Editor's Note

By Jeffrey Pothof, MD

In our first newsletter since returning from Scientific Assembly in Seattle, WA, I am happy to report that the QIPS section meeting was well-attended, and the view from the meeting room was nothing short of spectacular! Keynote speaker, Kevin Baumlin, MD, FACEP gave a presentation on Emergency Department Information Systems (EDIS) and Meaningful Use titled “Information Technology and Quality Improvement:  A Courtship or a Marriage?” He also highlighted key takeaways from the QIPS/EMI joint section grant white paper, “Quality and Safety Implications of Emergency Department Information Systems.”

This year’s Resident Quality Improvement Award went to William Fleischman, MD from the Icahn School of Medicine at Mount Sinai for his quality improvement project titled “Reducing Alarm Fatigue in the Emergency Department.”

As many of you may have heard by now, ACEP is participating in the ABIM Foundation’s Choosing Wisely campaign.  The press release can be found here.

The five recommendations for shared-decision making are:

  1. Avoid computed tomography (CT) scans of the head in emergency department patients with minor head injury who are at low risk based on validated decision rules.
  2. Avoid placing indwelling urinary catheters in the emergency department for either urine output monitoring in stable patients who can urinate on their own, or for patient or staff convenience.
  3. Don't delay engaging available palliative and hospice care services in the emergency department for patients likely to benefit.
  4. Avoid antibiotics and wound cultures in emergency department patients with uncomplicated skin and soft tissue abscesses after successful incision and drainage and with adequate medical follow-up.
  5. Avoid instituting intravenous IV fluids before doing a trial of oral rehydration therapy in uncomplicated emergency department cases of mild to moderate dehydration of children.

Contributors to this newsletter include:

  • David L. Meyers, MD, FACEP with his thoughts on attending the first international conference on “Preventing Overdiagnosis” and the Society to Improve Diagnosis in Medicine’s (SIDM) 6th annual conference, “Diagnostic Errors in Medicine (DEM): Define, Measure, Improve.” Balancing, over-testing and under-testing is something we all encounter on a daily basis across Emergency Departments in this country.
  • Mark J. Jaben, MD has contributed an article, “Good Metrics Gone Wrong” which points out the pitfall of attempting to improve a metric without considering the root cause of the problem.
  • Carol McCammon, MD, FACEP discusses opiate diversion in the Emergency Department.  Her article brings to life an issue that few of us are thinking about in day-to-day practice, and provides useful tips on recognizing this dangerous behavior.  It is certainly a must read.
  • Dickson Cheung, MD, MBA, MPH, FACEP, one of the founders of the QIPS section, takes us on a stroll down memory lane with the past and present of the QIPS section and the significant contribution the section has had on shaping the practice of emergency medicine.


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