“It ought to say to all of you that this organization and your colleagues have an opportunity to make a difference in thinking about what's the goal of your part of your profession and the patients you serve here,” Clancy said. She also highlighted the current push toward patient-centered care—and offered examples of how emergency room physicians can think about this approach.
“Whether that's noticing—I'm going to speak as an ER patient myself on a couple of occasions—noticing that it's a really cold in those emergency rooms when you're lying on a stretcher in these very, very thin gowns,” Clancy said, “or noticing that family friends are frightened, and as a patient is being discharged, actually are kind of clueless and don't know even know how to say: ‘I'm not understanding a word you're saying.'”
Continuing on this theme, Clancy discussed patient-centered outcomes research and challenged her audience to identify the areas in their field where they don't have the answers they need. As providers realize that assessing quality is no longer optional, Clancy said, the question then becomes: “What do we as a community think is important?”
Clancy's remarks resonated with conference attendee Dr. Nicholas Vasquez, an emergency physician at Phoenix-based St. Joseph's Hospital and Medical Center, which is a part of the 40-hospital Catholic Healthcare West system.
“I work in my hospital on a lot of quality stuff, and at a distance, it sounds much more like “Thou shalts,”” Vasquez said. “What she was talking about with the quality stuff was more like: We have this broad framework and we want to move from measuring these tiny little metrics to measuring outcomes. I'm very glad to hear that. I think that's the best way— to measure global patient outcomes and let people compete for the quality and pay them based upon that.”
Vasquez also said the nation's emergency physicians are “on board” with any healthcare delivery approach that will decrease duplicate services, lower costs and improve care, such as medical homes and accountable care organizations.
“We've come here with the question: what's the role of emergency medicine in ACOs?” Vasquez said. “And the answer is: to be decided. We don't know yet. We don't know where we fit.”
You can now follow Jessica Zigmond on Twitter @MHjzigmond.