The Hospital Executive's Guide to Emergency Department Management

Posted on Thu, Feb 12, 2015
The Hospital Executive's Guide to Emergency Department Management

By Kirk Jensen, MD, MBA, FACEP; Daniel G. Kirkpatrick, MHA, FACHE
Second Edition HcPro 2014

“The Hospital Executives Guide to Emergency Department Management” has its roots in my thesis for my Executive MBA program and my interest in operations management and its application to healthcare. I believe that emergency department physicians, nurses and other team members deserve an Emergency Department that works not just for their patients but for the healthcare team as well.

Working with my colleague, Dan Kirkpatrick, and the editors at HcPro we built out an approach that would allow busy healthcare executives and managers to get an overall summary and appreciation of all the facets that go into creating a highly efficient and effective emergency department. To provide top-notch care to the community and maintain a competitive edge, healthcare executives must implement processes that deliver quality, safety, and service. In the second edition of “The Hospital Executives Guide to Emergency Department Management” we built on the key elements of operational excellence, refining the tactics for dealing with increased patient flow, strategies for handling the needs of special populations, and creating models for compensation and physician employment. The January roll-out of the Affordable Care Act has and will impact all ED’s for the near future. We offer strategies and solutions to help meet and effectively deal with the challenges of healthcare reform. This second edition is intended to update fundamental approaches to managing an emergency department while also building in necessary approaches allowing nimble changes in both strategy and tactics as healthcare systems navigate this new era.

Topics covered in the book include:

  • Design for operational excellence
  • Leadership
  • The ACA and the impact of healthcare reform
  • The impact of specialized groups and populations on the ED
  • Fielding your best team
  • Improving patient flow
  • Ensuring patient satisfaction
  • Implementing a plan for improvement
  • Culture and change management
  • Patient safety and risk reduction
  • The role and necessity of the Dashboard
  • Physician compensation
  • Billing, coding, and collection
  • The “business case”
  • Recruiting and credentialing

While we wrote the book originally to address the fundamentals of managing the emergency department, some of the recent changes have resulted in new alignments between emergency physician groups and hospitals (or healthcare systems) and different alignments between the healthcare system and payers. We are moving into a new era of both shared risk and increased focus on outcomes. Change requires reconsideration of strategic and tactical initiatives in managing the emergency department. We have preserved the majority of the content in this second edition because it is conceptually sound and addresses fundamentals which are relevant to emergency department management. The core issues of patient satisfaction, patient safety, risk reduction, process improvement, and employee recruitment, retention, and satisfaction should be the basis from which strategies are formulated.

Emergency departments are complex operational micro-systems. Our intentions with the second edition remain constant: to define the key operational tools and techniques that have the power to turn every emergency department into a state-of-the-art practice through operational excellence and to improve how emergency medicine is practiced in this environment of reform. Our objective was to update the key resources for emergency department management and hospital executives whose goals are to remain financially healthy while implementing new models of patient flow, patient safety, reimbursement, compensation, and physician employment in this new era for healthcare. Our purpose revolves around improving Emergency Department performance, quality of care, and the bottom line.

Kirk B. Jensen, MD, MBA, FACEP
Executive Vice President, EmCare
Chief Medical Officer, BestPractices
IHI Faculty Member


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