10
The ED Is Playing a Pivotal Role in Joint
Commission Certification as a Stroke Center
The hospital is pursuing expanding its
emergency capabilities in other ways beyond
trauma care. We provide outstanding stroke
care in conjunction with the departments of
Neurology and Neurosurgery. To enhance
quality in stroke care, Walter Reed Bethesda is
pursuing Joint Commission status as a certified
stroke center.
By
working
together
to
meet
the
requirements
of
Joint
Commission
certification, we will achieve new milestones
that ensure Walter Reed Bethesda’s stroke
patients receive the latest innovations of care
that have been shown to improve outcomes
and reduce costs.
Clinic Decision Rules and New Technologies
Improve Care in Challenging Situations
The ED has partnered with other departments
in ways to bring the most recent, up-to-date,
evidence-based practices to the bedside of
our patients. On a monthly basis we invite
outside speakers to present current advances
in their specialties, where we review the most
current standards in care and adopt new ideas
and technologies.
Recent didactic sessions included “current
best practices in the management of
neutropenic fever” and “current management
of intraventricular shunts.” Sessions like these
have led to an increased use of clinical
decision rules to standardize care among
providers.
Emergency Department
staff train for mass
casualty exercises.
11
The Emergency Medicine
pharmacist verifying and
dispensing prescriptions
for a discharged patient.
Emergency Medicine staff
assist an elderly patient
being treated for a fall.
Walter Reed Bethesda is
one of only nine Trauma II
centers in the Washing-
ton, DC area, and as such
is highly sought-after for
its trauma skills.
For example, working with Pediatrics, the
Emergency Department introduced a decision
rule that reduced unnecessary use of head CT
scans in pediatric trauma. The Emergency
Department is always looking to see how new
technologies can be used to benefit our
patients. Recently, nursing staff have been
training to use ultrasounds to obtain
intravenous access. The goal is for all nurses,
corpsmen and medics to use this device when
faced with difficulty obtaining critical labs or
administering life-saving medications.
Using simulators, we have also trained staff on
emergency procedures that are not frequently
encountered. The Emergency Department
recently implemented triage carbon monoxide
testing to aid in the diagnosis of CO poisoning,
which can be difficult due to its non-specific
symptoms.
To Lessen Patient Waiting Time, the
Emergency Department Adds Its Own
Pharmacy to Serve Patients in Triage
The Emergency Department at Walter Reed
National Military Medical Center continues to
challenge itself to find innovative ways to care
for our patients.
Recently implemented initiatives have already
proven themselves invaluable to the patient
care experience. For example, using only
intrinsic
resources,
the
Emergency
Department launched its Fast Track to provide
faster service to a greater number of patients
presenting with minor illnesses.
There is also now a full-time pharmacist in the
Emergency Department to help review and
distribute discharge medications, preventing
lengthy waits at Pharmacy and enhancing
safety.
A current research project in the department’s
triage area is reducing times to pain
medication by administering them before the
patient is seen by a provider. Improving access
to medication, at the beginning and end of the
Emergency Department encounter, is just one
more way we are trying to exceed the
expectations of our patients.
12
Brian A Hemann, MD
Chief, Department of Medicine
Walter Reed National Military Medical Center
LTC (P)
|
MC
|
USA
Louis N Pangaro, MD
Chair, Department of Medicine
Uniformed Services University
COL
|
MC
|
USA
|
Ret
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Department of Medicine
Harnessing the healing power of light—the Dermatology Service uses narrow band ultraviolet therapy to treat a wide range of stubborn skin conditions such as psoriasis, eczema and
lichen planus; this cutting-edge technology provides precise delivery of a single wavelength of light that targets skin-related factors at the molecular level.