Emergency Medical Services

Example pages sent on e-mail request to apollomanagedcare@cox.net - please specify topic of interest.

The practice of evidence-based medicine means integrating individual clinical expertise with the best-available external clinical evidence from systematic research.

Centre for Evidence-based Medicine, Oxford University

Guidelines are an expected part of medical practice in today’s society. However, guidelines cannot be blindly accepted or considered inviolate. If that were to be the case, they would cease to be guidelines and would become “standards” or even “mandates”. Guidelines and their application must be directed primarily toward the well-being of the patient. The term “cost-effectiveness” should refer to efficiency with regard to time, safety, and utilization of resources for patient care, and should NOT be used as a means to maximize profit or for any other purpose that does not have the patient as the primary concern.

Statement on the use of proprietary guidelines by managed care organizations.

American College of Surgeons Bull Am Coll Surg 33-4, March 1998

Guidelines can in no way encompass every diagnosis or treatment of all disease states, nor can they include the variations that occur in the complexity of the human response to disease processes, which includes co-morbid conditions. Where clear discrepancies of opinion exist, the licensed physician as the caretaker of the patient must be responsible for guiding the individual patient’s course leading to diagnosis and treatment.

Statement on the use of proprietary guidelines by managed care organizations.

American College of Surgeons Bull Am Coll Surg 33-4, March 1998

Guidelines should be formulated such that they cannot automatically be used as a basis for disciplinary action or litigation if the physician or surgeon determines that strict adherence to their provisions is not in the patient’s best interest. The guidelines should be flexible to permit variations for patient condition and circumstances and should provide options for these variations, including severity of illness and co-morbid conditions. The guidelines should be formulated to consider the totality of an episode of care. For example, discharge criteria must take into account the supportive resources that are available to the patient, such as convalescent care, home care, hospice care, family availability, and so on.

Statement on the use of proprietary guidelines by managed care organizations.

American College of Surgeons Bull Am Coll Surg 33-4, March 1998

Referral to the foregoing reference in its entirety is recommended reading.

	Emergency services
	Emergency Medical Treatment and Active Labor Act
	ER Authorization System
	Benefit coverage – example language
	Redirection
	Appeals
	Response time by providers for authorization
	ER treatment review criteria matrix
	Ambulance and other medical transportation, review policy/procedure
	Reducing Emergency Room Visits – improving care and access in physician offices
	Physicians Utilization Guide for ER Care
	ER utilization benchmarks
	Emergency Care Overview - Clinical
	Emergency Care Committee
	Emergency Medical Care Protocols and Guidelines - links
	Mandatory Reports – Domestic Violence
	ACLS Certification
	Reimbursement for courses
	Emergency treatment protocols and guidelines
	Emergency ‘On-site’ Triage Policy for Ambulance, ED, and Telephone Calls
	Case Management in the ED for High Utilizers
	Reducing ER Care Visits
	Reducing ER Wait Times
	Office Emergency/Code Blue Policy and Procedure
	Code Blue
	Evaluation of Code Blue Response
	Emergency Equipment
	Adult Crash Cart: Content List
	Crash Cart/Defibrillator Check Lists
	Hand-offs
	Algorithms: Specialty Referral by UCC Physician Algorithm; Priority Care Appointment following UCC Visit; UCC Patient Disposition Algorithm; Pre-Admission Function/ER Algorithm
	Reducing medication errors in the ER
	‘Stat Nurse’ Call
	Provider Tips
	ER Staffing and Related Issues
	Chest Pain/Chest Pain Units
	Diagnostic X-ray, Post-trauma: Cervical spine, Knee, Ankle and Foot
	Guidelines for CT following minor head trauma;
	Patient Satisfaction with ER Services
	ED Case Management Intervention Services
	ACEP Fact Sheet Patient Waiting Times
	Advanced Directives
	Addendum – Court definition of emergency for Medicaid services
	Payments for Emergency Services to Non-contracted Providers – California Law
	Hospital Payments to Physicians for Emergency Services - Legal Issues;
	References for emergency medical services
	Emergency Medicine web sites
	Apollo’s publication list
	‘Famous Last Words’