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Speed of ED Care Goes Under Quality Microscope

Cheryl Clark, for HealthLeaders Media, July 28, 2011

"As we are going through healthcare reform, and we're trying to be more transparent and look more for quality improvements, we want to compare ourselves and so it's important to measure things the same way. If you don't, you can never compare yourself to someone else," she says.

In fact, there are more than 140 metrics that could be applied to evaluate emergency room care, says Shari Welch, another member of the committee grappling with these issues and an emergency physician with Utah Emergency Physicians.

Welch, a research fellow with Intermountain Institute for Health Care Delivery Research, said in an interview this spring that there are emergency room metrics that could apply "for every specialty, door-to-orthopedic doc for bone fractures, to-antibiotic for pneumonia, door- to-CT for acute stroke. The sheer volume worries me," she said.

All emergency room physicians realize that some of them will soon come onto CMS' radar, for tracking, and "maybe for not paying," Welch quipped.

Sometime down the line, most emergency room physicians I've talked with agree, CMS will start rewarding performance in the ED. "We all assume that at some point, payment will be tied to this," said James Augustine, vice president of the ED Benchmarking Alliance and a member a coalition trying to get stakeholders to agree on what these terms mean.

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