RESUMEN
Our emergency department had always relied on a paper-based infrastructure. Our goal was to convert to a paperless, efficient, easily accessible, technologically advanced system to support optimal care. We outline our sequential successful transformation, and describe the resistance, costs, incentives and benefits of the change. Critical factors contributing to the significant change included physician leadership, training and the rate of the endorsed change. We outline various tactics, tools, challenges and unintended benefits and problems.
Asunto(s)
Dolor en el Pecho/etiología , Medicina de Emergencia/instrumentación , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Pleuresia/complicaciones , Embolia Pulmonar/sangre , Embolia Pulmonar/diagnóstico , Biomarcadores/sangre , Diagnóstico Diferencial , Medicina de Emergencia/métodos , Humanos , Pleuresia/diagnóstico , Embolia Pulmonar/complicaciones , Medición de Riesgo/métodos , Sensibilidad y EspecificidadRESUMEN
A successful ED relies on its leaders to master and demonstrate core competencies to be effective in the many arenas in which they interact and are responsible. A unique matrix model for the assessment of an ED leadership's key administrative skill sets is presented. The model incorporates capabilities related to the individual's cognitive aptitude, experience, acquired technical skills, behavioral characteristics, as well as the ability to manage relationships effectively. Based on the personnel inventory using the matrix, focused evaluation, development, and recruitment of ED key leaders occurs. This dynamic tool has provided a unique perspective for the evaluation and enhancement of overall ED leadership performance. It is hoped that incorporation of such a model will similarly improve the accomplishments of EDs at other institutions.
Asunto(s)
Servicio de Urgencia en Hospital/organización & administración , Liderazgo , Modelos Organizacionales , Competencia Profesional , Adaptación Psicológica , Humanos , Personalidad , Programas de Autoevaluación , Estados UnidosAsunto(s)
Tratamiento de Urgencia/métodos , Productos de Degradación de Fibrina-Fibrinógeno/metabolismo , Tamizaje Masivo/métodos , Embolia Pulmonar/sangre , Embolia Pulmonar/diagnóstico , Teorema de Bayes , Tratamiento de Urgencia/normas , Reacciones Falso Positivas , Humanos , Tamizaje Masivo/normas , Selección de Paciente , Reproducibilidad de los Resultados , Sensibilidad y EspecificidadRESUMEN
Although the principles of healthcare economics are not usually part of the fundamental education of emergency physicians, an understanding of these elements will enhance our ability to contribute to improved health-care value. This article introduces the practical aspects of microeconomics, insurance, the supply-and-demand relationship, competition, and costs as they affect the practice of medicine on a daily basis. Being cognizant of how these elements create a dynamic interplay in the health-care industry will allow physicians to better understand the expanded role they need to assume in the ongoing cost and quality debate.