Global MedOps Command

05/21/2026

Take the 5 minutes to watch this video that will save you time and energy when transferring patients.

EMTALA says the transfer must be 'appropriate.' That word is doing enormous work.This Clinical Brief goes beyond EMTALA compliance as a checkbox — into what ...

05/19/2026

I just published this Observation Unit article on Medium this morning - check it out. No paywall.

I’ve seen observation used as a pressure valve, a dumping ground, and a throughput weapon. Only one of those is defensible.

05/15/2026

If you're an EM director, charge nurse, or aspiring service-line leader — and your hospital is talking about building or fixing an Observation Unit — I wrote this for you.

"ED Observation Units: The Operational Playbook" is a no-fluff, 90-minute read with the protocols, staffing math, metrics dashboards, and pitch deck I've used to build OBS units in two health systems.

What's inside:
– The 6 features of a real OBS unit (and how to audit yours)
– Sample protocols for chest pain, syncope, TIA, asthma, pyelo
– Staffing models and the financial case
– Metrics dashboard you can copy
– The 3 mistakes that kill OBS units in year one

Available now on Gumroad: https://shermerautomation.gumroad.com/l/pckuh

Built from 25+ years of running EDs, not from a textbook.

05/13/2026

I encourage you to start trialing software/AI platforms to make your job easier. The ambient scribe voice recognition platforms have gotten really good but you still need to make sure your chart says what you mean for it to say!

05/13/2026

Question for the EM and hospital-medicine community —

If you've built an Observation Unit in the last 5 years (or tried to), what was the single biggest obstacle?

I'm seeing the same patterns over and over in the consults I do:

– Nursing staffing model (shared vs dedicated)
– Physical space and IT build-out
– EM vs hospitalist ownership fight
– Order-set adoption and protocol drift
– Admin metrics that don't reward the work

Drop your story below. I'll compile the responses into a follow-up post and credit anyone who wants attribution. This is the conversation that doesn't happen enough at the conference circuit, and I think the field benefits when we share what actually went wrong.

05/12/2026

New on the GMOC blog: "Why Observation Units are the single highest-ROI move most EDs are still ignoring."

Personal note from me — this is the topic I get the most pushback on, and the topic where I see the most measurable wins when leaders actually commit. I've helped build OBS units in two health systems. In both, we cut inpatient admits 15-25% inside the first year and freed up enough capacity to materially reduce ED boarding.

The pattern I see: the leaders who succeed treat the OBS unit as an operational design problem, not a square-footage problem. The ones who fail try to "carve out" 4 beds in the main ED and call it observation.

If you're an ED director, COO, or hospital service-line leader — read this one. Then send it to the person on your team who will actually own the build.

(Link in pinned comment.)

05/11/2026

Here are some good points that any resident in emergency medicine (or any specialty) can use to make the most of your training before graduation.

There are things seasoned emergency physicians know that nobody tells you in residency. Not algorithms. Not procedures. The real lessons — how this specialty...

05/07/2026

Just published earlier on Medium (no paywall). Worth the read if you are using any AI/LLM tool to help care for patients. This helps produce a prompt that will give you the best responses.

Most “AI failures” in clinical settings aren’t model failures — they’re communication failures. SBAR already solved this problem for…

05/03/2026

Been working on a website upgrade after the original creation site would not allow certain modifications, despite being AI assisted! Now, on my new site, things look and function much better! Go to: https://globalmedopscommand.com for an overview of the company, an active blog section, and links to all offerings.

04/28/2026

AI is everywhere! I started reading and researching the topic a few weeks ago and wanted to share what I have learned in this Medium article (No Paywall). Check it out to learn more before any decisions are made in your organization.

The ambulance is where time-sensitive medicine starts — and where bad decision support quietly burns time, attention, and trust.

04/17/2026

At 3am, the department goes quiet.

No administrators. No consultants. Just you, your team, and whatever walks through the door.

AI tools are built on clean datasets and average patients.

The overnight shift has neither of those things. It has incomplete histories, atypical presentations, and a physician who has been awake for hours.

The doctor who practices safely at 3am isn't the one who trusts the algorithm. It's the one who knows exactly when not to.

AI literacy in emergency medicine isn't enthusiasm for technology. It's protecting the judgment no algorithm can replace.

Global MedOps Command | AI in Emergency Medicine