ACEP News - June 2008 - (Page 15)

JUNE 2008 • ACEP NEWS NEWS FROM THE COLLEGE Let Your Voice Be Heard: Submitting An ACEP Council Resolution BY CHRISTIE L. CARTER ACEP Ne ws Contributing Writer r. Robert Greenberg grew increasingly frustrated with the care that psychiatric and substance abuse patients received in the emergency department. Decreased funding and lack of available community resources often resulted in these patients boarding in emergency departments for days at a time. What frustrated Dr. Greenberg the most was that he knew these patients deserved better. Dr. Greenberg, an assistant professor and vice chair of the department of emergency medicine at the Texas A&M Health Science Center College of Medicine at Scott & White Hospital and Clinic in Temple, Texas, decided to bring awareness to the problem in 2006. He discussed it with colleagues in the Texas College of Emergency Physicians (TCEP), including Dr. Arlo Weltge, clinical professor of emergency medicine at the University of Texas Houston Medical School and ACEP Council vice-speaker. Together, Dr. Greenberg and Dr. Weltge decided to write an ACEP Council resolution to raise awareness and explore potential solutions for the problem—something that any ACEP member can do. “I realized that this issue affects me every day, and then I started asking questions and figured out that it affects nearly every emergency physician in the state,” said Dr. Greenberg. “Then the question becomes, does it affect emergency physicians nationwide? The answer to that is that it varies from state to state. While getting the support of TCEP’s 1,000 members is great, securing the support of ACEP’s 25,000 members really adds a lot of voice to this issue. We knew that this issue needed to go before the ACEP Council for consideration.” Although it requires just two ACEP members to submit a resolution for Council consideration, Dr. Weltge and Dr. Greenberg agree that there’s a better method. “It’s generally more effective when a chapter or section submits a resolution because it gets the input of a breadth of individuals to ensure that the wording is appropriate and on target,” said Dr. Weltge. “In addition, as the chapter or section moves that resolution forward, the delegation is then prepared to support it on the Council floor.” “We (TCEP) decide most of the time that we’re going to send a resolution through as a state chapter, not as individuals,” said Dr. Greenberg. “I believe this does make a difference in how the resolution is received. Seeing that an entire state or chapter is behind a resolution, you tend to think that it’s less of a niche issue.” The Minnesota ACEP Chapter took the same approach when it submitted a resolution to heighten awareness of psychiatric bed availability in 2006. “I wrote the resolution and then brought it forward to my chapter,” said Dr. Dan Hankins, an emergency medicine consultant at the Mayo Clinic. “The Minnesota Board agreed that it was a statewide problem, and we then submitted a consensus document from Minnesota ACEP.” Many resolutions start just that way—from an individual observing a problem or issue. “What I’ve found most effective is to jointly submit a resolution to my chapter with someone whom I respect, perhaps someone who’s been in chapter leadership,” said ‘TAKE ADVANTAGE OF THIS OPPORTUNITY AND EXERCISE YOUR RIGHTS AS PART OF OUR EMERGENCY MEDICINE COMMUNITY.’ Dr. Weltge. “We’ll comment on it between friends and then take that to the chapter and enlist their support. And occasionally, chapters or sections will recognize an issue and ask individuals to draft a resolution.” The ACEP Council meets annually for 2 days prior to ACEP’s Scientific Assembly. Resolutions go before ACEP Council reference committees that convene on the Council meeting’s first day. “This is an open forum where all members are free to speak to the reference committees, and we usually designate one person to speak on behalf of the chapter about why this resolution is important,” said Dr. Weltge. “Each resolution is individually considered, comments are taken, and the reference committees have the ability to rewrite or modify resolutions to make them more appropriate or effective, depending on the testimony that’s represented.” Resolution authors—and even their supporting chapters or sections—are encouraged to attend and show their support for their resolution. Several TCEP members, including Dr. Greenberg and Dr. Weltge, attended the reference committee session to support their resolution, and it passed because the Council recognized that psychiatric and substance abuse patients needed improved health care and more com- munity resources to address their issues effectively. Dr. Hankins and several fellow Minnesota ACEP Chapter members attended the 2006 reference committee sessions to offer testimony and support for their resolution on psychiatric bed availability. “We found a wellspring of support, and there were virtually no negative comments, because extended boarding times and long transfer distances for psychiatric patients are nationwide issues,” said Dr. Hankins. The reference committee did alter the original Minnesota resolution to make it less specific and more generalized to apply to the nationwide problem. “We had been a bit more specific about the issue of EMS transfers of psychiatric patients, and the reference committee wanted to broaden the resolution to hopefully bring it to the American Medical Association’s attention, because this isn’t just an emergency medicine problem—it’s a problem for hospitals in general that have psychiatric beds,” Dr. Hankins said. The resolution was presented at the AMA Annual Meeting in June 2007 and was approved by the AMA House of Delegates. (For more information about the subsequent AMA resolution, see article on page 20.) After ACEP reference committee members agree on the wording of the resolutions, they then summarize the debate and make recommendations to the ACEP Council, which deliberates all resolutions on the second day of the Council meeting. Resolutions not passed by the ACEP Council are often determined to be more local concerns than national issues. But that doesn’t mean members won’t benefit from bringing the issue before the Council. “Many times, by taking your issue forward to a larger audience, you will get some good ideas about how to address your local concern,” said Dr. Greenberg. “Regardless of why your resolution doesn’t pass, it should not be looked upon as a failure. The truth is, even if your issue didn’t get the action you wanted, you should still be satisfied with the process because you raised awareness of an issue—and perhaps gained some valuable input and advice in the process.” ACEP Council Speaker Dr. Bruce MacLeod, chairman of the department of emergency medicine at UPMC Mercy Hospital and clinical associate professor at the University of Pittsburgh School of Medicine, said Dr. Greenberg is right on target. “Writing and submitting Council res- Tips for Successful Resolutions Do some homework before submitting your resolution. The ACEP Web site is a great place to start. Does ACEP already have a policy on this topic? Has the Council considered this before? If so, what happened? “ACEP has a lot of resources to help with writing and submitting resolutions,” said Dr. Hankins. Talk with someone in leadership at your state chapter. “It’s not a difficult process,” said Dr. Greenberg, “but you do need someone who’s been there before to mentor you through it.” Consider the practical applications of your resolution. A wellwritten resolution that speaks to an important issue in a practical way passes through the Council more easily. Present your resolution (prior to submission) to your chapter or section and ask for their sponsorship. This allows your peers to give advice and assistance. Find and contact other stakeholders on your topic. They may have valuable insight and expertise and may cosponsor your resolution. Attend the debate concerning your resolution both in reference committee meetings and on the Council floor. If you cannot attend, prepare another ACEP member to represent you. olutions is what keeps our College healthy and vital, and it’s a great way for ACEP members to speak to College leaders and the Board of Directors. Even if your resolution doesn’t pass, the College will debate the topic and consider its ramifications. “In addition, other members may have resources or suggestions to address your issue,” Dr. MacLeod continued. “I encourage all of our members to take advantage of this opportunity and exercise your rights as part of our emergency medicine community.” For more information on what is required to write and submit an ACEP Council resolution, visit www.ACEP.org, and under the “About Us” section, click on “ACEP Leadership” and select the Council icon. The deadline to submit Council resolutions to be considered at this year’s meeting is July 28. ■

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ACEP News - June 2008 Contents News - Time to Move Tricks of the Trade - Revealing Tips Focus On - Dengue Fever Practice Trends - EMTALA Results

ACEP News - June 2008

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