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Hey guys!  It's been an minute and we're sorry about that, but we're back for a 5th season.  Dr. Wheatley and I are excited to bring a batch of new episodes starting with this one!  Dr. Emma Sizemore is a graduating resident and soon to be EM faculty at Emory.  She details the Medication Assisted Opiod Treatment pathway that we've been using in the observation unit at Grady.   Read Learn more about this pathway at www.obsprotocols.org Click on THIS LINK to read more about the COWS Dr. Wheatley mentions before the interview.  

Hey Pobscast crew, it's been a little longer than 1 month since our last show, but this one is packed with high yeild policy stuff. We do brief wrap up of the Obs conference in case you missed it.  We run over some things about psychiatric patients in observation status also.  We spend some quality time discussing the Society of Hospital Medicine's White Paper on obs.  In fact, the link is here.  Aslo we interview Dr. Bramante about what NY ACEP and further national ACEP is doing with the issue of self-administered medications (SAMs).  The resolution isn't public on the web yet, but when it is, we'll get it posted here.    

Hi guys!  Probably, most exciting thing we have this month is the new theme music from DJ Serengeti Yeti.  But also, we go deep on the Grady venous thromboembolism pathway and update the information on the OPPS.  Plus! Dr. Mahler (from the HEART Pathway studies) tells us who HE thinks needs (and doesn't need) a stress test in the ED.

This week, Dr. Wheatley and Dr. Osborne try to suss out how all of these acronyms relate to observaiton medicine.  Also, we have a new recurrent segment called 'WHO NEEDS A STRESS TEST.' So, who better to kick this off than the first author on the original HEART score paper.  Dr. Barbra Backus joins us from The Netherlands via Skype.  This is a can't-miss show! Feel free to email us questions or comments at pobservation@gmail.com.  

This is a new show format and we hope you love it.  In this episode we retrace some of the pivotal moments from the inception of the 2 Midnight rule. Dr. Wheatley and I consult experts throughout the field of obs and get their take on whether it helped or hindered their practices.  This week on the show we have Dr. Chris Baugh, Dr. Willie Smith, and Dr. Michael Ross joining us.  You won't hear a more comprehensive podcast on the policy and practice of the 2 midnight rule anywhere else.  

We had a great time at SAEM this year and we recorded this episode just after the Obs Interest Group meeting.  What are the differntiators from the ACEP group?  What esle can we do with this forum?  We sat with Dr. Capsers who shared with us some of his thoughts about the group, action items, and even the newer OIG report from December. Enjoy!  Also, email us at pobservation@gmail.com or check us out on twitter @pobservation.

Podcast friends! This week we have a special guest, Triffy Pacitti, who is the lead Advanced Practice Provider (APP) at Grady.  She tells Dr. Wheatley and I the real story of what managing APP's in observation units is all about.  She's got a ton of insight and experience.  If you're looking to start an observaiton unit that uses APP's, then this is a can't miss episode.  

Guys!  This week, Dr. Wheatley and I break down a couple of nuanced issues in obs.  We review an article about a newer risk score that may be translatable to your observation unit and then we take a deep dive into a recent publication about how physicians use obs in several hospitals.  PLUS, we take a look at the chatter from the ACEP Obs list serve and throw our two cents in.  All that...and we recorded a promo!...yeah...a promo.  Also, you can shoot us an email at pobservation@gmail.com.  

This week, Dr. Wheatley and I sit down with Dr. Stephen Pitts.  If you haven't read much of his health services research, then you are missing on some hard-hitting data about the role of the emergency department in national healthcare.  In addition to this special insight, Dr. Pitts was there at the beginning...of much of emergency medicine.  Hear how his first obs unit had a rough time and then get his take on where he thinks obs is going in the future.  There is real EM wisdom here to be attained!  Hope you enjoy!

Hi guys! This month we're talking about influenza and the MOON.  Do you put influenza-like-illness patients in your obs unit?  We talk some about the issues surrounding this treatment pathway and share the nitty gritty details of how both of the hospitals Wheatley and Osborne are handling Medicare Outpatient Observation Notice Act implemenation. The MOON slides from Mike Ross's update at ACEP 2106 are HERE The CMS form examples are HERE

Hey guys! This podcast, Dr. Wheatley and Dr. Osborne discuss some of the newest literature as it pertains to obs. Instead of butchering these innocent people's names, we put the info here! First we discussed this hot hot article from NEJM. Prevalence of Pulmonary Embolism among Patients Hospitalized for Syncope. N Engl J Med. 2016 Oct 20;375(16):1524-1531. Prandoni P Then we talked about this correlating study. Short-term Prognosis and Current Management of Syncopal Patients at Intermediate Risk: Results from the IRiS (Intermediate-Risk Syncope) Study. Acad Emerg Med. 2016 Aug;23(8):941-8. doi: 10.1111/acem.13013. Epub 2016 Aug 1. Numeroso F Then we talked about this interesting abstract. This is from the forum at ACEP and you can click the link to the PDF. It's abstract 76. Effect of a Sickle Cell Vaso-occlusive Crisis Observation Unit Pathway on the Admission Rate for Frequent Emergency Department Users Loeffler P, Sturgis L, Muelller T, Gibson R, Lyon M/Augusta University, Augusta, GA Then we finished with AHRQ study. It's also free can be found here! We hope you enjoy!

Did you miss the meeting of the Obs section?  Do you want to catch up on the MOON and what's going on with the psych-in-obs issue?  Well, look no further.  Dr. Wheatley and Dr. Osborne sum up the meeting and share their insights on the near future of obs and what's going on with the MOON act.  Don't miss this one!

If you are as deep in the world of Obs as Wheatley and Osborne, you'd know it's no secret that the facility payment for obs care has increased significantly.  We sit down with the Godfather of Obs, Mike Ross, who is break down the background and the future of this payment.  It's all you need to know and more to get up to speed on this important obs issue.  In fact, it's so much stuff, we gotta put some in this blog post just to keep it all straight!   This PDF covers how short stay inpatients will be reviewed.  

Hey guys!  Matt and I talk shop during this podcast and get down to the nitty of the gritty in operational details in one our best shows yet.  You've probably run into a lot of the same problems we have had and we're not perfect!  Also, we give some upcoming important dates about meetings and the big obs conference.  We even get to some listener emails.  Enjoy!

We recorded this one guerrilla-style in Boston.  So, those occasional loud bumps are just lobsters trying to get in on the action.  Wheatley and I sit down with Dr. Chris Baugh from Harvard to discuss some of the high points of the section meeting.  We cover a lot, but if you want to catch up on the Notice Act, read about that here!

Wheatley and I go deep in to a fairly controversial article abut the lack of studies in obs.  We recap the conference and talk money and syncope.  

Hey!  We discuss some of the finer updates around the 2 MN rule.  Additionally, we discuss Ben Sun's syncope paper and a smaller paper hammering home the points about how observation care does not hinder massive benefits from seniors.  Hopefully, we saw everyone at ACEP this year.  It was great.  Stay tuned for obs medicine conference.  THE DEFINITIVE ONE!

It's a long episode because it's a big deal.  Matt and I sit down with two big wigs from ACEP and go over the in's and out's of this rule.  We even get their thoughts about EM, Obs and the future.  You don't want to skip any parts of this show!

We've touched on heart failure in the past, but we're getting to the nitty of the gritty with Mike Ross.  We discuss 3 of the more current pieces in the literature today regarding obs and heart failure.  ENJOY!

This week we go to the archives from our trip to denver where we sat down with Carol Clark.  She discussed the upcoming observation medicine conference which will be in Troy, Michigan September 12-13 this year.  Enjoy!