bnapolitano, Author at Journal of Urgent Care Medicine

UCA Webinar: Improving Infection Control in Your Urgent Care Centers

With international travel and increasing levels of antibiotic resistance both on the upswing, helping patients who present with any variety of infections has never been more challenging for the urgent care clinician. The Urgent Care Association will host a webinar on the subject on Thursday, June 7, from 1 to 2 pm, Central. Speaker Lori Swanson, RN, MHSA, CHC, compliance and qualify officer for Physicians Immediate Care in Illinois and Indiana, will review best practices …

Humana Prefers You Don’t Know the Details of Its $45 Billion Tricare Contract

Humana’s military unit has filed suit against the federal Defense Health Agency in an effort to block the details of its $45 billion Tricare managed care contract from becoming public, as reported late yesterday by Law360. Humana Military is seeking a permanent injunction blocking the agency’s decision to disclose certain proprietary information provided by Humana as part of its bid for the Tricare contract, according to the complaint filed in Washington, DC federal court. Though …

Slow Medicine: ‘Unprescribing’ America

#TimesUp; #NeverAgain; #Privacy; #OpioidCrisis; #BlackLivesMatter…. The last year has been a dramatic one for turning points in long-festering social issues. For decades, we turned our cultural cheek on problems we knew existed (misogyny and bias) or should have seen coming (opioids, mass killings and privacy). But in 2017 and into 2018 we are witnessing a tidal wave of resistance and public denunciations against the ugly side of American life. A collective enough is enough echoes …

A 34-Year-Old Woman with an Unidentified Insect Sting

Case The patient is a 34-year-old woman who has just returned from the first camping trip of the year with her family. She relays that 2 days earlier, as she as she was setting up a tent, she “got stung” by something she didn’t see. As she struggled to free herself of the tent fabric, she was stung several more times on her hand and arm. She never saw the culprit. Not long after, she …

Developing a Reimbursement Policy for CME and Other Employee Expenses

Urgent message: Every urgent care center should have a clear policy outlining which employee expenses, including CME-related expenses, it reimburses and how reimbursement occurs. Alan A. Ayers, MBA, MAcc is Chief Executive Officer of Velocity Urgent Care and is Practice Management Editor of The Journal of Urgent Care Medicine. Managers, owners, and supervisors in nearly every field need to be familiar with the process of reimbursing employees for costs incurred while doing company business. Whether …

New Medicare Cards

Q: The Centers for Medicare and Medicaid Services (CMS) started issuing new Medicare cards to beneficiaries in April of this year. What do I need to know about these changes to limit disruption to my patients and medical practice? A: CMS is required to issue new Medicare cards as a part of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, which mandates that CMS remove Social Security Numbers (SSN) from all Medicare cards …

Head Injuries and Cirrhosis: Does everyone need a CT Scan?

Urgent message: The decision of whether or not to image a patient with a head injury has significant implications—for the patient and the urgent care provider. Understanding which patients are at greatest risk for serious head injury, indications for testing, and options for management/disposition is essential. Brandon Godfrey, MD; Haylie Wiesner, BS; and John Shufeldt, MD, JD, MBA, FACEP Case A 47-year-old male with a history of alcohol abuse and cirrhosis presents to an urgent …

A 17-Year-Old Male with Knee Pain After a Fall

Case The patient is a 17-year-old male who presents to urgent care with anterior knee pain after a fall while mountain biking. However, he states that he’d been experiencing pain for an indeterminate period of time before the incident that preceded his visit. View the image taken (Figure 1) and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page. Figure 1.

Concussion Management in Urgent Care: A Primer for Implementation

Urgent message: Sports-related concussions are particularly dangerous injuries due to their complex nature and difficulties associated with diagnostic and return-to-play decisions. Some of the most commonly employed assessment tools have been shown to be unreliable, leading to misdiagnoses. Guidelines for selecting more effective concussion assessment instruments and the use of such tests in urgent care settings are here suggested as an optimal framework for improved care. Len Lecci, PhD, MA IntroductionMillions of adults, adolescents, and …

The Effect of PECARN Guidelines on Minor Head Injury Referrals from the Urgent Care Center to the Emergency Room

Cathleen DeLaney DNP, MSN-FNP, APRN and Kris Skalsky MSNEd, EdD, RN Abstract Background and Purpose: The focus of this project was to determine if an evidence-based educational intervention had an impact on reducing the number of pediatric head injury referrals from the urgent care center to the emergency room. The urgent care center often makes referrals of pediatric head injury patients to the ED, contributing to the overutilization and overcrowding of an already taxed system. …