From the Chair

Anthony R. Rosania, MD, MHA, MSHI, FACEP

Greetings Observation Medicine Section! I’d like to thank you all for taking the time to both read this newsletter and to be a member of our robust, active, and energetic section. When I first got into Observation Medicine, one of the things that impressed me, and continues to impress me, is how welcoming and collegial everyone is who does this work. I remember feeling nervous as I asked others if they’d share their protocols. Without exception, they all smiled, nodded, and promptly emailed them to me. I was so impressed by this culture of sharing that it made me love the work even more. Perhaps in other “subspecialties” it is the same – but without doubt, in Observation Medicine (OM) we welcome the opportunity to work together, educate, and help others succeed.

I’ve never met a single “Observationalist” who would even think to not share a protocol, a paper, some data or evidence. It is only because so many others helped me learn and grow that we have managed to be successful in this work at my institution. And now, it’s been my pleasure to help others and to be the one who smiles when someone timidly asks, “would it be too much to ask to see your protocols.” I’m pretty sure we who do this work only get upset when someone doesn’t ask to see our protocols.

As we enter this new year, there is much to be excited about in OM. We are coming off a very successful inaugural conference at ACEP Accelerate. We awarded our third Lou Graff award. JACEP Open now hosts an OM journal. And we are well on our way to establishing an Observation Unit accreditation pathway. This work has been or is being done by several of our colleagues. I thank them all and will leave it to them to tell you about the great work they are doing in future newsletters.

This leaves us to look with a view toward the future. As the current Chair, I am engaging with ACS – COT leadership on the role of ED Observation Units in the management of trauma patients. For those who don’t know -- when we placed patients on our units, the ACS currently counts that as a “non-surgical admission.” Our goal is to have our OU patients removed from the denominator and treated as any other ED patient. This will allow us to better partner with our trauma colleagues on providing the complex care management that many of our injured patients need. If any of you have specific successes in this area, I would love to hear them from you.

Additionally, I hope to renew discussions among our leadership and membership on the pursuit of a Focused Practice Designation (FDP) for Observation Medicine. As I am sure many of us experience in our day-to-day, our field is becoming more niche and specialized as we take on the management of ever more complicated clinical cases, as well as the increasing need for robust care coordination for many of our more vulnerable patients. I’d love to hear from all of you on what your thoughts are on this – both in favor of, and against.

Lastly, I want to hear from each of you. What are your current OM challenges, and what are your triumphs? We want to hear about them and, even if they do not rise to the level of peer review, put them into future newsletters. For our institution, we are currently thinking a lot about the role of pediatric observation, and so I may be reaching out to some of you who have experience in this for your input. I’d love to see something in the newsletter on that subject.

So let me close by thanking you all again, and telling you how honored I am to be Chair of this section. I’m looking forward to this year, and the years beyond as we grow and mature as a field.