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Mon Oct 15 17:29:30 BST 2007

Yeah - back in the day we actually did that.  And then some friggin' yahoo invented the CT scanner and screwed the whole damn thing up!

As to finding staff, when I began in practice in 1982, I actually took care of all of the people I admitted all by myself with the help of a PA that was employed by the hospital.  Just think - if each one of us actually took responsibility of caring for the patients that we have been asked to care for, we would have a lot less need for that many staff type folks to fill the void.

Just my 2 cents, for what that is worth.

Ron

>>> "Andrew J Bowman" <andrewj.bowman at gmail.com> 10/15/2007 12:10 PM >>>
Didn't you guys used to do that in the 60's and 70's before we had all these
fancy gadgets?

And if you admit them based on H&P and get the tests as an in-patient where
are you going to get the staff to take care of all these admitted patients?
Yet where are you going to get the staff to take care of them in the ER?

There has to be a middle ground.

Andrew Bowman

----- Original Message ----- 
From: "Ronald Gross" <Rgross at harthosp.org>
To: <trauma-list at trauma.org>
Sent: Monday, October 15, 2007 12:01 PM
Subject: Re: Ideal length of stay in the ED

WAIT!!!  I have a novel concept!  Never been done before!

Are y'all ready????

Why don't we teach the residents to come to the ED, take a history, do a
physical examination, and admit the patient based on all of that??  I think
that really beats "Call me when the CT is done", and my guess is that the
patient would be moved out of the ED and on to the floor about 4 to 5 hours
sooner.

WOW.  I think I am on to something novel.  We might want to do a study or
something........

Y'know, sometimes I really crack myself up!

My best to all,
Ron

>>> <Krin135 at aol.com> 10/15/2007 11:52 AM >>>

In a message dated 14-Oct-07 10:35:16 Central Daylight Time,
KMATTOX at aol.com 
writes:

In a  message dated 10/14/2007 9:57:26 A.M. Central Daylight Time,
andrewj.bowman at gmail.com writes:

What  then do we do about the  attendings (fill in specialty here) who  are
reluctant to admit a  patient without the complete  workup????

Create a hospital  policy that allows, encourages, mandates that the EC
staff
have the  authority, and supported by the Medical Executive Committee to
admit  a patient to any hospital in-service where the service is slow to
evaluate
the patient or require that an entire work up occur there  prior to going to
an
in house bed.

k

I'd love it...now just need to convince the med exec committee (and the
hospitalists) that the hospitalists and attendings don't need every jot and
tittle done in the ED prior to admission....

and convince some of the residents at major teaching hospitals that they
can
finish the work up faster after they have the patient in their hands than
the smaller hospitals can do prior to transfer...

ck
Charles S. Krin, DO FAAFP

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Ideal length of stay in the ED