In 2006, the Institute of Medicine (IOM) released a series of three books on the Future of Emergency Care in the United States Health System. These reports contained recommendations that called on the federal government and private stakeholders to initiate changes aimed at improving the emergency care system. Three years later, in May 2009, the IOM convened a workshop to examine the progress to date in achieving these objectives, and to help assess priorities for future action.

The May 2009 workshop, summarized in this volume, brought stakeholders and policy makers together to discuss which among the many challenges facing emergency care are most amenable to coordinated federal action. The workshop sought to foster information exchange among federal officials involved in advancing emergency care and key stakeholder groups from around the country.

Contents

• THE NATIONAL ACADEMIES
• PLANNING COMMITTEE ON THE NATIONAL EMERGENCY CARE ENTERPRISE WORKSHOP
• Reviewers
• Overview
• 1. Federal Progress Reports: Advancing Emergency and Trauma Care
  • WORKSHOP OVERVIEW
  • KEYNOTE ADDRESS
  • FEDERAL PROGRESS REPORTS
  • AUDIENCE DISCUSSION
  • REFERENCE
• 2. How Federal Policy Affects Emergency Care at the Community Level
  • GENERAL AUDIENCE DISCUSSION
  • THE ROLE OF GOVERNMENTS AND LOCAL PROVIDERS
  • INTERNATIONAL APPROACHES TO ED CROWDING
  • TRAUMA SYSTEM SUPPORT
• 3. Quality and Patient Safety
  • IMPROVING ED CROWDING AND PATIENT FLOW
  • REGIONALIZATION AND QUALITY HEALTH CARE
  • TRAUMA SYSTEM EVALUATIONS
  • STANDARDIZING QUALITY IN EMS
  • EMERGENCY CARE AS A HEALTH SYSTEM BAROMETER
  • WHAT IS QUALITY?
  • FINDING QUALITY BY CONNECTING THE LINKS OF THE CHAIN
  • LEGISLATING QUALITY
  • BUNDLING PAYMENTS TO IMPROVE PROVIDER LINKAGES
  • PATCHWORK REGULATORY SYSTEMS
  • RECOMMENDATIONS TO FEDERAL PARTNERS
• 4. Enhancing Emergency Care Research
  • RESEARCH CAPABILITY AND PRODUCTIVITY
  • BARRIERS TO EMERGENCY CARE RESEARCH
  • OPPORTUNITIES FOR EMERGENCY CARE RESEARCH FUNDING
  • UNFULFILLED RESEARCH AGENDAS
  • AHRQ’S ROLE IN EMERGENCY CARE RESEARCH
  • AUDIENCE DISCUSSION
  • PRIVATE RESEARCH DOLLARS
  • BOLSTERING THE RESEARCH WORKFORCE
  • ENROLLMENT IN CLINICAL TRIALS THROUGH EDS
  • TRANSLATING RESEARCH TO EVERYDAY PRACTICE
  • SUGGESTIONS FOR ADVANCING EMERGENCY CARE RESEARCH
  • INCREASING THE PERCEIVED VALUE OF EMERGENCY CARE RESEARCH
• 5. Health Professions Training
  • A SHORTAGE OF EMERGENCY PHYSICIANS
  • A SHORTAGE OF TRAUMA SURGEONS
  • A SHORTAGE OF EMERGENCY NURSES
  • REFORMING EMS EDUCATION
  • NEW ROLES FOR EMS PERSONNEL
  • AUDIENCE DISCUSSION
  • ADDRESSING WORKFORCE SHORTAGES
  • DISASTER PREPAREDNESS
  • IMPROVING EMS EDUCATION
  • WORKFORCE INTEGRATION AND COLLABORATION
  • PERFORMANCE IMPROVEMENT
  • IMPROVING NURSE AND MEDICAL EDUCATION
  • REGIONALIZATION
  • ESTABLISHING A CRITICAL CARE CERTIFICATION
  • REFERENCE
• 6. Emergency Care Economics
  • IMPACT OF THE ECONOMIC DOWNTURN ON EMERGENCY CARE
  • MEDICARE PAYMENTS
  • THE HOSPITAL’S VIEW OF THE ED
  • FINANCING TRAUMA CARE
  • REIMBURSING EMS
  • A VIGNETTE
  • DISTORTIONS IN THE MEDICARE PAYMENT SCHEDULE
  • AUDIENCE DISCUSSION
  • FINDING NEW REVENUE
  • COVERING HOSPITAL COSTS
  • REFERENCES
• 7. Federal Partners Roundtable
  • SESSION CHAIR SUMMARIES
  • FEDERAL PARTNER OBSERVATIONS
  • SUGGESTED FEDERAL PRIORITIES
  • CLOSING REMARKS
• Appendix A Workshop Agenda
• Appendix B Workshop Participants
• Appendix C Federal Response to 2006 IOM Recommendations

Rapporteur: Ben Wheatley.

This study was supported by Contract No. HHSP233200800008T, Task Order #21 between the National Academy of Sciences and the Emergency Care Coordination Center, part of the Office of the Assistant Secretary for Preparedness and Response in the Department of Health and Human Services; other contributors include the American College of Emergency Physicians and the Society of Academic Emergency Medicine. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the workshop participants and do not necessarily reflect the view of the organizations or agencies that provided support for this project.

Suggested citation:

IOM (Institute of Medicine). 2009. National Emergency Care Enterprise: Advancing Care Through Collaboration: Workshop Summary. Washington, DC: The National Academies Press.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.