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Emergency Department Collaborative (2006-2007)

The Maryland Patient Safety Center (MPSC) Emergency Department (ED) Collaborative ,conducted in 2006 and 2007, included hospitals throughout the state of Maryland. Twenty-nine  multi-disciplinary teams representing over half of the hospitals in the state are working towards achieving a broad spectrum of ambitious goals geared towards ensuring that the sickest ED patients get the care they need quickly, and that all patients are cared for in a timely manner with the smallest possible exposure to preventable healthcare associated harm. As a starting point, the collaborative teams are implementing a series of change strategies that have been recommended in the scientific literature or reported as successful by other hospitals. These strategies are included in the Improvement Guide [pdf]

Workshop II [pdf]
Read about the stories shared at the second collaborative workshop.

Strategies for the Improving Treatment of Sepsis Patients [pdf]
The sepsis bundle is one of the most highly selected areas of focus in the collaborative. In order to provide teams with expertise and resources needed to tackle this initiative, we hosted a sepsis workgroup call in May 2006 with Nathan Shapiro, MD, an emergency physician at Beth Israel Deaconess Medical Center.

Strategies for Handling the Psychiatric Patient Population [pdf]
Many collaborative teams have noted that the increased numbers and disposition times for psychiatric patients have negatively affected access to emergency medical care for all patients, causing longer wait times, limiting the availability of hospital staff and decreasing the number of available emergency department beds. Despite this pressure, many departments in the collaborative have developed innovative ways to improve the care and safety of psychiatric patients.  The collaborative team call held in July 2006 provided an opportunity to share these ideas.

Holding Orders and Hospitalists in the Emergency Department [pdf]
The Emergency Department (ED) Collaborative held a team conference call that focused on two interventions identified as useful strategies to smooth flow and improve patient safety: holding orders and hospitalists.

Handoffs and Transitions in the Emergency Department Setting [pdf]
Improving communication at hand-offs and transitions in care have not been the subject of intense study or research within healthcare but has recently come to the fore as a potential tool for improving safety within the clinical setting. The most recent research into this area suggests that sign-overs are a double-edged sword, providing opportunities for failures but also for rescue and recovery. In order to provide collaborative teams with an opportunity to learn from our faculty and other collaborative teams, we hosted a call in September 2006 to discuss strategies that lead to more effective handoffs among staff and units in the hospital. This summary is intended to share this discussion and lessons learned from that call.