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WA-ACEP Joins Amicus Brief to Address Boarding of Psychiatric Patients in EDs
Washington ACEP joined the Washington State Medical Association, Washington State Hospital Association and Washington Emergency Nurses Association in an amicus curiae brief in a case related to boarding psychiatric patients. The case was recently accepted for review by the Washington State Supreme Court.
The question before the Court is whether patients in need of mental health treatment can be detained against their will while they are not receiving meaningful mental health treatment. The plaintiffs are challenging the commitment process whereby patients are declared in need of involuntary inpatient psychiatric treatment, but because no psychiatric beds are available, the patients are housed in emergency departments or other locations where no such treatment is available. The State's position has been that some "treatment" in emergency departments is better than the patients staying on the streets as a danger to self or others.
The underlying problem is that the state budget for mental health treatment has been cut deeply over many years. Hospitals board the patients because there is nowhere else for them to go; beds are not available at evaluation and treatment centers or at the two state psychiatric hospitals. As a result, emergency physicians and staff are forced to grapple with the complex psychiatric needs of patients.
The case could significantly impact the way Washington state funds treatment of involuntarily committed patients with psychiatric conditions. The case is on an expedited schedule; the Court will hear oral arguments June 26.
WASHINGTON'S LACK OF SUPPORT FOR EMERGENCY PATIENTS RECEIVES A NEAR-FAILING D+
Washington dropped to 35th place in the nation with a D+ in the American College of Emergency Physicians (ACEP) America's Emergency Care Environment: A State-by-State Report Card released January 16. In 2009, the state ranked 19th in the nation with a C. While our State ranks in the top 10 in the categories of Public Health and Injury Prevention, and Quality and Patient Safety, Washington received failing grades in three out of five categories.
• Access to Emergency Care - F
• Quality & Patient Safety Environment - B
• Medical Liability Environment - F
• Public Health and Injury Prevention - A
• Disaster Preparedness – F
Since 2009, our State did improve its overall ranking in the category of Access to Emergency Care. Washington still received a failing grade in this category, in part because of a severe lack of resources and inpatient capacity for mental health patients. The state also has some of the lowest levels in the nation of staffed inpatient and intensive care unit beds. To improve our grade, Washington must make greater investments in hospital infrastructure and mental health care, according to the Report Card. Read more.
The Report Card evaluates conditions under which emergency care is being delivered. The Report Card does not measure the quality of care provided by hospitals and emergency providers. For more information, please visit the links below:
What you can do to help Emergency Medicine in Washington State:
• Send the WA-ACEP Press Release to your local media outlets. Please contact the WA-ACEP office if you need media information.
• Use the talking points to draft a Letter to the Editor for your local newspaper. Please coordinate this effort with the WA-ACEP office.
• Contact your State House and Senate Members. Reference the talking points "Solutions" in your message.
ACEP JOINS CHOOSE WISELY
The College announced at the annual meeting that it has joined the Choosing Wisely campaign. ACEP released its list of five tests and procedures that may not be cost effective in some situations and should prompt discussion with patients in order to both educate them and gain their agreement regarding avoidance of such tests and procedures, when appropriate. Learn more. View the WA-ACEP Choosing Wisely Powerpoint Presentation for more information.
ACEP13 in Seattle: Largest Attendance in the Meeting's History
Although ACEP13 has ended and the more than 7000 attendees have departed Seattle, the buzz from the meeting will linger and remain palpable over the coming year. Because of your support, attendance, and leadership, ACEP13 is now THE most successful ACEP conference ever! Thank you! Attendance at the kickoff party and our own Space Needle reception marked record-setting numbers as well.
The visibility, credibility, and respect garnered will serve this chapter well for many years. Thank you for your continued support of the Chapter, College and Emergency Medicine!
Mrs. Wilkerson, ACEP Executive Director Dean Wilkerson, Washington Lt. Gov Brad Owen and WA-ACEP Past President Steve Marshall at the WA-ACEP Space Needle Reception during ACEP13.
ACEP13 Sets Records!
ACEP13 held in Seattle during October set four-day attendance records that exceeded 7000 members! In fact, ACEP13's Opening Party at Seattle Center and Closing Reception at the Museum of Flight had the highest attendance of any similar type events in the meeting's history.
The WA delegation poses with ACEP Staff, Dean Wilkerson, Sonja Montgomery and Craig Price.
Other highlights of the meeting:
• Three Resolutions were approved by the national Council
• WA ACEP members served on a national Pre-Conference Workshop and 10 national Committees
• WA ACEP Journal Club went national as Drs. Enrique Enguidanos and Stephan Anderson presented a medical marijuana session
• Members of the WA ACEP Board of Directors were able to talk in person with national ACEP staff on the Fair Billing Issue, Regionalization of Care, research on the impact of the legalization of marijuana on emergency departments, nationalization of an Opioid Prescription Monitoring System, and upcoming release of the National Report Card on the State of Emergency Medicine.
Because of your support and attendance, ACEP13 is now THE most successful ACEP conference ever!
RAND: ER Docs are Key to Reducing Health Care Costs
Emergency physicians are key decision makers for nearly half of all hospital admissions, highlighting a critical role they can play in reducing health care costs, according to a new report from the RAND Corporation. Download a free copy of the RAND report.
Hospital admissions from the ER increased by 17 percent over seven years, accounting for nearly all the growth in hospital admissions between 2003 and 2009. Hospital inpatient care is a key driver of health care costs, accounting for 31 percent of the nation's health care expenses.
"This report tells policymakers and hospital administrators that they should pay closer attention to the role that emergency physicians play in evaluating, managing and preventing hospital admissions," said Dr. Andy Sama, president of the American College of Emergency Physicians. "Clearly, emergency departments must be fully integrated in health care delivery systems for both inpatient and outpatient care."
Hospital admissions grew from 34.7 million to 36.1 million, offset by a 10 percent decline in admissions from primary care physicians and clinical referrals. Nearly all of the increase was from "non-elective" admissions from the emergency department — a rate 3.8 times the rate of population growth.
Increased admissions were highest among people ages 65 and older. Self-pay patients were less likely to be admitted to the hospital than patients with health insurance. The role ERs and emergency physicians play in deciding who to admit to the hospital is critical to hospital cost savings, since the average cost of an inpatient stay ($9,200) is roughly 10 times the average cost of a comprehensive emergency visit ($922).