Road Map for Change Pilot Project Research Objectives:
Given that this research proposes a pre/post implementation of Dr. Warden’s innovations, the following questions will be asked:
1. To what extent, is throughput of patients affected by this process redesign? Will results be the same in Ontario as in the U.S.?
2. Is patient and family satisfaction affected by Dr. Warden’s ED system?
3. To what extent, if any, is staff satisfaction and efficiency affected by Dr. Warden’s innovations? Will they have the same positive result as in the U.S.?
These questions are not meant to be exhaustive, but are crucial ones and easy to apply to this pilot project proposal.
The Road Map for ChangeTM Working Committee is the author and owner of this proposal. It is submitted in confidence to Glen Murray, MPP by Carol Mark, RegN, Todd Warden, MD; Terri Zborowsky, PhD.
Introduction
As detailed in the 2006 Institute of Medicine Report, “Hospital Based Emergency Care-At the Breaking Point,” hospitals throughout the United States increasingly struggled to meet the needs of patients coming through the doors of the nation’s Emergency Rooms and Departments (ER, ED) each year. ER crowding problems are multifactorial and pervasive across the country. One of the main problems is the persistent backup of admitted patients in the ER. This “boarding” of hospitalized patients in the ER essentially takes ER beds out of service.1 With fewer beds available for new patients, delays in the care of all ER patients are inevitable. Boarding also increases diversion of ambulance patients away from the facility. This problem is becoming more severe as ER visits continue to increase with 119.2 million ER visits in 2006 compared to 116 million ER visits in 2005. The boarding problem is likely to persist for several more years as hospitals slowly increase inpatient capacity. Alternatively, approximately 25% or less of ER patients required admission to the hospital: improvements in the care for non-admitted patients can have a major impact on the efficiency of care in the ER. All hospitals are struggling to develop innovative operational solutions in a time of limited resources to enhance throughput in the ER.
Research Background: Canada Facing issues similar to the US, authors of a recent report prepared for the
APPENDIX: BACKGROUND AND RESEARCH
Ontario Hospital Association conducted a literature review and interviews
with leaders of other ED’s who faced similar problems (OHA, 2010).3T
hey concluded that there are 5 cornerstone issues, addressing patient satisfaction, that provide an organizational structure for leading practices and improving the ER experience.
These include: Improve Patient Access
Improve the Waiting Experience for patients and family member
Provide an environment and care that is responsive to people’s needs.
Improving provider communication and customer service skills
Improving communication and education
Pilot Project Research Objectives:
The proposed High-capacity Model (HCM) detailed above provides an opportunity to test the assumptions made to increase ER capacity, decrease holding for admission and increased patient satisfaction. In essence, a “living lab” is proposed that provides a fertile ground to prove data that could prove a return-oninvestment.
To meet this end a multiple method research study is proposed that could answer the following questions (as they relate to the HCM identified above):
Improve Patient Access
Is there a decrease in waiting time?
Is there an decrease in time from entry to ER/ED (either walk-in or ambulance) to first physician contact?
Are there less patient’s who leave without being seen or treated?
Is there a decrease in overall length of stay to patient disposition?
Is there a decrease in lab reporting time?
Is there a decrease in Radiology report time?
Improve the Waiting Experience for patients and family member
Are patients more satisfied (ie. have their expectations met) with their waiting experience?
Are family members more satisfied (ie. have their expectations met) with their waiting experience?
Is the “perception” of waiting time for patients and their family members decreased?
How do patients perceive the Internal Disposition Area (IDA)?
Provide a physical environment and quality of care that is responsive to people’s needs.
Is pain managed better?
Are patients more satisfied (have their expectations met) with the quality of care received?
Are patient’s family members more satisfied (have their expectations met) with the quality of care received?
Are staff members more satisfied (have their expectations met) with giving care or performing their duties?
Do patients receive first line of treatments earlier i.e. ASA for acute myrocardia infarction?
Improving provider communication and customer service skills
Is patient communication with staff members increased?
Do patient’s perceive that they receive better care?
1 Moskop, J.C., PhD , Sklar, D.P., MD, Geiderman, J.M., MD, Schears, R.M., MD, MPH, Bookman, K.J.,MD. (November 25, 2008). Emergency department crowding, Part 1—concept, causes, and moral consequences [Abstract]. Annals of Emergency Medicine. doi: 10.1016/j.annemergmed.2008.09.019
2 CDC website, National Hospital Ambulatory Medical Care Survey: 2006 Emergency Department Summary, National Health Statistics Report, Number 7, August 6, 2008
3Ontario Hospital Association. Leading Practices in Emergency Department Patient Experience 2010/2011. Report written by Infofinders.
The Road Map for ChangeTM Working Committee is the author and owner of this proposal. It is submitted in confidence to Glen Murray, MPP and hospital administrators and doctors who may take part in any aspect of this proposal.
The Road Map for Change Working Committee comprises the following individuals: Carol Mark, RegN, Todd Warden, MD; Terri Zborowsky, PhD.
Notes:
Theresa Zborowsky
Curriculum Vitae
Education
Doctor of Philosophy
Department of Design, Housing & Apparel, University of Minnesota, 2008
Major: Interior Design
Dissertation: “Relationship between quality of life and the design features of housing and care environments for people with HIV/AIDS.”
Master of Science
Department of Design, Housing & Apparel, University of Minnesota, 1995
Major: Interior Design
Bachelor’s of Interior Design
Department of Interior Design, University of Manitoba (Canada), 1993
Nursing Diploma
Red River Community College, Manitoba (Canada), 1983
Teaching & Research Experience
Adjunct Faculty, Center for Spirituality and Healing, 2006-present Creating Optimal Healing Environments Co-instructor, Developed course curriculum
Critic, Department of Design, Housing & Apparel, University of Minnesota, 2009 Critique and evaluate senior thesis interior design projects.
Instructor, Department of Design, Housing & Apparel, University of Minnesota, 1998 Drafting Provide lectures. Critique and evaluate projects.
Teaching Assistant, Department of Design, Housing & Apparel, University of Minnesota, 1994-1996
DHA 1641: Interior Design, Studio 1
DHA 1642: Interior Design, Studio 2 Provide course syllabus and lectures. Assign, critique and evaluate projects.
Teaching Assistant, Department of Design, Housing & Apparel, University of Minnesota, 1995-1996
DHA 1101: Introduction to the Designed Environment Grade papers and exams. Organized field trips.
Teaching Assistant, Department of Design, Housing & Apparel, University of Minnesota, 1996
DHA 5103: Field Study: Design in Europe
Three week study of European interior design, architecture, and decorative arts in London, Paris, Luxembourg, Florence and Venice. Grade papers and exams. Organized field trips. Overseas mom.
Academic Advisor, Department of Design, Housing & Apparel, University of Minnesota, 1996-1997 Main advisor to undergraduates in interior design program.
Research Assistant, Department of Design, Housing & Apparel, University of Minnesota, 1996
Principle Investigator: Denise Guerin
“Color and culture.”
“Exploring writing-to-learn in design.”
Research Assistant, Department of Design, Housing & Apparel, University of Minnesota, 1996
Principle Investigator: Becky Yust Phillips Neighborhood Lead Collaborative
University Involvement Vice President
Department of Design, Housing & Apparel Graduate Student Organization, University of Minnesota 1996-1997
Diversity Committee
Department of Design, Housing & Apparel, University of Minnesota, 1994-1995
Professional Experience
Interior Designer, Medical Equipment Planner & Medical Space Planner
Currently Senior Medical Planner, Ellerbe Becket, 1997 - Present Worked on multiple projects in the Healthcare Business unit. Sample of Projects (additional project information available upon request):
Interior Designer Outpatient Imaging Center, Bozeman Hospital, Bozeman, MT, 2004
Mayo Clinic, Jacksonville, FL, (Junior Designer), 1995
NICU, Henry Ford Hospital, Detroit, MI (Junior Designer), 1993
Medical Space Planner (others available upon request)
Emergency Department (41 patient rooms) Gundersen Lutheran LaCrosse, Wisconsin
Completed DD, January 2010
Specialty Medical Office Building (XXX sf) Kaiser Permanente Portland, OR
Completed SD, January 2010
Patient Bed Tower (144 progressive care and medical/surgical beds)
Emergency Department (Level 1 Trauma 44 patient rooms)
Regions Hospital St. Paul, MN
June 2010
Emergency Center Renovation (30 patient rooms plus 12 bed Observation Unit)
Park Nicollet Methodist Hospital St. Louis Park, MN
April 2010
Specialty Care Center (Outpatient):
Sedation Center and Imaging Outpatient Oncology Unit Rehabilitation Specialty clinic
Children’s Hospitals and Clinics Minneapolis, MN April 2009
Neuro/Ortho/Spine Patient Care Center (128 patient beds) Abbott Northwestern Hospital Minneapolis, MN Completed 2006
Medical Equipment Planner Susan and Leslie Gonda Building, Mayo Clinic, Rochester, MN Equipment Planner for 10 floors of the clinic building, included outpatient sedation, diagnostic imaging and multiple clinic and outpatient functions. 1999-2002
Director of Healthcare Education & Research
Ellerbe Becket, 2005 to present Oversee all education and research efforts for the company. Includes a variety of tasks, includes the development of primary and secondary research projects as well as oversee in-house education efforts.
Research Activities: In-house Database: Assisted with development of in-house research database that now contains over 200 peer-reviewed articles.
Nursing Station Study: National primary research study conducted to compare and contrast effects of centralized and decentralized nurses’ station design on nurses’ psychosocial health and work behaviors, examining factors such as functional use of space, amount of time spent with patients and overall job satisfaction.
Patient Safety Study:
Longitudinal case study that is being conducted to examine the following questions; is there a reduction in the fall rate in patient rooms designed with the toilet on the headwall compared to rooms with the toilet on the footwall; and are there fewer falls and medication errors in acuity-adaptable patient rooms when compared with non-adaptable patient rooms.
Educational Activities: Research Database: Assisted with development of in-house research database that now contains over 200 peer reviewed healthcare design articles.
Healthcare Connections: In-house monthly office forum to update all the offices on projects, conference and educational opportunities throughout the firm.
Optimal Healing Environments Lecture Series: Co-creator of bi-yearly lecture series focused on educating the public on creating optimal healing environments. Joint effort with the Center for Spirituality and Healing of the University of Minnesota.
Related Work Experience
Editorial Assistant Journal of Interior Design (JID), 1995-1997
Registered Nurse
Concordia Hospital, Manitoba (Canada) 1988-1989
Registered Nurse Health Sciences Center, Manitoba (Canada) 1984-1988
Project Coordinator
Grace House (Adult Foster Care Facility for people with HIV/AIDS), 1996-1997 Designed questionnaire and completed data analysis in preparation of building second residential care facility.
Secretary & Committee Member
Coalition of Housing for People with HIV in Minnesota, 1994-1997
Review Committee Member
HOPWA (Housing Opportunities for People for AIDS), 1995-1996 Reviewed and made recommendations on housing proposals in the state of Minnesota.
Refereed Presentations (Presenter(s) underlined unless sole presenter)
Zborowsky, T.L, Morelli, A., & Crane, C. (2007). Panel Discussion: Evidence based design in architectural firms. Environmental Design Research Association. Sacramento, CA.
Morelli, A. & Zborowsky, T.L (2007). Central vs decentralized nursing station design. Environmental Design Research Association. Sacramento, CA.
Miller, N., & Zborowsky, T.L. (1996). Interior ecosystem model as a framework for programming in design education. Presented at the Interior Design Educators Council National Conference, Denver, Colorado.
Miller, N., & Zborowsky, T.L. (1995). Interior ecosystem model as a framework for programming in design education. Presented at the Interior Design Educators Council Midwest Regional Conference.
Zborowsky, T. L. (1995). Housing needs of people living with HIV/AIDS: An anaylsis of current literature. Paper presented at the Ninth Annual Conference on the Sociology of Housing, St. Paul, MN: University of Minnesota.
Zborowsky, T. L.,& Guerin, D. (1994). Supportive care environments for people with HIV/AIDS: Fact or fiction. Paper presented at the Interior Design Educators Council Midwest Regional Conference, Spring Green, WI.
Invited Presentations (Presenter(s) underlined unless sole presenter)
Zborowsky, T. (2011). Informing Design Decision Making through Research. Health Infrastructure and Medical Technology Conference. Delhi, India.
Bunker Hellmich, L., Zilm, F. & Zborowsky, T. (2010). Emergency Department Operations or ayout—Which is the Trump Card in Improving Efficiency? Healthcare Design 2010 conference, Las Vegas.
Schultz, E., Zborowsky, T. & Swanson, S. (June, 2010). Creating Optimal Healing Environments to Support Holistic Nursing Practice. Pre-conference Workshop, American Holistic Nursing Association National Conference, Colorado Springs, CO.
Zborowsky. T. & Bunker Hellmich, L. (May, 2010). The Role of Design in Creating Optimal Healing Environments. Society for the Arts in Healthcare National Conference, Minneapolis, MN.
Stichler, J., Gregory, D., Hayes, L. & Zborowsky, T. (June 2009). Inspiring and educating nurse leaders for their role in healthcare design. Lead Summit 2009, American Center for Nurses, Orlando, FL.
Zborowsky, T. (April, 2009). Transforming care through design. TORCH annual conference, Dallas, TX.
Zborowsky, T. (February, 2009). Healing environments. Minnesota Holistic Nurses Association monthly meeting, Minneapolis, MN.
Waugh, J. & Zborowsky, T.L. (2008). Exploring the ins and outs of patient room design workshop. ACI Communications, Houston, Texas.
Zborowsky, T.L. (2008). Improving practice through research: Integrating a design-based research agenda into an architectural firm. American Society of Healthcare Engineers, Atlanta, GA.
Community Involvement
Zborowsky, T.L. (2006). Improving practice through research: Integrating a design-based research agenda into an architectural firm. Center for Health Design National Conference, Altanta, GA.
Waugh, J., Devens, C., & Zborowsky, T.L. (2005). Step into the patient room of the future. International Academy for Design and Health, Frankfurt, Germany.
Waugh, J., Devens, C., & Zborowsky, T.L. (2004). Step into the patient room of the future. Paper presented at the Planning, Design and Construction Annual ASHE Conference. Florida.
Publications
Bunker-Hellmich, L. & Zborowsky, T. (Fall, 2010). Integrating Research into Design. HERD Journal.
Zborowsky, T., Bunker-Hellmich, L., Morelli, A., & O’Neil, M. (Summer, 2010). Centralized vs. decentralized nursing stations: Effects on nurses’ functional use of space and work environment. Health Environments Research and Design Journal.
Bunker-Hellmich, L. (2010, March). Patient focus—Developments in inpatient unit design. Health Facilities Management, 23, 26-29.
Zborowsky, T. (2010). Integrating research into a reflective practice of design: Moving interior design into the future. In C. Martin & D. Guerin (Eds.), State of the Interior Design Profession. Bunker-Hellmich, L. & Zborowsky, T. (2009, May/June). The inside scoop on safety. Medical Construction and Design, 5, 42-45.
Zborowsky, T. & Kreitzer, MJ (2008). Creating Optimal Healing Environments in a Health Care Setting. Minnesota Medicine.
Zborowsky, T. (2009). Integrating research into a reflective practice of design: Moving interior design into the future. In C. Martin & D. Guerin (Eds.), State of the Interior Design Profession.
Zborowsky, T. & Kreitzer, MJ (2008). Creating Optimal Healing Environments in a Health Care Setting. Minnesota Medicine.
Guerin, D. A., Olson, M. J., Zborowsky, T. & Lim, Y. (1999). Exploring writing-to-learn in design. Journal of Interior Design, 25 (1), 26-36.
TODD WARDEN, M.D. President Emergenuity Inc.
Professional Experience Summary
Executive
Integral executive leading an Emergency Physician group from small local provider into a major regional player
Took the physician lead in merger into major national firm creating the nations largest Emergency Medicine Physician contract company Led integration of 250 Emergency Physicians into national firm
As the Executive Vice President of national firm had bottom line responsibility for a budget of $85M
Physician Management and Leadership Development
Managed clinical and financial performance of over 300 Emergency Physicians, 40 Medical Directors and 12 Regional Medical Directors
Provided physician leadership in the development of a comprehensive incentive compensation program
Over twenty five years of physician management experience with demonstrated ability to manage physician performance
Process and Change Management
10 years experience working intimately with hospital and Emergency Department (ED) leadership to define process enhancements that have dramatically improved ED performance
Created the first integrated program (PDIM2) that standardizes strategies for ED performance improvement with focus on:
Process Design
Implementation
Maintenance and Metrics
Defined innovative approach to nursing functional performance in ED high-performance units
Pioneered a change in productivity assumptions for ED bed capacity from 2000 to 4000 patients per bed per year
Developed tools to evaluate ED flow metrics that impact ED design
Worked intimately with architecture companies to develop new ED designs that complement the process and functional enhancements that has created:
Construction that require 1/3 the capital of traditional ED design
Significantly lower cost of operations due to innate efficiencies of ED design and process enhancements
Developed informatics and technology driven approach to ED Case Management and Observation Medicine
Worked with nursing colleagues to create a program that dramatically reduced the number of patients waiting in the ED for admission
Reduced length of stay and denials of patients admitted through the ED
Clinical Informatics
Fifteen-year history of relational database experience and well versed in database theory, application and programming
Created a “dynamic reporting environment” for clients utilizing healthcare transactional data
Reduced utilization of expensive and unnecessary testing when more sophisticated and less expensive alternatives were available
Improved utilization of appropriate medication in the ED that significantly improved patient outcomes and decreased patient LOS and cost of hospitalization
Clinical tool creation to assist with manual data collection as well as tools to drive clinical and operational decision making
Developed clinical data collection tools that have built-in logic and assist in patient management decision making
Creation and maintenance of Physician Management Tools that provide actionable metrics for physician practice management
Recent Publication
Warden, Todd, MacKenzie, Richard; Understanding Emergency Department Capacity, Failure Mode Analysis: The Bi-Modal Key to ED Crowding. Published in the HFMA New Jersey Chapter professional journal Focus. November/December 2010, page 12. http://www.hfmanj.org/public.assets/23771_Focus.pdf
Introduces the concept of ED bi-modal peak volume impact on departmental capacity needs that have been virtually unreported
Discusses the inadequacy of traditional ED design and bed capacity assumptions
Reviews how new high-capacity ED models address the capacity to increase ED productivity
Demonstrates how new models have much lower cost of operations and cost of construction
Professional Experience
2000 – Present Emergenuity, Inc. www.emergenuity.com
Emergenuity was founded in 2000 by Dr. Todd Warden, a residency trained Emergency Physician, to address the overwhelming issues of ED crowding and improve the safety of the patient’s environment by reducing the time patients spend in the waiting room
Secondary but powerful financial implications were demonstrated
Marked reductions in patients that left without being seen with attendant increases in patient revenues
Virtual elimination of ambulance diversions
Improvements in patient satisfaction especially “the patients perception of time to provider”
Increased ED volumes and increased patient revenues
ED Case Management programs have reduced the: Time patients wait in the ED for admission
In-patient’s length of stay
Payer denials
Emergenuity is a change management organization focused primarily on using aggressive process enhancements to create dramatic improvement in Emergency Department performance and creating a safer patient environment
Secondarily utilizing the power of innovative ED design to complement processes being introduced into the healthcare environment
Then integrating technology to hardwire process and design enhancements
Worked with a major healthcare system and national architectural firm to create the first de novo high-performance unit in the country utilizing Dr. Warden’s high performance design and processes
Dramatic reduction in cost of construction
Incorporates best practices in EM
Pioneers the functional division of nursing labor to enhance productivity
Utilizes clinical internal waiting to markedly increase ED capacity
Creates the first ED beds rated at a capacity of 4,000 patients per bed per year compared to traditional ED bed capacity of 2,000 annually 1/3 the construction cost
Much lower cost of operations due to efficiencies of process and design integration
Turnaround of a Florida Emergency Department
Hospital had a 24% left without being treated rate
Loss of 10,000 patient annual volume over a two year period
Utilizing “tipping point” techniques and “organizational anxiety” management methodologies
Increased ED patient revenue by $2.5M with no additional labor or construction cost
Implementation of Rapid Evaluation Unit in North Jersey ED
Time to physician decreased from 1.75 hours to 11 minutes
Waiting room emptied
Left without Being Seen decreased from 5.5% to 0.2%
Increased volume 6-7% annually no additional FTEs
Increased revenues by $800K annually
Medical staff satisfaction improved
Stabilized ED physician group contract with hospital
Dramatically improved patient satisfaction
Implementation of Rapid Evaluation Unit in Queens NYC ED
Time to physician decreased 2 hours to 15 minutes
Waiting room emptied
Left without Being Seen decreased from 6% to virtually 0%
Patient satisfaction increased 22 points raw score on “patients perception of time to physician”
Increase ED patient revenues by $1.5M with only minimal construction costs and no increase in labor costs
2000 – 2002 Sinai Hospital of Baltimore Maryland Baltimore, Maryland
Interim Chief, ER-7
Department of Emergency Medicine
Successfully served as Chief of ER-7 on an interim basis, stabilizing and improving department performance until permanent candidate was selected
Successfully implemented “Patient Resource Management System”
Created physician assessment tool to evaluate physician test ordering, turn around times, and patient satisfaction score. Encouraged improved behaviors and physician accountability
Improved turn around times of discharged patients by 70 minutes
Reduced patient walk-out by 50%
Reduced unnecessary lab test ordering by 23%
Reduced x-ray ordering by 18%
1996 – 2002 EmCare, Inc.
Executive Vice-President Northeast and Mid-Atlantic Division
Responsible for $85M in revenue. Led a team of 300 ED physicians with 12 Regional Directors
Negotiated contract agreements with insurance plans and third party payers
Horsham, PA
Defended claims submitted and successfully secured collections from insurance plans for services rendered by Emergency Physicians
Supervised operations and management of Emergency Departments in up to 40 individual hospitals and hospital systems
Designed and implemented all strategic planning for administrative, financial, and clinical operations for the Northeast Division
Responsible for $85M in revenue. Led a team of 300 ED physicians with 12 Regional Directors
Negotiated contract agreements with insurance plans and third party payers
Defended claims submitted and successfully secured collections from insurance plans for services rendered by Emergency Physicians
Supervised operations and management of Emergency Departments in up to 40 individual hospitals and hospital systems
Designed and implemented all strategic planning for administrative, financial, and clinical operations for the Northeast Division
1993 – 1996 Spectrum Healthcare Services Horsham, PA
Executive Vice-President Northeast Division
Responsible for $60M in revenue and led a team of 250 ED physicians and 8 Regional Directors
1986 – 1993 Coordinated Health Services, Inc. Horsham, PA
Medical Director
1985 – 1991 Our Lady of Lourdes Medical Center Camden, NJ
Chief, Emergency Medical Services
1984 – 1985 Methodist Hospital Philadelphia, PA
Director, Department of Emergency Medicine
1982 – 1984 Methodist Hospital Philadelphia, PA
Assistant Director, Department of Emergency Medicine
1971 – 1975 Princeton University Princeton, NJ
Degree: Bachelor of Arts Magna Cum Laude
1975 – 1979 Northwestern University Medical School Chicago, Illinois
Degree: M.D.
1979 – 1982 Hospital of the Medical College of Pennsylvania Philadelphia, PA Emergency Medicine Residency
Certification
Diplomate: American Board of Emergency Medicine Certified November 1983 Re-certified October 1993
Fellow: American College of Emergency Physicians November 1986
Appointments
Assistant Clinical Professor
Section of Emergency Medicine
Thomas Jefferson University Hospital Philadelphia, PA
Publications
Warden, Todd, MacKenzie, Richard; Understanding Emergency Department Capacity, Failure Mode Analysis: The Bi-Modal Key to ED Crowding. HFMA New Jersey Chapter professional journal Focus. No vember/December 2010, page 12. http://www.hfmanj.org/public.assets/23771_Focus.pdf
Warden M.D., Todd, A Radical New Approach to Clinical Information Management. Business Integration Journal, February 2005
Sacchetti, A, Harris, R, Warden, T, Moakes, ME: Utility of UB-92 Data for Monitoring Emergency Department Performance Improvement. Journal for Healthcare Quality. 2001; 23: 26-28
Sacchetti, AD, Warden, T, Moakes, ME, Moyer, V: Can Sick Children Tell Time?: Emergency Department Presentation Patterns of Critically Ill Children. Academic Emergency Medicine 1999; 6:906-910
Warden, Todd, M.D., Sacchetti, Alfred, M.D., Klodnicki, Walter, M.D.: Magnesium Sulfate Termination of Torsades de Pointes Following Failure of Cardioversion. American Journal of Emergency Medicine; 1989; 7:126-127
Ramoska, Edward, M.D., Sacchetti, Alfred, M.D., Warden, Todd, M.D.: Credentialing of Emergency Physicians: Support for Delineation of Privileges in Invasive Procedures. American Journal of Emergency Medicine; 1988; 6:268-271
Sacchetti, Alfred, M.D., Carraccio, Carol, M.D., Warden, Todd, M.D., Gazak, Stephen, M.D., Community Hospital Management of Pediatric Emergencies: Implications for Pediatric Emergency Medical Ser vices. American Journal of Emergency Medicine Vol 4, No. 1, January, 1986
Warden, Todd, M., M.D.: Incision and Drainage of Cutaneous Abscesses and Soft Tissue Infections in Hedges, J., and Roberts, J., (eds): Clinical Procedures in Emergency Medicine, Phila., W.S. Sanders Com pany, 1985
Abstracts
Sacchetti, A, Harris, R, Roth, S, Warden, T: Contribution of Emergency Department Admissions to Inpatient Revenue. (SAEM) Academic Emergency Medicine 2000; 7:543-544
Sacchetti, A, Warden, T, Harris, R: The Utility and Futility of UB-92 Data for Emergency Department Profiling. Annals of Emergency Medicine 1999; 34:S71
Sacchetti, AD, Moakes, ME, Warden, TM: Can Sick Children Tell Time? Presentation Patterns of Critically Ill Children Do Not Match Hours of Part-Time Pediatric Emergency Departments. (SAEM) Academic Emer gency Medicine 1998; 2:385
Sacchetti, AD, Moakes, ME, Warden, TM: Immediate Documentation Feedback System for a Transcribed Patient Record. (SAEM Abstract) Academic Emergency Medicine. 1994; 1:A104
Sacchetti, AD, Warden, TM, Baker, MD: A Novel System for Emergency Pediatric Airway Access. (Proceedings of Annual Meeting AAP) Pediatric Emergency Medicine Care. 1990; 6:232
Education/Training
Research Presentations
Sacchetti, A, Harris, R, Roth, S, Warden, T: Contribution of Emergency Department Admissions to Inpatient Revenue. SAEM Annual Meeting, May 22-25, 2000, San Francisco, CA
Sacchetti, A, Warden, T, Harris, R: The Utility and Futility of UB-92 Data for Emergency Department Profiling. ACEP Research Forum, October 11-12, 1999, Las Vegas, NV
Sacchetti, AD, Moakes, ME, Warden, TM: Can Sick Children Tell Time? Presentation Patterns of Critically Ill Children Do Not Match Hours of Part-Time Pediatric Emergency Departments. SAEM Annual Meeting, May 17-20, 1998, Chicago, IL
Sacchetti, AD, Moakes, ME, Warden, TM: Immediate Documentation Feedback System for a Transcribed Patient Record. SAEM Conference, 1994, Washington, DC
Author’s Replies
Ramoska, Edward, M.D., Sacchetti, Alfred, M.D., Warden, Todd, M.D.: “Credentialing of Emergency Physicians.” American Journal of Emergency Medicine, 1988; 6:424 - 425
Annette Hastings CEO, St. Johns Hospital, NY
CEO, Palisades Medical Center, NJ
© Dr. Todd Warden
© Dr. Todd Warden
© Dr. Todd Warden