Reducing Nonemergent Visits to the Emergency Department in a Veterans Affairs Multistate System.

Study Objective: The purpose of this quality improvement study was to reduce nonemergent visits to the emergency department attendance within a multistate Veterans Health Affairs network.

Methods: Telephone triage protocols were developed and implemented for registered nurse staff to triage selected calls to a same-day telephonic or video virtual visit with a provider (physician or nurse practitioner). Calls, registered nurse triage dispositions, and provider visit dispositions were tracked for 3 months.

Association between physician time-unlimited vs time-limited internal medicine board certification and ambulatory patient care quality.

Importance: American Board of Internal Medicine (ABIM) initiatives encourage internists with time-unlimited certificates to recertify. However, there are limited data evaluating differences in performance between internists with time-limited or time-unlimited board certification.

Objective: To determine whether there are differences in primary care quality between physicians holding time-limited or time-unlimited certification.