Journal of Urgent Care Medicine

Documentation Excellence: The Trifecta

Brad Laymon, PA In the dynamic environment of urgent care (UC) medicine, precise, and thorough documentation serves as a cornerstone for both clinical and operational success. Beyond merely fulfilling regulatory requirements, documentation excellence has 3 critical functions, which I refer to as the “trifecta:” 1. Improved patient outcomes through clear communication of care; 2. Mitigation of malpractice risk through clear and defensible explanation of medical decision making (MDM); and 3. Accurate description of complexity to …

Dateline: Washington, D.C.

On February 5, a group of Urgent Care leaders returned to our nation’s capital to continue the work toward federal payment reform. The new administration had just settled in, and there were signs of turnover everywhere you looked: offices under reconstruction; evidence of recent unpacking; reporters everywhere; protestors on a few corners; phones ringing off the hook in every office; circles under more than a few eyes; and emotions both high and low on display. …

Urgent Care Evaluation and Management of Hip Osteoarthritis

Urgent Message: Osteoarthritis of the hip most commonly affects older adults and those with other risk factors including obesity and prior hip injury. It is a diagnosis of exclusion, therefore, the initial priority in urgent care for patients presenting with hip pain involves excluding alternative, time-sensitive etiologies. Alex Dragota, BSME; Matthew Baird, MD; Michael Weinstock, MD Citation: Dragota A, Baird M, Weinstock M. Urgent Care Evaluation and Management of Hip Osteoarthritis. J Urgent Care Med. …

68-Year-Old With Dyspnea

A 68-year-old female presents to urgent care with dyspnea for 2 days. She has a medical history of heart failure. An ECG is obtained. View the ECG captured above and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

New 5-in-1 Meningococcal Vaccine Adds to Provider Options

The Food and Drug Administration has approved a meningococcal ABCWY vaccine for use in individuals aged 10 to 25 years, according to a press release from manufacturer GSK. The vaccine targets 5 groups of the bacteria Neisseria meningitidis (A,B,C,W, and Y), which represent the most invasive meningococcal disease cases globally. The vaccine combines antigenic components of the meningococcal group B vaccine and meningococcal groups A, C, Y, and W-135 oligosaccharide diphtheria CRM197 conjugate vaccine. Trial …

Urgent Care Rises to Improve Rural Access to Care

Longstanding financial and logistical challenges seem to be intensifying for rural-area providers, as evidenced by new data from consulting firm Chartis, which highlights that 46% of rural hospitals currently have negative operating margins and many of those are in danger of closing. In the past year, 18 rural hospitals closed or transitioned to provide only outpatient care. Of the 48 states that are home to rural hospitals, 38 have at least one hospital that is …

Clinical Review of Current Best Practices for Tuberculosis Screening, Testing, and Treatment in the Urgent Care Setting

Urgent Message: Patients may present with needs surrounding tuberculosis (TB) screening, testing, and treatment to urgent care centers. There is considerable nuance in the approach to these scenarios with consequences for both patient and public health. Urgent care centers should develop clear guidelines for ensuring clinicians select the appropriate TB test for each patient and interpret the results accurately. Erin Loo, PA-C; Lindsey E. Fish, MD Citation: Loo E, Fish LE. Clinical Review of Current …

Looking Beyond the Mouth–A Rare Case of Acute Glaucoma Presenting with Dental Pain: A Case Report

Urgent Message: Acute angle closure glaucoma can present with a variety of types of head and facial pain. Rapid identification of concern for elevated intraocular pressure (IOP) or confirmation of elevated IOP by tonometry is critical for preserving vision. Mackenzie Brown, MD; Joshua W. Russell, MD, MSc, ELS, FCUCM, FACEP; Alexander Branson, MD Citation: Brown M, Russell JW, Branson A. Looking Beyond the Mouth–A Rare Case of Acute Glaucoma Presenting with Dental Pain: A Case …

16-Year-Old With Hip Pain

A 16-year-old female presents to urgent care with her mother after soccer practice at school. She says she felt a “pop” in her left hip, immediately followed by posterior hip pain. Walking makes it worse, but resting makes the pain better. An x-ray is ordered. Review the image and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.

74-Year-Old With Lightheadedness

A 74-year-old woman presents to urgent care with epistaxis, controlled on arrival. She is also complaining of lightheadedness and fatigue that’s been going on for the past 2 weeks. View the ECG captured above and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

Login to JUCM