Chaos in the emergency department is common. How to fix it is not always clear. Mary P. Mercer, MD, MPH, from the University of California, San Francisco, discusses how they successfully fixed their long dwell times at the emergency department at San Francisco General Hospital. Their solution was to create a fast-track unit that managed low-acuity patients separately from the rest of the emergency department cases. The most important aspect of this quality improvement effort was the ongoing and regular engagement of executives from the medical center with frontline staff.

Read the article: Reducing Emergency Department Length of Stay

Electronic health records are the bane of most clinicians’ existence. They were supposed to help us but not only have they made life more difficult for clinicians, they are the cause of medical errors. Described here is a case of the patient receiving an unnecessary procedure because an order was not canceled in an EHR where it had disappeared from the clinicians’ view. A second theme in this case that is consistent in nearly all of the JAMA Performance Improvement articles to date is inadequate communication among clinicians.