New CMS Guideline: Door-to-Dilaudid Time

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WOODLAWN, MD – Today the Center for Medical Surveys (CMS) announced a radical change to benchmarking and patient satisfaction surveys.  Realizing the opportunity to capture more data while ensuring emergency medicine physicians meet patient’s demands, they will soon measure door-to-Dilaudid time (DDT).  Starting April 8th, each emergency department engaged in the CMS system will be reporting this data along with the other 138 data points required.

hospital door cms“We are very excited about this measure,” explained Ima Uselessleader, a spokesperson for CMS explained.  “Many emergency department patients complain about pain.  Pain relief is the number one satisfier of ED patients.  This indicator will be vital in deciding how well emergency room physicians are performing.  We are excited to set ever more challenging time requirements and provide penalties or eliminate funding for poor performing institutes.  This will undoubtedly drive exceptional patient care.”


We found one hospital that predicted this addition and is ready for this change.  “We recently hired an British nursing director,” said University of Maryland Medical Center emergency physician Dr. John Avad.  “In his typical English way, with his receding hairline and dry wit he quipped in one meeting, ‘Next they’ll measure door-to-Dilaudid time.’  We realized that this change was likely to come about soon and we prepared.  We have modified all of our nursing triage protocols, and we are confident we can reach the 90-second door-to-Dilaudid benchmark.”

Other physicians are wearier.  One doctor, who requested to remain anonymous (Alex Witherspoon), stated that he was working with colleagues to determine dosing requirements.  While he would like to give a mere 0.1 mg of Dilaudid to all patients, he is concerned that the new requirement might demand higher doses for severe pain such as that related to cancers, splinters, or bugs in ears.  He also wants to know if the patient leaves after receiving their Dilaudid will it affect another measure: left without being seen. He stated that “there is a lot of unknowns, but in my time as a physician all the changes by various governing bodies have only made health care better, so I am happy to accept.”

Uselessleader assured all who share concerns, we are doing this for our patients.  “The key to great care is rapid treatment and satisfied patients,” he insisted.  “I can not think of a better way to accomplish both.”

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