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Get to Know our September Clinician of the Month: Dr. Matthew Carrick

Posted on Tue, Sep 30, 2014
Get to Know our September Clinician of the Month: Dr. Matthew Carrick

EmCare has more than 10,000 clinicians serving communities across the country and we want to share their stories with you. Get to know these hard-working, difference-makers right here with our monthly “Clinician of the Month” blog post. Do you know a clinician who should be featured? Email!

Dr. Matthew Carrick is the Site Medical Director for The Medical Center of Plano in Plano TX.
This shining account of Dr. Carrick’s character and professionalism was written by EmCare’s Acute Care Surgery CEO, Dr. John Josephs.

Matt Carrick not only exemplifies the mission of EmCare through superior physician service but embodies the characteristics of a true visionary and leader within the Acute Care Surgery organization.

One of Matt’s many demonstrations of compassion is his tremendous ability to communicate with establishing patient and family trust during difficult situations.  By demonstrating his character to patients and family, he has instilled in the nurses, fellow physicians and staff this same character which has impacted significantly the rate of organ donation at The Medical Center of Plano.  This particular element of his character and ability to collaborate with the entire medical staff has driven the Acute Care Surgery Trauma Team at The Medical Center of Plano to advance the end of life patient care management as well as impact the community and the lives of others through increasing the availability of viable organs for donation.  Through his leadership The Medical Center of Plano has become the leading facility for organ donation in the Region even though by volume they are not the highest volume or acuity facility.

Matt graciously extends his service beyond his physician-patient scope of practice to one of leadership and collaboration with the entire medical director team within Acute Care Surgery.  As Acute Care Surgery has expanded its service to institutions across the nation, Matt has been instrumental in offering a front-line perspective to other hospitals seeking trauma designation. 

He also serves as a mentor and a resource to both our seasoned professionals and our aspiring future physician leaders.


10 physician documentation, billing considerations for ICD-10 implementation

Posted on Tue, Sep 23, 2014
10 physician documentation, billing considerations for ICD-10 implementation

This article was originally published on and is republished with permission.


While CMS announced the new effective go-live date for ICD-10 is Oct. 1, 2015, it's important providers not put off the training and other preparations require to prepare their organizations for the ICD-10.

In April, the HHS announced that it was delaying CMS' implementation of ICD-10. Oct. 1, 2014 was no longer the "go live" date. 

The delay came as a surprise to many in the healthcare community. Providers and payers had already invested millions of dollars in software updates and staff training to be ready for Oct. 1. Now what? Continue reading at Becker's Hospital Review.>> 


Tips to Boost Your Documentation Process: Secondary Diagnoses

Posted on Wed, Sep 10, 2014

Good documentation is important for new physicians as well as veteran caregivers. While documenting can seem like a very straightforward skill, there are often “best practices” that can be utilized. As a hospitalist for EmCare at St. Petersburg General Hospital in St. Petersburg, FL I write a “weekly documentation tip” email to help physicians improve their clinical documentation. I also share these documentation strategies with the residents I teach.

by: Timothy N. Brundage, M.D., CCDs

Secondary Diagnoses

A secondary diagnosis is a condition that coexists at the time of admission, develops brundage.png subsequently or that affects the treatment received and/or length of stay of the patient. Remember that secondary diagnoses support the severity of illness (SOI) and show that your patient is as sick on paper as they are in the bed.

Secondary diagnoses are defined as those conditions that consume one of the following hospital resources:

• Clinical evaluation

• Therapeutic treatment Further evaluation by diagnostic studies, procedures or consultation Extended hospital length of stay (LOS)

• Increased nursing care and/or other monitoring

For example, if you are monitoring tele and continuing home amiodarone, DO NOT document “history of A. Fib.”This would meet the criteria for the secondary diagnosis of chronic A. Fib and coders cannot code a “history of.”

Timothy N. Brundage, M.D., CCDs is a Certified Clinical Documentation Specialist and Diplomate of the American Board of Internal Medicine.


EmCare’s Genesis Cup Honors Innovation, Creativity in Healthcare

Posted on Tue, Sep 09, 2014

This article was originally published in the June 2014 issue of EmCare's EmPressions Magazine.


EmCare Marketing Communications Manager

A dramatic redesign has allowed the busiest emergency department in Florida to drastically patient-flow.jpg decrease wait times while improving other key metrics. This dynamic turnaround not only improved operations for the Lakeland Regional Medical Center’s emergency department (E.D.), but also earned the redesign team the prestigious 2014 Genesis Cup award.

The Genesis Cup is an award for healthcare innovation presented each year by EmCare, a leading national physician practice management company. This year’s Genesis Cup honoree, a team that works in the Lakeland E.D. in Lakeland, Fla., presented its award-winning redesign during EmCare’s Annual Leadership Conference at The Wynn in Las Vegas.

“The Lakeland E.D. [emergency department] is the busiest single-site E.D. in Florida,” said Dr. Jim Melton, III, medical director for the Lakeland E.D. “It had roughly 170,000 ED visits in 2012 and is on track to have more than 180,000 E.D. visits this fiscal year. Despite the increase in volume, the E.D. has managed to decrease wait time, length of stay rate and rate of patients leaving without being treated. These improvements are the result of an E.D. redesign that began in 2011, driven by the hospital’s executive leadership.”

Melton’s Genesis Cup-winning redesign team includes:

  • Maureen Leckie, R.N., MSN, the associate vice president of clinical operations at LRMC
  • April Novotny, R.N., MSN, the CEN director of emergency services
  • Pam Carter, R.N., BSN, the assistant director of emergency services
  • Joanne Fuell, R.N., BSN, the assistant director of emergency services

Before this redesign, LRMC’s E.D. had a long-standing practice of segregating adult patients by levels of clinical acuity into either a critical care area or an immediate care area.

The redesigned E.D. care model grouped rooms into nine pods: one for triage, six that serve adults, one that serves children and one for minor non-urgent conditions. A registered nurse (R.N.) acts as a “bed traffic controller” for the triage pod, assigning triaged patients to one of the pods on a rotational basis so no single pod becomes overwhelmed by multiple patient arrivals.

Because the E.D. relies on multiple hospital departments to deliver care, an E.D. redesign required changes outside of the E.D. as well. LRMC created a team with representatives from the E.D., radiology, lab, pharmacy, respiratory department, transportation and patient placement. The team met weekly to review data and ensure the E.D. was regularly maintaining or improving its patient flow.

Data analysis was another driving component of the redesign. The redesign team received daily and weekly summaries of detailed data from the hospital’s strategic analysis team. One unique tool Lakeland had in its redesign was a simulation model developed by an industrial engineer. The model uses existing data to predict outcomes, such as wait times, under various situations, including staffing levels and patient volumes.

The redesign clearly led to improvements for Lakeland Regional Medical Center’s E.D.:
  • E.D. volume increased 16.5 percent from January 2011 to January 2013
  • On average, patients are now assessed by a physician in 20 minutes or fewer
  • The time from when a patient arrives in the E.D. to when he/she is seen by a healthcare practitioner is 38 percent faster than the national average
  • The number of E.D. patients who left without treatment decreased from four percent to 0.3 percent
  • The average length of stay is about two hours
  • Most patients are treated and discharged in fewer than three hours – a 50 percent decrease resulting from the redesign
  • Patients are admitted 30 percent faster than the national average
  • Patients get to a bed after admission 56 percent faster than the national average

EmCare also recognized two runners-up in this year’s Genesis Cup program. Dr. Harry Jung, III, an anesthesiologist who practices at Seton Regional Medical Center Harker Heights and a regional medical director for EmCare, earned runner-up honors through reports of the effectiveness of ultrasound-guided regional nerve blocks. These nerve blocks have been shown to reduce pain, shorten hospital stays and speed recovery post-operatively better than more common pain medications and narcotics.

The second runner-up for the Genesis Cup is E.D. team from Sinai Hospital of Baltimore. The Sinai team was recognized for their Ambulance Immediate Offload Project, and was made up of:
  • Diane Bongiovanni, M.A., BSN, R.N., CHEP, NEA-BC, director of emergency department and critical care
  • Amy Riesner, MSN, BSN, R.N., CHEP, NREMT-P, the E.D. clinical leader and EMS liaison
  • Lakecia Lewis, BNS, R.N., CEN, emergency department RN2
  • Alma Ta-Asan, BSN, RN, emergency department RN2
  • Chandresh Shelat, M.D., E.D. physician and EMS coordinator
  • William Jaquis, M.D., chief of emergency medicine
  • Will Williams, captain of EMS quality assurance and improvement officer with city emergency medical services
  • Christian Griffin, NREMT-P, fire director of county emergency medical services

This new offload program has been very successful: since the faster offload times translated directly to faster EMS response times, in September of 2013 the Sinai E.D. was ranked number one by the City Fire Department.

“All three of these groups personify EmCare’s mission of making healthcare work better,” said Dr. Dighton Packard, EmCare’s chief medical officer. “When you are able to reduce wait times, improve patient flow, better manage pain – it ultimately leads to improved outcomes for the patient.”

EmCare designed The Genesis Cup program to recognize and celebrate the creativity and innovation of everyday physicians as part of the company’s never-ending pursuit to improve the delivery of patient care. In addition to recognizing the inventor/ innovator, The Genesis Cup recognizes those involved in the initiative, including the emergency department, radiology department, hospitalist team, anesthesia team and the regional office in supporting such endeavors.


Get to Know our Clinician of the Month: Ginger Wirth

Posted on Tue, Aug 26, 2014

EmCare has more than 10,000 clinicians serving communities across the country and we want to share their stories with you. Beginning in August, you can get to know these hard-working, difference-makers right here with our monthly “Clinician of the Month” blog post. Do you know a clinician who should be featured? Email!

Ginger Wirth joined EmCare in 2013 as a Divisional Director of Clinical Services for the South gingerwirth-ddcs.jpg Division with the strong belief that she could continue to make positive changes within healthcare by helping others focus on quality, excellence and the overall patient experience.

She regards her role as Director of Clinical Services as the ideal opportunity to partner with nursing, physician and facility leaders to make positive changes to the entire patient care experience. Her 20+ year nursing career has been dedicated to quality and excellence, promoting overall positive outcomes and safety for patients.

Get to know Ginger!

  1. Proudest moment during your career? I actually took care of a young mother who was recently post-partum and having severe complications.  I took care of her for several hours prior to having to go back to surgery (over 5 hours) and to this day she still sends me a Christmas card with pictures of her family and how it has grown over the years.  She says that I was “her angel” and without my care she would not have been alive to raise her son and now her 2 other children.  She has even gone to the trouble of making sure she had my address when I moved from California to South Carolina.  It is amazing to see her children grow up (in pictures) and to see her family so blessed!
  2. I hope my patients remember me as: a nurse that was caring, compassionate and made a difference in their lives.
  3. The one piece of healthcare advice I wish everyone would follow is: in order to make a difference in patients’ lives, you have to take care of yourself~ personally, professionally and physically!
  4. What are the most promising tools, technologies, processes that you think will drive the future of healthcare?  I believe that the biggest driver for healthcare today will be making sure that we never forget to go back to the basics.  Make sure we are not getting caught up in technology, and forget the humanity of healthcare!
  5. Describe your best day on the job.  Being able to take care of patients that really need help makes every day a “best” day!  I also feel very lucky to be working at EmCare and to be able to go into client hospitals and share best practices, provide consultations on flow and processes and to be able to take home some of their “wins” and connect with others all over the country. 


I was a victim of violence in the E.D. Here's my story. Pt. 1

I was a victim of violence in the E.D. Here's my story. Pt. 2