Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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There are widespread and growing concerns about the variable and too often inadequate quality of health care in the United States. As a result, health care quality is being questioned and subjected to scrutiny as never before. ⋯ Emergency medicine will definitely be affected by the quality improvement movement and should quickly move forward to define and establish performance measures for high-quality emergency care in an era when chronic disease dominates the agenda. Emergency medicine should also aggressively work to operationalize a culture of quality to minimize medical errors, to practice evidence-based medicine, to translate research results into clinical practice in a timely manner, and to establish accountability mechanisms for quality improvement and clinical excellence.
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To determine whether computer-assisted prescription writing reduces the frequency of prescription errors in the emergency department (ED). ⋯ Computer-assisted prescriptions were more than three times less likely to contain errors and five times less likely to require pharmacist clarification than handwritten prescriptions.
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Although acute coronary syndromes (ACS) represent a well-recognized source of morbidity and mortality for patients with cardiovascular disease, evidence-based therapies shown to improve outcomes for ACS are frequently underused in appropriate patients, especially in the emergency department (ED). Despite dissemination of expert recommendations from the American College of Cardiology/American Heart Association (ACC/AHA) and ED-focused recapitulation of them in the emergency medicine literature, significant barriers continue to limit the adoption of guidelines in clinical practice and appear to hinder the use of beneficial therapies and interventions in the ED. Unique and creative approaches are therefore needed to stimulate better adherence to practice guidelines and improve the quality of care for patients with non-ST-elevation myocardial infarction (NSTE) ACS. ⋯ This initiative represents a truly innovative approach to improving care for ACS patients in the ED as well as on the cardiology service. This article describes the CRUSADE initiative and its implications for the practicing emergency physician. It is the intent of CRUSADE to improve patient care in the ED by tracking and encouraging compliance with evidence-based guidelines for the evaluation and management of NSTE ACS.
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Professionalism, long a consideration for physicians and their patients, is coming to the forefront as an essential element of graduate medical education as one of the six new core competency requirements of the Accreditation Council for Graduate Medical Education (ACGME). Professionalism is also integral to the widely endorsed Model of the Clinical Practice of Emergency Medicine (Model). ⋯ A focused Consensus Group addressed the specific core competency of professionalism during the course of this conference, and the results are highlighted in this article. The definition and curricular requirements relating to professionalism are highlighted, specific techniques for evaluating this core competency in EM are reviewed, and recommendations are provided regarding the most appropriate assessment method for EM programs.