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[Editor's note: This is the second in what is now scheduled to be a three-part series on reducing violence in the ED, due to breaking news. In last month's article, our experts discussed the importance of a "zero tolerance" policy. In this article, we outline key steps recommended for reducing violence and discuss the importance of having clear procedures when it comes to dealing with patients and their families. Next month we will examine the Sentinel Event Alert just published by The Joint Commission that discusses why the ED is particularly susceptible to episodes of violence, outlines leading causal factors, and provides additional guidance for violence prevention.]
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It is not current practice in most EDs, and it is not without controversy. In fact, one ethicist has called the practice "ghoulish." However, a government-funded pilot program at University of Pittsburgh Medical Center (UPMC) Presbyterian Hospital and Allegheny General Hospital, both in Pittsburgh, is seeking to make organ donation from the ED a reality, while at the same time addressing the ethical challenges that have been raised and the logistical challenges that can lower the odds for success.
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A program designed to find a "medical home" for complex pediatric patients can reduce the number of ED visits by 55%, according to a study published in the March 11, 2010, online edition of the Journal of Pediatrics.
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In most EDs, the last thing a provider wants is an extra, non-clinical individual "getting in the way."
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EDs at a number of Hospital Corporation of America (HCA) hospitals in the Southeast are using "new media" to inform patients of their average wait times over the past several hours. These times have been posted on hospital web sites, digital billboards, and most recently, via text messaging.
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[Editor's note: This article is the first in a two-part series on preventing violence. In this story we examine the keys to a zero tolerance policy. In next month's issue, we will discuss key recommendations from the Occupational Safety and Health Administration and the importance of communicating effectively with patients and their families.]
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"Good people who exercised poor judgment" recently took cell phone pictures of a shark attack victim who later died in the ED at Martin Memorial Medical Center in Stuart, FL, according to a statement released by hospital officials. Although no staff members were fired, the hospital has disciplined several ED employees for taking the cell phone pictures and has asked anyone with copies of the photos to destroy them.
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Taking nearly seven months to transition from an ED staffing model of a contracted physician group to one that involved a partnership with a neighboring medical school might seem overly long, but the leadership at St. Joseph's Hospital in Buckhannon, WV, says they wanted to "do it right." That process included bringing on properly credentialed physicians, as well as doctors who would relate well with the surrounding community.
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The Joint Commission has approved revisions to Medical Staff (MS) 01.01.01, formerly known as MS.1.20. This standard, it says, "is designed to contribute to patient safety and quality of care through the support of a well-functioning, positive relationship between a hospital's medical staff and governing body."
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The Joint Commission is seeking comments in two areas of concern to ED managers: candidate performance measures for inpatient and ED care of sudden cardiac arrest patients, and its revised National Patient Safety Goal (NPSG) 03.07.01, which addresses medication reconciliation.
