Abstract
Background
As part of the growth of emergency medical care in our state, our university-based
emergency medicine practice developed a network of affiliated emergency department
(ED) practices. The original practices were academic and based on a faculty practice
model; more recent network development incorporated a community practice model less
focused on academics.
Objective
This article discusses the growth of that network, with a focus on the recent addition
of a county-wide two-hospital emergency medicine practice. During the transition of
the two EDs from a contract management group to the university network, six critical
areas in need of restructuring were identified: 1) departmental leadership, 2) recruitment
and retention of clinical staff members, 3) staffing strategies, 4) relationships
with key constituents, 5) clinical operations, supplies, and equipment, and 6) compensation
structure. The impact of changes was measured by comparison of core measures, efficiency
metrics, patient volumes, admissions, and transfers to the academic medical center
before and after the implementation of our practice model.
Conclusion
Our review and modification of these components significantly improved the quality
and efficiency of care at the community hospital system. The consistent presence of
board certified emergency physicians optimized utilization of clinical resources in
the community hospital and the academic health system. This dynamic led to a mutually
beneficial merger of these major state healthcare systems.
Keywords
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References
- Report of the regionalization of acute care services task force.American College of Emergency Physicians, Irving, TX2009
- Division of Medical Sciences, National Academy of Sciences.Accidental death and disability: the neglected disease of modern society. National Academy of Sciences, Washington, DC1966
- Optimal trauma outcome: trauma system design and the trauma team.Emerg Med Clin North Am. 2007; 25: 643-654
- Regionalizing emergency care: workshop summary.The National Academies Press, Washington, DC2010
- The future of emergency care in the United States health system.The National Academies Press, Washington, DC2006
American Academy of Emergency Medicine. Position statement on emergency physician-to-patient ED staffing ratios, February 2001. Available at: www.aaem.org/positionstatements/physiciantopatient.php. Accessed July 12, 2010.
- Relational coordination: coordinating work through relationships of shared goals, shared knowledge, and mutual respect.in: Kyriakidou O. Ozbilgin M. Relational perspectives in organizational studies: a research companion. Edward Elgar Publishing, Northampton, MA2006
- ACEP emergency ultrasound guidelines—2001.Ann Emerg Med. 2001; 38: 470-481
- Compensation arrangements for emergency physicians.Ann Emerg Med. 2005; 46: 104
Article info
Publication history
Published online: August 29, 2011
Accepted:
May 25,
2011
Received in revised form:
December 31,
2010
Received:
October 14,
2010
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
