Indeed, existing on both sides of the doctor-patient fence has given me an unexpected opportunity to observe emergency care, hospital acute care and clinical quality improvement and its measurement through a different lens. It only redoubles the imperative of the CEDR team and leadership to answer the challenge “what’s CEDR got to do with it?” both on behalf of us who do emergency care and us who may someday be patients.

This issue highlights a number of different CEDR themes and updates from the CEDR team staff and leadership: continuing robust growth and growing pains of operations, ongoing measure updates and changes, strategic planning and visioning, personnel roles and transitions, regulatory advocacy, and specific measure education.

Abhi Mehrotra, CEDR Committee Chair, offers his leadership perspectives and insights on current CEDR issues.

  • Kelly Burlison, Quality Project Manager updates us on 2019 measure changes and developments.
  • Team Spotlight: Nalani Tarrant, MPH, PMP, current senior manager project manager, E-QUAL, will become the Director of Quality Collaboratives, Data & Quality Measures. In her new role she will provide leadership and oversight to measure development in the Quality Department.
  • Bill Malcolm, CEDR Operations Manager updates current robust growth and collaborative initiatives with FIgmd to improve data extraction.
  • Jeffrey Davis, Director, Regulatory Affairs, our new contributor, pulls back the curtain on a critical but not well publicized- aspect of CEDR: ACEP advocacy with the federal regulators
  • Pawan Goyal, Associate Executive Director, Quality Division comments on the recent joint ACEP and EMF Data Summit and upcoming ACEP Health IT Summit in July, 2019, Objective of the summit theme “Evolving Emergency Care with Technology” is to create an ACEP-industry collaborative 10-year vision and tactical 3-year roadmap for the future of emergency medicine
  • Don Lum, Outreach Sub-committee Chair, comments on preparation for 2018 participant group experience survey and service improvement plan and early groundwork to build and launch the CEDR participant group community, an initiative to promote interactive communication and networking.
  • Adam Rodos, ACEP Fellow, reflects on a pioneer in clinical decision support and imperative for informatics expertise in the training of future physician leaders.
  • Rural ED Corner highlights success stories of E-QUAL and CEDR implementation by rural/critical access hospital emergency departments.
  • Nicholas Genes, MD, PhD, Clinical Informatics & IT Digital Health, our regular contributor on measure education, bravely goes under the hood once again to explain everything we need to know about the CEDR measure “Tobacco Screening and Cessation Intervention” (ACEP-25).

As always, please reach out to us with any comments, concerns, requests for further information/resources or feedback.