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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com




Thursday, December 22, 2016

Variation in ED Admission Rates

Emergency Physicians Monthly
EP Monthly - By Bukata R - December 16, 2016
"EPs too seldom follow guidelines when making this expensive, impactful decision. 
If you were to do a search on the word “variation” in the EM Abstracts database for the last five years you would find that there are 155 emergency medicine-specific citations with the word “variation” in the title – a huge number. Emergency medicine literature is full of papers telling us that the variation between physician practice is substantial – if not huge. Some physicians order lots of antibiotics, some much less. Some physicians order lots of CTs, some much less. Some physicians order lots of blood tests, some much less.
The bottom line – the emergency medicine literature indicates there are lots of opportunities to address variation and, ideally, create a narrow bell shaped curve focusing on the uniform practice of evidence-based medicine. The motivation to narrow variation seems obvious – to provide patients with consistent cost-effective, quality care. Large variations in care imply that many patients are not getting the care they should receive...
Taking on the huge challenge of narrowing the variability in admission rates for discretionary diagnoses must be an effort that involves multiple aspects of the hospital or health system leadership. The Venkatesh paper should serve as a wake-up call to both hospital executives and medical staff leaders to address a quality improvement opportunity associated with enormous medical and economic potential – but which can be expected to be extraordinarily difficult."