Future of Emergency Care Dissemination Workshop Summaries (2007) / Chapter Skim
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5 Workshop in New Orleans, Louisiana
5 Workshop in New Orleans, Louisiana
Pages 60-79
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From page 60... ...
The workshop began with opening remarks from Alan Miller of Tulane University. He welcomed attendees and emphasized the importance of visitors coming to New Orleans to witness the recovery from Hurricane Katrina and taking note of the work that still needs to be done.
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From page 61... ...
Senator Vitter noted that he is a cosponsor of the Access to Emergency Medical Services Act, which would provide liability protection and increase compensation for emergency providers. Finally, Senator Vitter discussed the movement toward pay for performance under Medicare, advocating for a system in which physicians receive higher reimbursement for reporting quality measures.
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From page 62... ...
Ms. Stone-Griffith said that the key messages of the IOM reports are that the system is fragmented and underfunded, and that regionalization of emergency care is needed.
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From page 63... ...
Dr. Moises noted that the IOM reports may raise the awareness of policy makers to these issues.
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From page 64... ...
supports the IOM reports and is working in Washington, DC, to try to move forward with some of the recommendations. He also noted that, despite all the problems in the system, emergency physicians and nurses work in EDs by choice.
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From page 65... ...
Third, the reports call for a considerable amount of new funding; however, there is a need to look at alternative models for emergency care that could be developed in the absence of new funding. Finally, he expressed strong support for a federal lead agency for emergency care in the Department of Health and Human Services (DHHS)
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From page 66... ...
Alliance of Emergency Medicine highlighted a section of one of the IOM reports on hospital-based emergency care, which said that there are not enough residency-trained, board-certified emergency physicians in the United States to staff all EDs, so physicians from other specialties remain an essential part of the ED workforce.
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From page 67... ...
EMS is in a state of evolution that reflects advances in emergency medicine, the advent of trauma systems, and EMS advocacy at the federal, state, and local levels. It has also benefited from many national reports and studies on EMS, the IOM reports being the most recent.
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From page 68... ...
A STATE PERSPECTIVE Jimmy Guidry, the state health officer of Louisiana, spoke about some of the ongoing initiatives to improve emergency care and emergency preparedness. For the past four years, the state has been working through the legislative process in partnership with EMS, hospitals, emergency physicians, and surgeons, to develop the Louisiana Emergency Response Network (LERN)
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From page 69... ...
ADVANCING PREHOSPITAL EMERGENCY MEDICAL SERVICES The first afternoon session focused on EMS. Four presentations on various EMS issues were followed by an open discussion.
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From page 70... ...
He concluded by saying that the single most important recommendation from the IOM reports is the call for building accountability into the emergency care system. Improving Funding, Reducing Crowding, and Enhancing Disaster Response Kurt Krumperman, senior vice president of federal affairs and strategic initiatives at Rural/Metro discussed three issues that were raised in the IOM reports: EMS financing, ED overcrowding, and disaster preparedness and response.
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From page 71... ...
Finally, he called on DHHS and DHS to host a stakeholder summit to address federal response issues. Implementation of EMS Strategies Drexdall Pratt, head of the Office of Emergency Medical Services, Division of Facility Services, North Carolina Department of Health and Human Services, discussed implementation issues surrounding many of the IOM committee's recommendations for EMS.
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From page 72... ...
Dr. Yancey began his presentation with a quote from the IOM report Emergency Medical Services at the Crossroads: "While EMS systems are frequently organized to address major traumas and serious medical emergencies that are an important part of EMS, they often overlook the fact that the overwhelming majority of EMS patients have relatively minor complaints.
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From page 73... ...
Considerable financial, operational, medical, and emergency preparedness benefits are expected from the ANCC referral program. Open Discussion Bill Brown voiced disagreement with two conclusions drawn in the report Emergency Medical Services at the Crossroads.
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From page 74... ...
Racial Disparities in Emergency Care and Disaster Preparedness Albert Morris, president of the National Medical Association, spoke about how the emergency care system and disaster preparedness pose crucial challenges for minority patients and physicians. In contrast to whites, blacks are more likely to be uninsured, use the ED for primary care, wait longer in the ED, and not receive pain medication.
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From page 75... ...
The National Medical Association's Environmental Health and Bioterrorism Task Force published a series of recommendations to improve disaster preparedness for all citizens, among them: provide specialized disaster training for health care providers, include minorities at all levels of disaster planning and emergency management, ensure that emergency plans specifically address minorities and other vulnerable populations, perform disaster needs assessments of minority and other vulnerable populations, ensure that medical distribution plans can overcome identified access barriers for minorities and other vulnerable populations, and provide culturally relevant disaster materials and resources.
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From page 76... ...
Randy Pilgrim, president and chief medical officer of the Schumacher Group, began his remarks by noting how overwhelming it can be to develop an all-hazards preparedness and response plan with so many different critical components for disaster response and preparedness. Based on his experience working with 37 EDs that implemented disaster plans after Hurricane Katrina and Hurricane Rita, Dr.
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From page 77... ...
Several local physicians reflected on their experience during and after Hurricane Katrina. David Klein, a neurosurgeon and professor at Louisiana State University, discussed three issues of importance after Hurricane Katrina: communications, coordination, and care.
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From page 78... ...
If that team had lacked pediatric expertise and 10 percent of its patients had to be transferred, it would have overwhelmed Houston's hospitals. One of the problems with the DMATs that came to New Orleans is that few included pediatricians or pediatric emergency physicians.
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From page 79... ...
He noted that the day-to-day work of providing care for the sick and injured in the United States is held together by a very fragile system of good will and ingenuity. The IOM committee and many of the workshop presenters provided direction and tools for improving emergency care and disaster preparedness, but now is the time for action.
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