Providing Online Reference Library Realizes 0% Morbidity
Shortly after hire, Temple University purchased the hospital. A nursing strike followed the merger along with resignation by the CEO and a drastic decline in available hospital resources caused a lack of communication and support. The acquiring company terminated striking nurses, which further heightened the sense of chaos and distrust. As a new administrator, only several years out of residency, forced to functional beyond the initial job description and personal experience to keep the ER functioning.
Appealed to the medical staff and administration to champion for the needs of the Emergency Department. Served as administrator on call for transferring critically ill patients to other facilities with intensive care capability. Provided staff support in managing the critically ill patients too sick to transfer.
Named the Interim Chair to maintain full functionality of the ER pending a search committee finding a permanent replacement. Maintained a zero mortality and morbidity rate.
Instituting New Electronic Systems Improves Services
The company fired striking nurses and many department heads tendered resignation. Named as the Interim Chair; however, many of the internal consultants and resources the Emergency Department relied on left. Personal time constraints compounded by a lack of financial resources to offset the loss of staff impeded improvement. Pursued and implemented electronic bilingual discharge instruction system to replace the handwritten directions. This greatly enriched patient understanding and physician liability. Set up an online reference library that including links to MEDLINE, MICROMEDEX and various physician reference manuals and texts that helped counterbalance the loss of the internal consultants. The system delivered the needed data, predating universal database systems available now via the internet.
Negotiating Transport Program Secures 0% Morbidity Rate
The mayor and senate representative addressed pressure from the community to fund the reopening of the Medical College of Philadelphia. Unfortunately, following the election, the promised funds never materialized. Clients presenting to the ER and admitted did not generate the required revenue to keep the hospital and ER open.
Leveraged relationships with private ambulance services and negotiated contracts to facilitate the safe transfer of critical patients from the ER to medical facilities able to deliver adequate care. Arranged for stationed, dedicated ambulances at the Emergency Department.
With approximately 70 patients transported daily in the first few months, the program achieved a 0% mortality rate. Opened a fully functioning Emergency Department, however funds dissipated and a complete shutdown occurred. Stabilized all presenting patients for transfer to adjoining hospitals.
Convening Commission Of Multiple Directors Enhances Level Of Care
An American College of Surgeon's consensus paper updated the suggested care of potential pre-hospital spinal cord injury patients. Local systems adhered to outdated policies and frequently, multiple agencies engaged in mutual assistance. Numerous medical directors and various agencies hampered improvement. Hospitals expected a specific level of care. Deviating from the standard, yet antiquated system led to vexation and confusion at the receiving facilities.
In conjunction with the Chief of Mt Laurel EMS, contacted and convened a committee composed of all the medical directors in the county. A commission such as this never existed previously.
The consistency of care improved and the effort created a forum for future policy development among the various agencies. Approximately 80% of all EMS agencies participated in the group covering the southern part of New Jersey. The initiative dramatically cut the misuse of backboards and reduced inappropriate use.
Launching New Business Services 65,000+ Patients
A law passed in Pennsylvania requiring physician oversight of all ambulance services. The opportunity arose for a formal business to take advantage of the new law.
Leveraged personal network of peers, friends and colleagues in business, tax accounting and legal industry for advice. Learned the necessary skills in web design, blogging, web development and search engine optimization as well as ideas to surmount anticipated obstacles.
As a result, launched a highly successful private venture company that since grew to services far beyond the Delaware Valley, including national presence as far away as Washoe County, Nevada. That county consisted of a multi-level care, 13-agency system including fire, contract and stakeholder organizations with 6,550+ square miles and 430,000+ residents. Worked to develop a regional protocol for the delivery of pre-hospital patient care for all agencies in that county.
Implementing Computer System Decreases Physician Liability
Paper charting, the standard at the hospital at that time, determined as the reason for a 90% rate of down coding and reimbursement compared to the care provided. The handwritten chart notes and discharge instructions in a predominantly Spanish community led to noncompliance and increased physician liability. A lack of guidance on documentation requirements to maximize billing existed.
Led the initiation and implementation of computerized bilingual patient discharge instructions to enhance patient understanding while reducing physician liability.