Newsletters

POSTED: December 1st, 2023
POSTED IN: 2023 Quarter 4, EM Pulse - The Official Newsletter of MOCEP,

Do You Want to be an EM Medical Director?

Written by Kevin O’Rourke 

Do you find yourself looking around your Emergency Department and seeing opportunities for improvement?  Do you want to implement new protocols and guidelines?  Do you want to enhance the quality of care and patient safety in your ED?  Are you tired of just punching the clock?  Then the role of Medical Director may be right for you.

That’s how it started for me.  Seven years ago, while working a shift, I stopped my then-chair, Dr. Matt Gratton, and asked him if we could clarify the triage process for women who were more than 20 weeks pregnant.  He told me that it seemed like a great project for me to take on and, a month later, I became our Director of Operations (hint: no one else was interested in the position).  As I worked through this first project, I enjoyed thinking through the process from presentation to the ED to transfer to Labor and Delivery.  I had to think about the exclusions – chief complaints and vital sign abnormalities.  I researched recommendations from ACEP and ACOG.  I had many meetings and emails with our OB/GYN colleagues and nursing from both departments.  When we finally implemented the process, we continued to refine it and kept an open dialogue between departments.  While no process is perfect all the time, we have reduced the number of patient safety events in pregnant women and people seem to be happier with the process.  I’ll take that as a win.

As a medical director, I have enjoyed spending time investigating process failures, thinking about the outcome we are trying to achieve and putting in processes to consistently get there.  I have had the opportunity to call patients who weren’t satisfied with their ED visit, listen to their concerns and apologize with the hopes they will give us another chance the next time they have an emergency.  I’ve reviewed innumerable clinical order sets with my tech-savvy residents hoping to improve their experience in the electronic medical record.  One of my favorite roles is attending our high utilizer patient meetings and figuring out a plan to help these patients get care in a more appropriate place and address the barriers that are leading them to visit the ED so frequently.  We’ve been prescribing buprenorphine for medication-assisted treatment, we recently started giving long-acting injectable antipsychotics for a few of our patients with chronic schizophrenia, and in the future, I want to prescribe naltrexone to our patients with alcohol use disorder who want help getting sober.

Being a director has been one of the most fulfilling parts of my professional career at University Health – Truman Medical Center.  I have the ability to make changes that improve the lives of patients, nurses and doctors.  If you have an inkling this may be something you are interested in, I highly recommend you give it a shot.  Even the smallest of wins make for a great day.

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