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Maximally Efficient

The Maximally Efficient and Optimally Effective Emergency Department

Rade B Vukmir MD, JD


In this book Dr. Vukmir defines both the qualitative and quantitative aspects of the emergency department( ED) practice. The Emergency Department(ED) drives the efficiency of the remainder of the hospital, perhaps more than most other medical care unit. It is the "front door"
of hospital and often forms the first impression of the facility.


The book begins with an outline of the efficacy, the "best circumstance" operation, versus  effectiveness or "real world performance". This is followed by analysis of the efficiency, or "work product" based on resources utilized and outcome achieved. Through the benchmarking process, he attempts to "objectify" the care provided by physicians, mid-levels, nurses and ancillary care providers. The more subtle thematic aspects of ED operations and its interface with other hospital departments are also reviewed.

The text is subdivided operationally into distinct, yet still integrated working units such as patient intake, registration, testing and data processing, as well as the admission, consultation and discharge processes. Potential solutions are offered to the common issues of ED staffing, quality of care, operational efficiency, performance improvement and risk management issues.

The team approach is emphasized to achieve the best patient outcome possible in the ED.


Rade B. Vukmir MD,JD is President of Critical Care Medicine Associates, a medical administrative and consulting enterprise founded in 1991. He is certified in Emergency and Critical Care Medicine, and has a degree in law with a certificate in health law. Dr. Vukmir has written forty-three medical journal articles, and is the author of ten books.

These works include The Mill (1999), Outcome of the Critically Ill: Medicine, Surgery and Trauma (2000), Airway Management in the Critically Ill (2001), Lessons Learned: Successful Management in the Changing Marketplace (2003), ER: A Year in the Life (2005), ER: One Good Thing a Day (2008), The Maximally Efficient and Optimally Effective Emergency Department (2009), ER: One Hundred (2012), Physician Contract Guidebook (2014); and Disruptive Provider Behavior: An Evidence Based Analysis (2016).