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Administration Rotation

Assignments: 

1. Complete Administrative Curriculum   (SEE BELOW)

2. Read White Coat Investor Book

3. Read Ideal Team Player book 

4. Complete DISC assessment - Contact Dr. Quentin Reuter

Individual Meetings: 

1. Personal Finance

        a. Contact Dr. Dave Scott (dscott@usacs.com) regarding personal
            finance lectures and coaching.

2. Schedule a meeting with Dr. Kevin Markowski regarding Departmental QI.

3. Schedule a meeting with Dr. Mark McDowell regarding patient complaint process. 

Individual Meetings: 

1. Meeting invites will be sent to you. 

2. ED Ops/Department Meeting - third Tuesday from 8-11 AM 

    a. To give presentation at Departmental meeting on Resident update/issues. 

Click on the purple below to download these documents 

Checklist
Appendix A
Appendix B

Emergency Medicine Administrative Rotation Curriculum

Goal:

Enhance Senior resident's understanding of the administrative, clinical and educational aspects of academic, community and hospital-based emergency medicine. 

Objectives:

Patient Care: 

Demonstrate literacy on issues of :

  • ​EMTALA Compliance 

  • ED management, clinical operations and finance

  • Contract principles and managed care

  • Documentation, billing and coding

  • Liability and Risk Management

  • Provide patient care for assigned shifts and on call back- up schedule for the Emergency Department. 

Interpersonal and Communication Skills:

  • ​Understand principles of people management and how to apply appropriate management styles to common emergency department scenarios. 

  • Demonstrate competence on the following: 

    • Teamwork​

    • Interdepartmental Relationships

    • Customer Service & Patient Satisfaction 

  • Develop comfort and skill in presenting to small and large groups on emergency medicine topics. 

  • Develop public relations and social media skills for emergency medicine. 

Practice Based Learning and Improvement:

  • ​Understand and apply triage methods by validating cases using the Emergency Severity Index. 

  • Understand and apply appropriate documentation and coding to an Emergency Medicine encounter

  • Analyze medical records and present Morbidity and Mortality cases designed to reduce error and improve physician and staff performance in the ED.

  • Give core competency-based feedback to emergency medicine learners.

Professionalism:

  • ​Exercise time management by designing schedule and completing assigned projects during rotation month.

Systems Based Practice:

  • ​Develop and complete an administrative Continuing Quality Improvement (CQI) project.

  • Understand and make recommendations to develop systems designed to reduce error, provide efficient processing of emergency medicine patients through the emergency department and improve physician and staff performance in the ED.

Objectives with Reading Assignments:

Reimbursement / Documentation / Billing

Objectives: 

  1. Understand the proper documentation required for Emergency Medicine reimbursement.

  2. Understand the relationship between quality charting/diagnosis and reimbursement from patients and insurance carriers.

  3. Define CPT, ICD-10 and coding procedures.

  4. Understand bad debt, contracted allowances, and charity.

  5. Review and understand ambulatory patient groups.

  6. Understand the process and function of a billing agency.

  7. Understand the role of billing in capitated and managed care systems.

  8. Understand MIPS and its future implications for physicians.

Assignments:

a. Documentation Training Programs:            (Click purple links for PDF's)

Physician Documentation White Paper

Clinical Examples

For the Busy Emergency Physician

ED Tip Card

The Business of EM

Defining Value in EM

New Documentation Guidelines for 2023

New Documentation Guidelines Powerpoint

b. Future of Medicine and Implications of payment Reform:   (Click purple links)

- From MIPS to MVP and beyond.... 

Emergency Medicine Informatics Section // From MIPS to MVP and Beyond... (acep.org)

- What is P4P? 

-Lecture on Defining Value in Emergency Medicine 

- ACEP Clinical Emergency Data Register (CEDR)

​

​Powerpoint Presentation from ACEP

Customer Service/Patient Relations

Objectives: 

  1. Understand the role of customer service and its relation to health related outcomes.

  2. Understand the role of patient satisfaction surveys and ED-CAHPS.

  3. Identify ways to improve patient satisfaction.

  4. Understand the role of benchmarks and their relation to customer satisfaction.

Assignments:                                (Click purple links for content)

a. Customer Service Excellence

b. Emergency Department Patient Experiences with Care

c. ED CAHPS At-A-Glance

d. Service Recovery: Improving the Patient Experience 

e. Patient Complaint Management 

Risk Management/ Continuous Quality Improvement

Objectives: 

  1. Identify the high risk areas of Emergency Medicine.

  2. Identify strategies to reduce medical-legal risk in the ED.

  3. Understand the difference between a “claims made” and “occurrence” malpractice insurance.

  4. Recognize the importance of a comprehensive follow-up program for patients discharged from the ED.

  5. Introduce residents to the components of the ED’s continuous quality improvement plan.

  6. Develop skills in implementing the Quality Management process.

  7. Describe the mechanisms for follow-up of abnormal lab results, ECG’s, and radiology reports and the importance of doing this.

  8. Discuss JCAHO requirements for quality management in the ED.

Assignments:                                (Click purple links for PDF's)

a. AHRQ Courses

b. Risk Management Curriculum

c. EMTALA PowerPoint

d. PSQI IHI Methodology for Improvement - Components for Proposal Slides and Posters

e. Reducing ED Recidivism 

f. SBAR

Contracts

Objectives: 

  1. Describe and understand the types of ED contracts: Individual, Insurance, Managed Care, and Billing.

  2. Understand the difference between employee and independent contractor status.

  3. Describe and understand the process of developing a contract proposal.

  4. Describe the various contract negotiation strategies

Assignments:                                (Click purple links for PDF's)

a. Contracts for Emergency Physicians (Frank)

b. Physicians Guide to Employment Contracts

c. Employment Contracts

d. Key Contract Issues for Emergency Physicians

e. Negotiating Emergency Physician Employment

f. Negotiation Pearls

Recruitment/Retention/Employee Benefits

Objectives: 

  1. Describe the various recruitment methods and associated costs.

  2. Understand how to evaluate a potential job opportunity.

  3. Describe various methods of physician retention.

  4. Describe physician compensation and benefit plans.

  5. Understand the types of insurance needed once in practice and how to start planning for your retirement.

  6. Understand wellness techniques for emergency physicians.

Assignments:                                (Click purple links for content)

a. ACEP Webinars​​

​

b. How to Design the Optimal Schedule for Working Shifts

c. Review personal finance series​​

d. ACEP Wellness Guide

e. Four Tips for Landing an Emergency Medicine Job in a Competitive Region

f. A Guide for the perplexed: Start Early to Find the Best Job after Residency 

g. What Emergency Medicine Physicians want from Recruiters 

Medical Director and Academic Careers: 

Objectives: 

  1. Understand the various careers in Emergency Medicine.

  2. Understand the role of teaching in Emergency Medicine.

  3. Understand the role of the ED Medical Director.

Assignments:                                (Click purple links for content)

a. 12 Tips for Bedside Teaching

b. Bedside Teaching in Emergency Medicine

c. EM Teaching Methods

d. Teaching When Time is Limited

e. Medical Director Issues

f. ACEP Crowding Solutions White Paper

Specific Goals and Activities: 

I. Emergency Department Function   

A.  Describe most common metrics of ED performance and how to improve them 

  • ED physician profiling metrics ​

  • Billing, Coding and Documentation Issues 

  • Reimbursement issues

  • Risk management issues

  • ED function and administrative roles

  • Recruitment, Retention and Scheduling issues

  • Contract issues

  • Public Relations and Social Media

B. Activities:                                               (Click purple links for content)

  • Meet with ED Medical Directors, Drs. Wellock and Smith.

ULU Courses: 

a. Engaging with the C-Suite

b. Building Effective Hospital Relationships 

c. Medical Director Finances 

d. Medical Director MBO's

e. Continuous Process Improvement 

f. Coaching Essentials

  • Meet with Dr. Markowski regarding quality and risk management.

  • Attend one Emergency Department Peer Review Meeting. 

  • Meet with Dr. Seaberg to discuss contract and administrative roles. 

  • Complete readings. 

II. Hospital Function 

A.  Describe most common metrics of Hospital performance and how the ED impacts on these metrics. 

  • Quality and Patient Safety

  • HCAPS

  • Risk Management

  • Medical Staff issues

  • Compliance

  • Credentialing

  • Electronic Medical Record

B. Activities:                                          

  • Assignments

    • AHRQ Advances in Patient Safety Courses 

      • See Appendix A for assignments. ​

    • Complete Assignment of setting up an administrative quality study​

    • Read Ideal Team Player book

    • Complete DISC Assessment - Contact Dr. Reuter 

  • Individual Meetings

    • Schedule meeting with Dr. Kevin Markowski regarding Departmental QI.​

    • Schedule meeting with Dr. Mark McDowell regarding patient complain process.

    • Schedule a meeting with Summa President, Dr. Dave Custodio, regarding hospital strategic plan and emergency department expectations (please go through Dr. David Seaberg.

C. Hospital and Departmental Meetings:​

  • QAPI Meetings​

  • Patient Experience Oversite Committee

  • USACS NW Medical Director Zoom

  • Hospital through-put Meeting 

  • Medical Director Meeting

  • ED Peer Review

  • ED Ops/Department Meeting 

    • To give presentation at Departmental Meeting on Resident Update/Issues. ​

D. Complete CQI or Patient Safety Project ​

  • See Appendix B for assignment. ​

III. Personal Management                         (Click purple links for content)

Burnout Resources

A.  Understand Personal Finance Issues ​

B. Read White Coat Investor book. 

C. Understand Emergency Physician Wellness Issues 

D. Activities​

  • Read The White Coat Investor: A doctors guide to personal finance and investing

  • Meet with Dr. Scott on Personal Finance

  • Review ACEP Wellness Readings 

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