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There are many things that factor into missing a diagnosis of appendicitis, says William Sullivan, DO, JD, FACEP, director of emergency services at St. Mary's Hospital in Streator, IL.
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"This takes the longest to document," he says. "I might not remember every piece of history I asked, or every part of the physical exam that I did, even with computer guidance," he says. "But I spend most of my time on medical reasoning."
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Last month's ED Legal Letter analyzed some recent tort reform court battles. This month, we review cases where physicians are suing state governments to stop them from pilfering the cash in patient malpractice compensation funds, and a few more cases litigating state and federal tort laws.
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Though myocardial infarction is often a key area of focus when it comes to ED misdiagnoses and subsequent lawsuits, appendicitis is another common and serious misdiagnosis in the ED.
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"Many times, something as simple as a check mark as to whether the patient had anything to eat or drink while they were in the ED may become an important fact in the defense of a lawsuit," says Stimmel. Here are some of Stimmel's recommendations:
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This is the first of a two-part series on documentation and ED liability. This month, we explore the legal risks of inadequate documentation and information that should not be omitted.
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Career ladders can be an excellent way to improve retention in your patient access department. However, there are some pitfalls to avoid. "Career ladders must be current and relevant to the job," says Holly Hiryak, MNSc, RN, CHAM, director of hospital admissions and access services at University Hospital of Arkansas in Little Rock. "There may be complacency if [employees] are not goal-driven with measurable roles and responsibilities."
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Some front-end staff, unfortunately, view your department as a revolving door or jumping-off point. However, others choose to make a long, fruitful career for themselves in the field of patient access.
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