As a method to increase transparency and improve collaboration on contracting initiatives, especially in physician preference items in the operating room, being able to share pricing and price comparisons between vendors with your MD's can prove to be very beneficial.

That being said, many vendors work language into their contracts that prohibits such sharing of data. From a legal perspective, has anyone experienced this and what risk is a hospital actually at if they engage their MD's in this fashion on contract initiatives?

To what extent are not for profit organizations implementing the SO guidelines into board oversight? While it is a process that guides publicly traded companies, the principles certainly seem to mesh well for any well-managed HCO. Please share your experiences within your organizations. Our board structure has recently changed from a joint-conference committee structure to one that involves key community members. We have a great opportunity now to address the expectations, evaluations and improvement process of the group’s function over time.

Does anyone have any insight as to what kind of information can be shared between hospitals and the medical colleges that employ the physicians?  I am also interested in any reference materials on the subject matter.

I'm wondering how other organizations are interpreting EMTALA.  Most organizations have taken a very conservative stance on EMTALA given the negative publicility that can come from even being accused of patient dumping.  Yet, over-use of the ED, increased wait times, increased bad debt ,and uncompensated care is forcing organizations to take a different approach with applying EMTALA.

Examples include:

1.  Placing a physician/PA in the triage room to deliver the MSE, and securing payment once an emergency medical condition is determined to not be present.

2.  With-hold discharge instructions/prescriptions until payment has been received

3.  Triage-less ED's

4.  Pre-scheduled ED appointments for non-emergency conditions.

5.  Patient registration kiosks - which brings up a follow-up question as to how EMTALA applies to a patient when they self-register

Slide 42 of the presentation indicates EMTALA applies to all individuals who come to a hospital's dedicated ED or elsewhere on hospital property. 

This is unclear to me because my understanding of EMTALA is that a patient must request emergency care.  So, if a hospital has an outpatient clinic on the property, does EMTALA apply to patient's arriving for a clinic appointment simply because it is on the same campus as the Emergency Department? 

Again, a patient must clearly request emergency care or state that an emergency exists in order to EMTALA to apply.

The question I have is when hiring for various positions many factors are looked at and how do you balance finding the best canidate while trying to make sure you don't dicriminate on any of the many factors?  While you always want the best candidiate how do you ensure your view of each candidate is 20/20 and not biased?