American College of Emergency PhysiciansMonday, November 7
8:00 - 8:15 am – Intro - Robert W. Strauss, Jr., MD, FACEP
8:15 - 9:00 am – State of ACEP/Healthcare – Christopher Kang, MD, FACEP; Susan E. Sedory, MA, CAE
ED leaders are responsible for creating vision, communicating effectively, motivating others, and holding them accountable. To be effective, leaders require an understanding of the healthcare system, its dramatic changes, and the actions that ACEP is taking to guide us through the process. Leaders are inevitably responsible for developing partnerships with the hospital leadership, the group, and organizations like ACEP to develop effective responses.
9:00 - 10:15 am – The Role of the Medical Director: Developing Leadership and Communication Skills – Thom A. Mayer, MD, FACEP
The ED has a substantial impact on the institution’s and community’s provision of health care. Effectively leading the ED, its staff, and programs require navigation through a myriad of complex processes that may at first seem daunting. The presenter will highlight the issues of leadership and change in a complex organization. Specific examples of effective leadership and a description of the importance of effective communication skills (written and verbal) for the successful ED physician leader will also be discussed.
10:15 - 10:30 am – BREAK
10:30 - 11:45 am – Effective Conflict Management Skills – Robert W. Strauss, Jr., MD, FACEP
Callousness, anger, frustration, and tantrums are commonplace in the stressful environment of the emergency department. Many of our customers are in crisis. Everyone – emergency caregivers, private practitioners, patients, and administrators – has needs that must be met. Explore what causes “communication breakdown.” Participants will discuss the origin of common ED conflicts and successful methods to resolve them.
11:45 am - 12:45 pm – Rewarding Champions, Corralling Stragglers: Improving Performance Through Mutual Accountability – Thom A. Mayer, MD, FACEP
Rewarding the champions and “corralling the stragglers” is not a motto—it is a disciplined, formal, carefully considered approach to delivering the results that matter to our patients and our colleagues. It requires holding members of the team mutually accountable for aligned strategic incentives and metrics-based results—good for the patient and good for the team taking care of the patient.
12:45 - 1:45 pm – LUNCH
1:45 - 3:00 pm – Customer Relations and Patient Satisfaction – Thom A. Mayer, MD, FACEP
Do you know who your customers are and what they really want? Hospital leadership is placing increasing emphasis on patient satisfaction survey scores. Emergency department leaders are being held accountable to be able to interpret scores and develop and implement an action plan to improve scores on an ongoing basis. This presentation will offer a discussion on developing a work team, motivating and training staff, survey development, monitoring, and implementing responsive programs to address issues in a timely and effective manner as they arise.
3:00 - 3:15 – BREAK
3:15 - 4:15 pm – Containing Costs While Providing Prudent Care – Jay A. Kaplan, MD, FACEP
The effective ED leader must understand cost appropriate care and efficient utilization of critical resources. Financial realities place pressure on all participants in the healthcare environment and frequently necessitate a critical review of utilization. Too many CTs, admitting patients eventually denied by third party payors, unnecessary laboratory tests, staff cutbacks, etc., are all areas of frequent ED review. Critical review, peer comparisons (locally and nationally), and effective communication all play a role in defining appropriate utilization. The presenter will describe methods of encouraging practitioner (utilization) behavior change, when appropriate.
4:15 - 5:15 pm – Driving Hospital Quality – Jay A. Kaplan, MD, FACEP
The Emergency Department can be a major driver of hospital quality. Typically 40% of hospital admissions come through the ED and, as such, opportunities to "jump start" quality care for a broad array of inpatients exist. Leaders of EDs should seize the opportunity not only to provide exemplary care of their own patients but also to take a broader role in being a champion for hospital quality. This presentation will focus on the opportunities that emergency department leaders have to impact the quality of care not only provided in their departments but throughout the hospital.
5:15 - 6:45 pm – TeamHealth and Vapotherm Reception Discussions
Tuesday, November 8
7:00 - 8:00 am – BREAKFAST
8:00 - 9:00 am – Billing and Coding – Michael A. Granovsky, MD, CPC, FACEP
Most emergency departments generate money the old-fashioned way – they earn it by caring for patients. The key is to convince the payers that the providers are due reimbursement for the clinical services provided. Several basic principles of documentation, E/M coding, CPT definitions, RVUs, billing, charge structure, write-offs, bad debt, accountability, compliance, etc., will be discussed. Several time-tested methods of improving reimbursement will be discussed, as will methods to monitor your ED’s performance in this critical area. Additionally, the presenter will identify and suggest how to prevent billing, coding, and supervision issues subject to fraud and abuse.
9:00 - 10:00 am – Reimbursement Issues – Michael A. Granovsky, MD, CPC, FACEP
The bottom line is the bottom line. Without appropriate financial resources, your ED and group will fail. ED groups and hospitals are dependent on patient care revenues to support the mission of the department. Medicare cuts, managed care practices, and heavily discounted fee schedules may threaten the financial viability of ED practice. The presenter will provide an overview of today’s trends in ED reimbursement issues, including APCs, discounted arrangements, denials, etc.
10:00 - 10:15 am – BREAK
10:15 - 11:10 am – Addressing Burnout, Impairment and Achieving Work-Life Balance – Frank Lee, MD, FACEP
So much to do, so little time. The hospital wants better performance. TH wants implementation of a new program. Practitioners want more money and a better schedule. Patients are dissatisfied. And now, one of the docs has become irritated and comes to work disheveled. How can you address everyone’s needs and what about yours? Is it possible to avoid burnout, enjoy a balanced life, and keep the vitality necessary to be a healthy leader and simultaneously address the needs of those around you? YES!! TeamHealth has developed support systems to help you recognize and deal with the sometimes-overwhelming nature of the job. The presenters will share the nature of the problem, how to recognize it yourself and others, and the resources available to you to address these daunting challenges.
11:10 am - 12:15 pm – Negotiation Skills – Robert W. Strauss, Jr., MD, FACEP
It has been said, “You don’t get what you deserve; you get what you negotiate.” The presenter will describe and demonstrate critical negotiating principles and techniques that you can use in your professional and personal life to get you what you want and deserve. Critical concepts of time, deadline, starting position, and concessions will be described with real examples. Participants will recognize how effective negotiators use power techniques such as competition, expertise, and higher authority.
12:15 - 1:10 pm – LUNCH
1:10 - 1:45 pm – Working with Generations of Clinicians – Tracy G. Sanson, MD, FACEP
Millennials, Baby Boomers, Gen Xers, etc. all can be characterized by a variety of attributes that relate to what they believe and how they work. This presentation reviews the characteristics of the various generations in the workplace, defining effective approaches to each group. Armed with this objective information, a medical director can develop an approach to feedback, support, communication, etc. that are most likely to create the best team.
1:45 - 2:25 pm – Providing Clinician Feedback – Performance Conversations – Tracy G. Sanson, MD, FACEP
As a medical director, perhaps the most difficult responsibility is to provide effective feedback, particularly negative feedback. And yet, if the message is not conveyed in a clear manner, the recipient is unlikely to recognize the problem or change behavior. Where do you get the tools? Right here! With practice, you will be able to deliver the message in a way that both helps your providers and changes behavior.
2:25 - 3:00 pm – Problem Providers – Tracy G. Sanson, MD, FACEP
One of the most difficult situations an emergency department director must face is the problem physician. This practitioner can come in many forms (aggravates staff / patients / medical staff, resistant to necessary change, substandard care). This course will identify some of the more common types of problem practitioners and describe counseling techniques, the development of corrective actions with measurable outcomes, and end points. The presenter will also describe effective methods of termination.
3:00 - 3:15 – BREAK
3:15 - 4:15 pm – Staffing and Scheduling Methodologies I - Jody Crane, MD, MBA, FACEP
One of the most important aspects of being a director is creating the right mix of physicians and mid-level providers to ensure efficient care, satisfied patients, and proper revenue. Proper scheduling and awareness of practitioner wellness is essential for practitioner satisfaction. The presenter will review several methods for making an ED schedule that maximizes staff satisfaction yet effectively provides necessary ED coverage. When is another attending physician needed? When is a mid-level provider the best option? The most recent staffing trends will be discussed in light of the current increases in patient volume and acuity that many emergency departments are experiencing. Despite little scientific data, the current experiences of the most efficiently run emergency departments will be discussed.
4:15 - 5:15 pm – Staffing and Scheduling Methodologies II - Jody Crane, MD, MBA, FACEP
The formation of an effective leadership structure can move idea and commitment to implementation and improvement. The panel will describe how to develop various forms successful to ED organizational leadership. The participants will be given ample time to ask questions and describe barriers to successful leadership in their own organization. Panel members will comment on and make suggestions for improvement.
5:15 - 6:45 pm – Vapotherm Reception Discussion
6:45 – 8:15 pm – Vapotherm Complimentary Dinner and Educational Presentation
Wednesday, November 9
7:00 - 8:00 am – BREAKFAST
8:00 - 10:00 am – Legal Interviewing, Hiring, and Terminating – Daniel J. Sullivan, MD, JD, FACEP
Interviewing, hiring, and terminating is substantially more complex that it would appear to a new director. This presentation is designed to familiarize the medical director with the necessary approach, documentation and communication involved in legally hiring and firing. The presenter will provide case studies to demonstrate appropriate and inappropriate techniques of interviewing, hiring, counseling, and firing personnel. A full understanding of the essential steps in this common process protects the interests of all parties.
10:00 - 10:15 am – BREAK
10:15 am - 12:15 pm – Risk Management I & II – Daniel J. Sullivan, MD, JD, FACEP
Time, expectations, communication, errors, etc. all conspire against us to create dissatisfaction and poor outcomes. We and our colleagues all experience situations leading to less than optimal care. Preventative techniques will substantially reduce risk and improve the perceptions of care and caring by those receiving it. There are many known high-risk situations that when identified can be controlled and the impact limited. Among them are operational situations, such as change of shift (sign-out) and return visits, clinical presentations, such as chest pain and pediatric fever, behavioral issues, such as AMAs and communication. The speaker will review the major causes of malpractice and methods that you and others in your practice may use to avoid them.
12:15 - 1:15 pm – LUNCH
1:15 - 2:15 pm – Conducting Effective Meetings – Robert W. Strauss, Jr., MD, FACEP
“Oh no! Not another meeting!” The presenter will review when to and when NOT to have a meeting, and how to make the meetings you do have more effective and rewarding. Learn how to guide the overbearing, the sarcastic, the bashful, and the detractor. Discover effective methods to open and close discussions. This meeting will help to improve the rest of your meetings.
2:15 - 3:00 pm – Physician Contracts – Rebecca B. Parker, MD, FACEP
The success or failure of the contract between a physician and the group/hospital is based on effectively recognizing, discussing, and negotiating the difficult issues in advance. It is critical to clarify the important issues, expectations, and responsibilities when relationships are good, but what happens when they are not and termination is inevitable? What are the expected responsibilities, duties, and compensation? What is breach, is there a “no-cause” termination clause, what procedures exist for resolving disputes, and what are the restrictions?
3:00 - 3:15 – BREAK
3:15 - 4:00 pm – Facility Contracts – Rebecca B. Parker, MD, FACEP
When contracting with hospitals to provide emergency physician services, it is necessary to have a thorough, well-thought out and detailed contract. Attention to key elements of the cost incurred in providing emergency care, the duties and responsibilities of the parties, term and restrictions are critical to ensuring that both sides enter the agreement with an understanding of the performance expectations. The presenter will review the most common contract problems and methods to avoid them.
4:00 - 5:15 pm – Keeping Your Contract: Preventing and Dealing with Problems – Panel – Rebecca B. Parker, MD, FACEP; Daniel J. Sullivan, MD, JD, FACEP; Moderator: Robert W. Strauss, Jr., MD, FACEP
The formation of an effective leadership structure can move idea and commitment to implementation and improvement. The panel will describe how to develop various forms successful to ED organizational leadership. The participants will be given ample time to ask questions and describe barriers to successful leadership in their own organization. Panel members will comment on and make suggestions for improvement.
5:15 - 6:45 pm – AstraZeneca Reception Discussion
6:45 - 8:15 pm – AstraZeneca Complimentary Dinner and Educational Presentation
Thursday, November 10
7:00 - 8:00 am – BREAKFAST
8:00 - 9:30 am – Diversity and Inclusion Panel Discussion – Andrea Green, MD, FACEP; Berard Lopez, MD, FACEP; Stanley Thompson, MD, FACEP
Equality, equity, diversity, and inclusion are multiple concepts that are all critical to the success of an organization and its participants. Implicit biases developed during our childhood and after, prevent us from recognizing how we participate in non-equity and exclusion. This presentation will demonstrate multiple ways in which we unconsciously exclude others and methods of addressing those biases. The presenters will discuss the specific affects of bias and how to develop an inclusive environment. They will also address participant questions.
9:30 - 10:30 am – Malpractice Litigation Stress: Doctor Beware – Diana Nordlund, DO
Many of you and members of your team will be sued during your careers. Litigation is a major cause of stress and burnout in emergency medicine. Physicians who have been sued often practice defensive medicine, order unnecessary tests and consultations, and are more likely to make errors, all creating additional malpractice risk during this stressful period. As medical directors, you may have additional risk and accountability related to your departmental policies, procedures, and supervisory responsibilities. The presenter will describe the impact a malpractice claim has on an individual physician and emergency department.
10:30 - 10:45 am – BREAK
10:45 - 11:45 am – (Virtual) New Physician Recruiting and Orientation – Azita Hamedani, MD, MBA, MPH, FACEP
Does your recruitment/orientation process consist of a) "You want to interview, OK come see me during my shift tomorrow,” and b) “Now that you have completed the tour, here is a copy of the chart. Good luck!" Successful recruitment requires an elaborate organization of reviews and interviews and a thorough understanding of the candidate’s capacity and aspirations. Effective orientation incorporates substantial exposure to the EDs processes, policies, support systems, and operations prior to beginning clinical activities. The participant will be given guidance to develop effective processes for your own ED.
11:45 am - 12:45 pm – LUNCH
12:45 - 1:45 pm – Bringing Up Young Leaders – Teresa Wu, MD, FACEP
Leaders are not born, they are created by intrinsic motivation combined with opportunity, empowerment, mentoring, and feedback. And yet those with great potential are often overlooked because of implicit bias, preventing current leaders from recognizing and encouraging other group members. Others are held back by our inability to delegate and create accountability. We must create opportunities for others and develop them. Done successfully, everyone wins.
1:45 - 2:45 pm – Preventing Errors in Emergency Medicine – Matthew A. Silver, MD, FACEP
Mistakes happen! The Institute of Medicine report has focused significant attention on the ubiquitous nature of medical errors and the associated morbidity and mortality. This course will specifically focus on types, theories and causes of errors in emergency medicine as well as situations, practices and systems that are most likely to lead to mistakes. In addition, this course will look at system-based (process) solutions to errors.
2:45 - 3:00 – BREAK
3:00 - 4:00 pm – (Virtual) Rescuing Victims: A Primer on Recognizing and Addressing Human Trafficking and Domestic Violence – Jaime H. Hope, MD
When was the last time you saw a patient who was being trafficked…a human slave? How do you know it wasn’t your last shift? In fact, if you don’t think about it, you won’t see it. Human Trafficking is modern-day slavery. It’s ubiquitous and largely unrecognized. According to Homeland Security, more than 300,000 children a year lured into trafficking in the United States. But what can you do? The good news is…information, programs, and resources now exist that make a difference. You can educate your staff, provide assistance to your patients, and coordinate with community development programs.
4:00 - 5:15 pm – Patient Complaint Management – Robert W. Strauss, Jr., MD, FACEP
“Oh no…not another complaint!!” People complain when they are dissatisfied. Add the anxiety, confusion, and potential peril of an emergency and the number and seriousness of complaints increase. Complaint recognition and management are critical components of a successful ED director. When handled properly, a dissatisfied and angry person can achieve satisfaction. Alternatively, the improper management of a complaint can lead to a disgruntled person who seeks retribution. Leaders that recognize the relationship between quality and consumer satisfaction seek opportunities to improve by taking steps to reduce the root cause of dissatisfaction. The presentation will consider three issues: a) Who complains, why they do and methods of prevention; b) Successful program (process and tools) for complaint and compliment management; and c) Several classic ED complaints with underlying issues and methods of resolution.
5:15 - 6:45 pm – Beckman Coulter Reception Discussion
6:45 - 8:15 pm – Beckman Coulter Complimentary Dinner and Educational Presentation
Day 5 | Friday, Nov. 11
7:00 - 8:00 am – BREAKFAST
8:00 - 10:00 am – Engineering Patient Flow: Theory, Metrics, and Application – Karen Murrell, MD, MBA, FACEP
Your ability to operate an efficient emergency department is paramount to your success and tenure. This becomes one of our greatest management challenges. The speaker will describe methodologies to identify barriers and bottlenecks that compromise efficient patient flow. A discussion of queuing theory, crowding, and essential metrics will help you develop strategies to improve workflow, build effective relationships with ancillary providers, and incorporate structural redesign into the already complicated picture. The manner in which informed participatory decisions can improve operational efficiency and throughput also will be discussed.
10:00 - 11:00 am – (Virtual) Telemedicine: Expanding Opportunities to Deliver Emergency Care – Judd Hollander, MD
The pandemic has expanded the need and urgency for effectively delivered telemedical care. Is this an opportunity for natural expansion of emergency medical expertise both into the field (pre-hospital) and into consultative care (provider-to-provider). Just what are the opportunities, risks, training requirements, back-up systems? Listen to and ask questions of this expert panel to determine if this is an opportunity for you and your group
