Toward the Painless Toward the Painless Emergency Department Emergency Department Robert W. Strauss, M.D., FACEP Robert W. Strauss, M.D., FACEP ACEP Scientific Assembly ACEP Scientific Assembly San Francisco San Francisco October 20, 2004 October 20, 2004
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Toward the Painless Emergency Department Robert W. Strauss, M.D., FACEP ACEP Scientific Assembly San Francisco October 20, 2004.
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Toward the Painless Toward the Painless Emergency DepartmentEmergency Department
Robert W. Strauss, M.D., FACEPRobert W. Strauss, M.D., FACEPACEP Scientific AssemblyACEP Scientific Assembly
San FranciscoSan FranciscoOctober 20, 2004October 20, 2004
Arrival to physician time (door to Dr.)Arrival to physician time (door to Dr.) Boudreaux AEM(s)10/03 (High acuity more satisfied)Boudreaux AEM(s)10/03 (High acuity more satisfied)
Turn-around-timeTurn-around-time Advisory Board – Patients get care 20% of stay Advisory Board – Patients get care 20% of stay
Caring, comforting and informingCaring, comforting and informing
Arrival to physician time (door to Dr.)Arrival to physician time (door to Dr.) Boudreaux AEM(s)10/03 (High acuity more satisfied)Boudreaux AEM(s)10/03 (High acuity more satisfied)
Turn-around-timeTurn-around-time Advisory Board – Patients get care 20% of stay Advisory Board – Patients get care 20% of stay
Caring, comforting and informingCaring, comforting and informing
Specific approaches to presenting problemsSpecific approaches to presenting problems Usable pain scalesUsable pain scales Rapid use of analgesicsRapid use of analgesics
Collaborate in research protocols Collaborate in research protocols Show relationship between PM and Show relationship between PM and
satisfactionsatisfaction Which PMOs – those using P-GWhich PMOs – those using P-G Incorporate pain reduction in EMRsIncorporate pain reduction in EMRs
RRC – EM ApproachRRC – EM Approach Change program requirements?Change program requirements?
Slow processSlow process Reticence to adding specific requirementReticence to adding specific requirement
Incorporate into the competenciesIncorporate into the competencies Which ones?Which ones? Provide programs with tools they need to Provide programs with tools they need to
demonstrate competencies demonstrate competencies
ABEM - ModelABEM - Model Current lack of focus on PMCurrent lack of focus on PM
All examples relate to pain presentationsAll examples relate to pain presentations Pain only mentioned 9 times in contentPain only mentioned 9 times in content Appendix – Procedures and Skills – “Other”Appendix – Procedures and Skills – “Other”
If a focus is createdIf a focus is created Programs will teach itPrograms will teach it ABEM will test itABEM will test it
Add to the LLSA reading list Add to the LLSA reading list
ACEPACEP Submit education proposalsSubmit education proposals Create a section on Pain ManagementCreate a section on Pain Management
ACEP staff supportACEP staff support Notice by membersNotice by members Seat at the councilSeat at the council Opportunity to propose / promote resolutionOpportunity to propose / promote resolution Influence committee objectivesInfluence committee objectives