IEDLI Essential Emergency Department Leadership Course
October 22-26, 2012
Detailed program agenda will be online soon
Below please find session descriptions from the 2011 IEDLI Essential Emergency Department Leadership Course which was held in Boston, MA. Please note that the 2012 agenda is subject to change and will be online soon. Note that the course will be held Monday - Friday from 9:00am - 5:00pm each day. Please check back soon for an updated schedule.
Monday, October 22 (tentative schedule)
Introduction and Overview
This first session will review the program goals, introduction of participants, practical logistics, and the scheduled plan for the week.
Needs Assessments
As Emergency Medicine continues its global growth and evolution, attention has begun to turn to understanding and impacting clinical and administrative operations. Along with this understanding comes the need to effectively communicate the current state, potential solutions and expected outcomes of these solutions to all stakeholders including clinical staff, patients and administrators. At the conclusion of this session, students will be able to:
* Understand how to approach a comprehensive operations assessment, including what to measure and how to measure it;
* Quantify the impact of current state operations to effectively communicate their impact on clinical, operational and financial performance;
* Effectively communicate the outcomes of the operations assessment to both clinical and non-clinical stakeholders found both within and outside of the ED.
Using Emotional Intelligence as an Essential Part of Team Building
Few ED leaders have enough time to carry out all the administrative tasks necessary for running their department. The use of high-performing administrative teams is a proven strategy for delegating responsibilities in order to give staff members greater input and to improve employee satisfaction. Building and leading an administrative team requires emotional intelligence, a combination of self-management and social skills that allow leaders to change and further the objectives of their organization. In this section, we will explore:
* When to use teams to accomplish organizational goals;
* Building and managing teams;
* Models of team behavior;
* The 5 components of emotional intelligence;
* How to improve emotional intelligence.
Change Leadership
Establishing a new Emergency Department in a hospital where one did not previously exist or introducing a new model of emergency care delivery that breaks with past tradition involves significant changes to work processes, provider roles, resource allocation, work culture, etc. All of these changes occur in a political environment inhabited by multiple stakeholder groups. Understanding and skillfully navigating this landscape are essential skills for the successful emergency department leader.
Workshop: Change Leadership
This workshop will provide opportunities to practice skills and techniques borrowed from the business world in order to analyze complex change scenarios. We will work in small groups during this session.
Tuesday, October 23 (tentative schedule)
Triage Systems - An Overview
The initial evaluation of ED patients is a crucial process which has implications for healthcare quality, patient safety, flow and resource utilization. There are numerous approaches and models for triage which have been developed. How do you find the best one for your ED?
In this session, we will discuss:
* The most common triage systems;
* Strengths and weaknesses of each triage system;
* How to choose the best triage system for your hospital.
Observation Units
There is clear evidence that observation units, or places where those patients not clearly ready for either admission or discharge can be cared for, have the potential of reducing cost while also increasing patient comfort levels. Typically, observation units are used to treat patients with chest pain, asthma and heart failure but have also been used for other diagnoses including abdominal pain and transient ischemic attack. In this section, we will discuss:
* How to develop an observation unit as part of the emergency department;
* Staffing considerations;
* How to develop protocols;
* Virtual observation units.
Intro to Lean
Lean management, typically associated with Japanese manufacturing and the Toyota Production System, is a proven process improvement and management strategy that focuses on cutting costs by improving efficiency, eliminating waste and streamlining and standardizing processes. This introductory session will introduce participants to using lean methods in the Emergency Department to:
* Impact productivity;
* Reduce cost;
* Improve quality;
* Improve patient care.
Modeling and Improving Patient Flow
This session will provide an overview of ED flow as a day-to-day problem: what causes it and how to alleviate it. Special attention will be given to models of triage and ED design. The objectives for this session are:
* To look at ways and tools with which to measure flow;
* To develop simple fixes to increase speed of flow;
* To develop long-term methods for fixing the overall problem.
Overcrowding
Overcrowding is a problem common to most EDs around the globe. This session will discuss the underlying causes of and strategies for decreasing overcrowding. Topics include:
* Overcrowding: myths vs. reality;
* Problems that lead to overcrowding;
* Evidence of the real causes of overcrowding;
* Modeling solutions to overcrowding.
Workshop: Improving Emergency Department Flow
Improving patient flow in the ED is key to increasing patient satisfaction and ED productivity. In this workshop participants will:
* Analyze patient flow in their own EDs;
* Discuss different strategies to improve patient flow;
* Explore the use of observation units or fast track units;
* Map ED bottlenecks;
* Develop a formulized approach to problem solving.
Emergency Medicine for Pioneers
This optional session is aimed at those participants who are currently in the early stages of conceptualizing or designing an integrated emergency department. We will discuss consolidating multiple EDs and the associated staffing and organizational issues (moving to a single provider system, organizing and training a diverse group of specialists, etc).
This informal session will be held “round table style” and will include snacks and beverages. All participants, regardless of the stage of their ED development, are invited to share their own personal experiences.
Wednesday, October 24 (tentative schedule)
Understanding Your Budget
There are a large variety of reimbursement structures for EDs across the globe. Regardless of the given healthcare system in which they practice, ED leaders must have a basic understanding of budgets and the different types of costs that occur within their departments in order to be able to make appropriate managerial decisions. In this course, we will discuss:
* Different types of budgets;
* Different types of costs and how they impact the budget;
* Which costs can be controlled.
Adjusting Your Budget
At some point during their career, most leaders will be asked to decrease program budgets or make budget decisions regarding new ED services, equipment or staffing. This session will explore important strategies including:
* How to evaluate the cost and potential revenue of a new service, equipment or staff;
* How to evaluate the potential financial and non-financial impact of your decisions;
* How to present your considerations to decisions makers.
Quality Assurance / Quality Improvement
Defining and measuring the quality of care delivered by the Emergency Department is essential both for demonstrating to external stakeholders the value of the provided service and for identifying areas in which emergency care delivery can be improved. In this session, we will discuss:
* What is quality?
* A framework for describing healthcare quality: structure, process, and outcome;
* Setting standards based on evidence-based guidelines;
* Characteristics of indicators;
* Selecting an appropriate array of indicators;
* Strategies for measurement and how to get started.
Implementing Clinical Pathways
Institutional clinical pathways can be a powerful strategy for translating evidence-based guidelines into improved patient outcomes. This session will discuss strategies for developing and implementing clinical pathways to minimize variability and improve quality. After taking part in this activity, participants will be able to:
* Describe examples of critical pathways for improving management and outcomes of acute
patients;
* Discuss the results from major quality improvement initiatives showing that critical pathways
work to enhance patient outcomes;
* Work with hospital teams to improve and implement critical pathways;
* Customize, design or modify tools for implementing critical pathways.
Internal Peer Review: Different Models and How to Get Started
Internal Peer Review is an important leadership and educational tool for establishing and maintaining standards of care within the emergency department. In this session, different approaches to internal peer review and strategies for implementation will be discussed such as:
* Morbidity & Mortality Case Conference;
* Case audits;
* Openness in peer review.
Workshop: Risk Management, Patient Safety and Quality
Strategies for managing risks associated with medical legal liability are a key component of overall efforts to improve quality and patient safety. Risk management begins with ‘proactive’ strategies for identifying and mitigating the high risk aspects of emergency medicine practice, but also encompasses ‘reactive’ strategies for responding to adverse events or errors that inevitably can happen even in the best prepared emergency departments.
This lecture and workshop will focus on:
*Basic principles of risk management for reducing legal liability;
*Identifying high risk areas in your emergency department;
*Using evidence-based practices to mitigate risk;
*Developing plans for responding to incidents with potential medical legal liability.
Thursday, October 25 (tentative schedule)
Emergency Department Informatics
Effective operational management of the Emergency Department and clinical management of patients in the Emergency Department increasingly depend upon the gathering and exchange of information. Successful Emergency Department leaders need to understand the spectrum of operational and clinical data necessary for running a safe and efficient department, as well as understand the types of informatics tools that are available for gathering and exchanging this information.
This session will touch on issues related to:
* Information needs related to clinical management of patients in the ED (electronic patient medical records, diagnostic and lab data, , patient/ data tracking
* Information needs related to operational management of the ED (patient volume, flow data; time stamping of actions related to work and patient flow)
* Computerized Provider Order Entry
* Clinical decision support
* integration of real-time communication (PCP notifications, critical value alerts, paging consultants, flags, PCP call-ins, provider)
Building a Learning Organization
Learning organizations facilitate the increase of knowledge of its members through new patterns of thinking. People use these patterns of thinking both individually and collectively. This section will help the participant understand the benefit of developing a learning organization using:
* System thinking;
* Personal mastery;
* Mental models;
* Shared vision;
* Team learning.
Building an Emergency Department Leadership Team
Regardless of an Emergency Department’s size, its leadership team consists of more than one individual; typically, a physician director, nursing director, associate directors, and various managers who have specific responsibilities within the ED. This section will explore:
* Assessing the needs for team members;
* Delegating responsibility;
* Cross-functional leadership between nurses and doctors;
* Methods of communication.
Emergency Department Facility Design
The design of an ED facility can either support or hinder the desired flow of patient care in the emergency department. In this session we will address a range of planning issues related to new construction or renovation of emergency departments including:
* Design process, needs assessment and dimensioning;
* Evidence-based design strategies;
* Innovative approaches to dealing with overcrowding, surge capacity and disaster-proofing.
Staffing Models
Implementing the right staffing model for your ED can lead to satisfied patients, improved patient throughput and contented clinicians who suffer less from fatigue and burnout. This session will explore staffing models and look at ways to more efficiently staff the ED. We will discuss:
*Evaluating staffing needs;
*Static vs. dynamic staffing;
*Strategies to improve patient throughput.
Strategic Planning
Strategic planning in the emergency department is important for achieving budgetary and staffing goals and for positioning the ED to handle competitive pressures. In this session, participants will learn how to:
* Develop an environmental analysis;
* Formulate both short and long term strategies;
* Implement the chosen strategy;
* Monitor progress with the strategic plan.
Workshop: Developing a Project Plan
Project planning involves the development of a written proposal that reflects careful planning and includes: a budget; a detailed description of the new idea, facility, or project; a consensus document with which to build stakeholder support; and tools with which to gauge support. In this workshop, participants will learn how to develop:
* A budget, timeline, stakeholder analysis and scope of work;
* A stakeholder consensus;
* A project proposal.
Celebratory Dinner (dinner included with your registration)
Friday, October 26 (tentative schedule)
Motivating Professional Staff
Understanding incentives is crucial to motivating professionals to improve performance. Pay-for-performance is just one technique. This workshop will explore innovative, non-financial incentives. We will discuss:
* What motivates us;
* The unmotivated employee;
* How to motivate a group for change;
* Financial and non-financial performance incentives.
Establishing the Emergency Department's Role in the Hospital
Where interdisciplinary EDs are new, ED leaders are tasked with providing high-quality emergency care but often lack support from other departments in the hospital. ED leaders must focus on communicating the value that the ED currently brings to the hospital and on strategies for increasing that value. We will discuss:
* Operating in a competitive environment;
* Strategies for increasing the ED's negotiating power;
* Interdepartmental relations.
Emergency Medicine Physician Specialty Training
In this session, we will compare and contrast the "triage to service" model with the EM model of emergency care. We will discuss the relationship between emergency medicine specialty training with ED quality of care and operational efficiency. One of the objectives of this session is to prepare the participants to serve as advocates for implementing emergency medicine specialty training in their home countries. Discussion topics include:
* Challenges of establishing a new EM specialty training program;
* Dealing with setbacks;
* The political process;
* Developing a curriculum.
Public Relations and Working with the Media
Many EDs suffer from negative images of being undesirable places to work and clinical settings that provide low-quality care. Creating a positive image of the ED, both with the general public and within the hospital, helps ED leaders accomplish their development goals. This session will explore:
* External and in-hospital public relations;
* Developing a public relations plan;
* Tips for handling media interviews.
Challenges of Building a National Model of Emergency Medicine – A Panel Discussion
During this panel discussion, emergency medicine leaders from several countries will provide a brief overview of the process, challenges and solutions they encountered during the establishment of emergency medicine as a specialty in their countries. Topics include:
* Getting specialty recognition;
* Developing training and certification programs;
* Forming national societies.
Emergency Department Tours (Optional)