American College of Emergency Physicians

Action on 1998 Resolutions

Memorandum

To:	2001 Council
From:	Colin C. Rorrie, Jr., PhD, CAE Council Secretary
Date:	September 7, 2001
Subj:	Action on 1998 Resolutions

This report summarizes the actions taken by the Board of Directors on the 26 resolutions adopted by the 1998 Council and the three resolutions referred to the Board of Directors (Attachment A). Resolution 27(98) was referred to the Steering Committee.

Resolution 2 AOBEM Certification for Fellow Status
This was an amendment to the Bylaws. The Board of Directors adopted the first resolved, which made AOBEM diplomates eligible for fellow status. The Bylaws were revised in October 1998 to reflect that change. The Board did not adopt the second resolved pertaining to life fellow status. The Board determined that the second resolved contained a transcription error and although the Council approved the resolution it would be inappropriate for the Bylaws to have different requirements for fellow status and life fellow status. A resolution to correct this inconsistency was submitted to the 1999 Council and it was adopted by the Council and the Board. The Bylaws were revised in October 1999.

Resolution 4 Adding Vice Speaker to the Finance Committee
This was an amendment to the Bylaws and was adopted by the Board. The Bylaws were revised in October 1998. A resolution was submitted to the 2000 Council to delete the vice speaker as a standing member of the Finance Committee and designating the "speaker of the Council or his/her designee." The Bylaws were revised in October 2000.

Resolution 5 General Medical Officers
This was an amendment to the Bylaws and was adopted by the Board. The Bylaws were revised in October 1998.

Resolution 6 Filling a Board Vacancy
This was an amendment to the Bylaws and was adopted by the Board. The Bylaws were revised in October 1998.

Resolution 7 Removal of a Board Officer
This was an amendment to the Bylaws and was adopted by the Board. The Bylaws were revised in October 1998.

Resolution 11 Membership Dues
RESOLVED, That the ACEP Board be directed to investigate options by which members may spread out payment of annual dues over a period of time and report these to the 1999 Council.

The Board adopted the resolution and it was assigned to the Membership Committee to develop a recommendation to the Board. The Board adopted a dues installment payment program in January 2000.

Resolution 12 Benchmarking
RESOLVED, That ACEP develop appropriate standards for emergency department benchmarking and evaluate current methods of "benchmarking" for appropriateness to the emergency department.

The Board adopted the resolution. The Emergency Medicine Practice Committee and the Research Committee continue work on the issues identified in the resolution. The Research Committee is exploring the development of criteria for methodology and implementation of statistically valid patient satisfaction surveys in the ED.

Resolution 13 Ultrasound Imaging by Emergency Physicians
RESOLVED, That ACEP develop and implement a verification of training program and model Q&A program for emergency medicine ultrasound imaging skills in conjunction with the ACEP Ultrasound Section of Membership; and be it further

RESOLVED, That such a verification of training program for emergency medicine ultrasound imaging be developed to a level which can serve as a minimum standard to assist emergency physicians in obtaining clinical privileges in ultrasound imaging for emergency department use.

The Board adopted the resolution and it was assigned to the Emergency Medicine Practice Committee. The Ultrasound Section took the lead on the issues identified in the resolution and section members worked with representatives from SAEM to develop a paper. The Board of Directors adopted the "2001 Emergency Ultrasound Guidelines" at their June 13-14, 2001 meeting.

Resolution 15 Certifying Emergency Departments
RESOLVED, That the ACEP Board ask a task force to study the following issues and relevant related issues and report back to the Board of Directors; and be it further

RESOLVED, That the Board of Directors report back to the 1999 Council on:

Developing policy regarding the advisability of regionalization of care for certain types of emergency patients (burns, trauma, chest pain, pediatrics, strokes, sexual assault, etc.).
Developing a strategy to consolidate certifying agencies to as few as possible.
Considering development of an ACEP certifying agency to replace as many other certifying agencies as possible.
Finding additional ways to improve emergency department readiness for all patients by means other than certifying agency inspections.
Studying the feasibility of collecting data to show whether criteria set by any certifying agency actually improves emergency patient care.
Developing strategies to implement policy resulting from the deliberations of the Task Force, the Council and the Board on these and related issues.

The Board adopted the resolution and a task force was appointed to further study the issues and potentially collaborate with SAEM.

Resolution 16 Emergency Department Internet Access
RESOLVED, That ACEP encourages all emergency care facilities to support emergency care providers with timely and convenient access to the Internet and the World Wide Web.

The Board adopted the resolution. The policy statement was added to the Policy Compendium.

Resolution 17 Responsibilities of On Call Physicians
RESOLVED, That the American College of Emergency Physicians will study this issue and its impact on members; and be it further

RESOLVED, That ACEP will work with organizations such as the American Medical Association (AMA), its Federation, and the American Hospital Association (AHA) to ensure their understanding of the ramifications of this issue.

The Board adopted the resolution. A resolution was submitted to the AMA House of Delegates for consideration at their December 1998 Interim Meeting. The AMA referred the resolution to its Council on Medical Services to develop a report. ACEP, AHA, the California Hospital Association and other groups provided information and data for the report. At their September 1999 meeting the ACEP Board of Directors adopted the revised policy statement "Hospital, Medical Staff and Payer Responsibility to the ED Patient" that addresses the responsibilities of on call physicians.

Resolution 18 Influenza and Pneumococcal Immunizations
RESOLVED, That the American College of Emergency Physicians endorse the routine immunization of high risk patients against influenza and pneumococcal disease in the emergency department; and be it further

RESOLVED, That ACEP develop guidelines for administering these immunizations in the Emergency Department setting.

The Board adopted the resolution. The first resolved was a policy statement and was added to the Policy Compendium. The policy has also been incorporated into ongoing liaison and lobbying efforts as well as working with appropriate agencies to assure funding for providing immunizations to those who have no other access to vaccines.

Resolution 20 States' BAC Reporting Systems
RESOLVED, That ACEP study the effectiveness of states' reporting systems rather than promoting any specific strategy. Data to track include refusals at scene, total drivers treated, tested, impaired, arrested, convicted, in therapy, and any change in statewide DUI convictions and crashes. Based on these data, ACEP will develop recommendations and assist with both federal and local legislation; and be it further

RESOLVED, That as states implement new reporting systems, ACEP will continue to collect and track the data. Using these data, ACEP will modify its plan appropriately.

The Board adopted the resolution. The State Legislative/Regulatory Committee continues to monitor NHTSA's activities related to state BAC reporting systems

Resolution 21 EMTALA (COBRA): Mandatory Reporting
RESOLVED, That the ACEP Board of Directors actively seek legislative, regulatory, and/or administrative relief through elimination of the onerous EMTALA mandatory reporting of suspected violation requirement.

The Board adopted the resolution and a task force was appointed to study the issues. A report from the task force was prepared for the 1999 Council. The Emergency Medicine Practice Committee recently completed a review of the task force report and concluded that the recommendations contained in the report are currently being addressed by the College through a variety of efforts on both the state and federal level. The College is also collaborating with the AMA to educate physicians about the on call provision of EMTALA.

Resolution 22 Violence Prevention
RESOLVED, That ACEP support the principle that violence victims and their families frequently need psychological and emotional referral and support, that without this sequelae as well as repeat episodes of violence as either victim or perpetrator; and be it further

RESOLVED, That ACEP establish a national dialogue between interested parties on this issue, and that ACEP encourages the National Institute of Mental Health and Center for Disease Control and Prevention and others to make available financial support for research into this area.

The Board adopted the resolution. The first resolved was a policy statement and was added to the Policy Compendium. The policy was also incorporated into ongoing liaison efforts.

Resolution 23 Appropriate Use of Antibiotics
RESOLVED, That ACEP develop a public educational campaign on the unnecessary use of antibiotics; and be it further

RESOLVED, That ACEP develop educational materials for physicians and patients on the dangers of inappropriate use of antibiotics.

The Board adopted the resolution and it was assigned to the Public Health Committee. The committee prepared information on antibiotic resistance that was added to the EMRA antibiotic guide and also worked collaboratively with the CDC EMERGency ID Net group on an article for Annals. The committee has continued its work on this issue in FY 00-01.

The committee continues to explore ways to educate emergency physicians on the use of antibiotics.

Resolution 28 In Memory of Ronnie W. Lee, MD, FACEP
The resolution was adopted by acclamation. A framed resolution was mailed to Dr. Lee's family.

Resolution 29 Commendation for Mark L. DeBard, MD, FACEP
The resolution was adopted by acclamation. A framed resolution was presented to Dr. DeBard.

Resolution 30 In Memory of Michael McCallum, MD, FACEP
The resolution was adopted by acclamation. A framed resolution was mailed to Dr. McCallum's family.

Resolution 32 Commendation for Larry A. Bedard, MD, FACEP
The resolution was adopted by acclamation. A framed resolution was presented to Dr. Bedard.

Resolution 33 Commendation for Nancy J. Auer, MD, FACEP
The resolution was adopted by acclamation. A framed resolution was presented to Dr. Auer.

Resolution 34 Commendation for Gail V. Anderson, Jr., MD, FACEP
The resolution was adopted by acclamation. A framed resolution was presented to Dr. Anderson.

Resolution 36 In Memory of Robert L. Stauter, MD, FACEP
The resolution was adopted by acclamation. A framed resolution was mailed to Dr. Stauter's family.

Resolution 37 Commendation for Mark Baker, MD, FACEP
The resolution was adopted by acclamation. A framed resolution was mailed Dr. Baker.

Resolution 38 Recognition of Certifying Bodies
RESOLVED, That the Board of Directors review prior actions on recognition of certifying bodies in emergency medicine.

The Board adopted the resolution. The Board reviewed their prior actions on recognition of certifying bodies in emergency medicine. The Board rescinded the policy "ACEP Criteria for Recognizing Certifying Bodies in Emergency Medicine effective November 1, 2000. The Board adopted the policy "Recognition of Certifying Bodies in Emergency Medicine" in October 2000.

Referred Resolutions (to the Board of Directors)

Resolution 14 Merit Badge Medicine
RESOLVED, That the ACEP policy on "Merit" Badge Medicine read as follows:

The American College of Emergency physicians believes that certification of knowledge and skills in emergency medicine can result only from successful completion of examinations administered by a recognized board in emergency medicine. The successful completion of any course, or series of courses, or a specified number of continuing medical education hours in a sub-area of emergency medicine, may serve as evidence of knowledge and skill of a certain sub-area of emergency medicine. However, the completion of such does not serve as an acceptable substitute for certification of knowledge and skills to practice emergency medicine.

Therefore, ACEP strongly discourages the use of certificates of completion of courses such as ATLS, ACLS, PALS, BTLS or a specified number of continuing medical education hours in a sub-area of emergency medicine as requirements for credentialling or employment of any physician certified in emergency medicine by the American Board of Emergency Medicine (ABEM) or the American Osteopathic Board of Emergency Medicine (AOBEM).

The resolution was assigned to the Emergency Medicine Practice Committee to review the policy "Certification in Emergency Medicine" and the Board adopted the revised policy statement "Use of Short Courses in Emergency Medicine as Criteria for Privileging or Employment" in June 1999.

Resolution 24 HMO Practices
RESOLVED, That ACEP support the requirement that all insurance information packets clearly state that any patient who perceives that they are experiencing an emergency should proceed directly to an emergency department without the need for preauthorization; and be it further

RESOLVED, That ACEP support the requirement, whenever a patient calls the HMO for a question regarding the need for medical care even if perceived by the patient to be non-emergent, that any decision made via telephone call by an HMO regarding treatment, disposition, or evaluation be made by a licensed medical professional.

The resolution was assigned as an objective for the Federal Government Affairs Committee and the Emergency Medicine Practice Committee. The Board adopted the revised policies "Providing Telephone Advice from the Emergency Department" and "Managed Health Care Organizations and Emergency Care" in July 2000.

Resolution 25 911 Legislative Network
RESOLVED, That the ACEP office that coordinates the 911 legislative network also include state legislative district information in their database; and be it further

RESOLVED, That ACEP develop a system for notifying the statewide 911 legislative contracts when issues arise at the state level; and be it further

RESOLVED, That ACEP develop a cost analysis for providing toll free telephone contact numbers for state legislative issues.

The resolution was assigned to the Federal Government Affairs Committee. Alternative state legislative grass roots contact databases and systems were explored and a demonstration of new software was presented at the 2000 Leadership/Legislative Issues Conference. New software for the 911 Legislative Network is now in use.

Referred Resolutions (to the Council Steering Committee)

Resolution 27 Strategic Planning Process
RESOLVED, That the annual Council meeting include a report from the Board of Directors regarding the status of ACEP's strategic goals; and be it further

RESOLVED, That the Council agenda include time for assessing and prioritizing issues of importance for the College; and be it further

RESOLVED, That the Council's assessment and prioritization of issues are available to the Board of Directors for its strategic planning process; and be it further

RESOLVED, That the Council Steering Committee review and prioritize resolutions, and the agenda as a whole, for the purpose of focusing Council time and energy on issues which directly relate to the ACEP mission.

The Steering Committee discussed this resolution at their January 1999 meeting. The resolution was addressed as the Steering Committee conducted their strategic planning initiatives.

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