There are few words in the business world open to as much interpretation as integration. In health care, the word is suddenly ubiquitous. It’s part of the language of health care’s brave new world. And it leaves oh so many details shrouded in mystery.

The new integrated acute care program at US Acute Care Solutions (USACS) has proven it can achieve dramatic results at two pilot locations in Pennsylvania, with left without being seen rates falling from 1.2 to 0.3 percent averaged over five months since implementation. Over the same period, arrival to provider time and length of stay for discharged patients also saw significant drops. Length of stay for admitted patients has fallen by 18 hours. More...

Oh, 2016. What a year it was! Whatever words or sentiments you choose to ascribe to The Year 2016, it was nothing if not consequential. What is true for the world and for the country in 2016 was also true for US Acute Care Solutions. In the past 18 months, USACS has roughly doubled in size. We closed out this year with another huge announcement, the addition of Texas-based ESP as a founding partner. It has been a year of enormous consequence for USACS - perhaps its most consequential ever. More...

I probably set a record for the earliest a physician ever burned out: less than a year after earning my MD. Some may not call it burnout; it could just as well be called “internship.” I call it burnout because beyond the exhaustion and can’t-take-it-anymore, there was a gnawing sense that something fundamental was missing — something that no amount of time would fix. More...

“8-month old cardiac arrest. ETA 10 minutes.”

Of all the cases we see, a pediatric SIDS death is without question the most difficult to bear. I recently cared for a child who a few hours earlier was a happy and playful infant and now arrived in cardiac arrest, pale and lifeless. Despite our usual resuscitative efforts, the child did not survive. In reality, when the medics were called out the child was likely already gone. More...

A few weeks ago, we received a letter from a patient who had recently been treated at one of our integrated acute care locations at Somerset Hospital. The patient had come to the emergency department and was ultimately admitted to the hospital. The letter detailed how grateful he was that the same physician assistant who had seen him in the ED also treated him in the hospital. The patient didn’t have to tell his story over again to a new provider once he’d been admitted, and there was no confusion about any of the care he’d just received. Handoffs, which normally occur between different groups, one in the ED and the other on the hospitalist side, have gone from riddled with delay and prone to communication breakdown, to smooth and uneventful. More...

Four years ago, I was having a conversation with a friend of mine. We had graduated residency the same year and our careers had taken us to different parts of the country. It was ACEP 2012. We’d been mingling with old friends and current colleagues, and the conversation turned to kids. More...

When I began my career some 25 years ago, my measure of success was pretty simple: take better care of my patients. The average emergency medicine clinician will treat 75,000 patients over a 25-year career. That’s a staggering number of lives to touch.
 
At some point early in my career, I realized there were different ways to serve patients. For me, it began as helping to establish a pediatric emergency department where none existed. So instead of impacting 3,000 patients a year, I’ve helped influence the care of over 15,000 children by building a better system of care at one hospital. More...

Emergency physicians know well the realities of evidence-based guidelines in emergency departments throughout the country: either there is wide variability in their use and uptake, or there just aren’t any evidence-based guidelines.

Patients don’t often think about it when choosing emergency departments - they mostly think about the wait time - but it’s there. Two patients, each with the same complaints and same risk factors may get completely different treatments depending on which emergency department they walk into. More...

When is peak recruiting season for emergency medicine residents? It depends. Everyone knows about when it starts and roughly when it ends. The first residents to sign usually do so in the summer, and the last are usually picking up the rear sometime in January (on the East Coast, that is).
 
But it's that start of the season that changes from year to year. Sometimes it starts early, with a rush of residents signing in June and July. Sometimes, though, it all seems to start a little later, with the rush coming in September. More...