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Among the most challenging standards from The Joint Commission for the first half of 2008 was standard IM.6.50 "Designated qualified staff accept and transcribe verbal or telephone orders." According to the organization, 40% of hospitals were not in full compliance.
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(Editor's note: Janiak has served as an emergency medicine medico-legal consultant for more than 30 years, and he has reviewed hundreds of malpractice cases. In the process, he has recognized common patterns and mistakes that emergency physicians make that set them up to be sued. With his tongue firmly planted in his cheek, Janiak points out the following potential mistakes and ways that lawsuits are created.)
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A new initiative at Boston University Medical Center called the Re-Engineered Hospital Discharge Program (RED) has significantly reduced additional ED visits and readmissions.
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The ED managers and administrators at Cuyahoga Falls (OH) General Hospital and the Greater Baltimore Medical Center agree that careful attention to design considerations in their new departments significantly improved patient flow and communications among staff members.
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The hiring of physician scribes, known as "clinical information managers," has helped Saddleback Memorial Medical Center, a five-hospital system based in Laguna Hills, CA, to save a significant amount of money by avoiding the hiring of physician assistants (PAs) for its two EDs.
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The ED at Catawba Valley Medical Center in Hickory, NC, has realized annual savings in excess of $1 million with the implementation of staffing strategies that involved the virtual elimination of contract staff and overtime for nurses.
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While the response rate (4.6%) was small, the message delivered in the results of a survey by the Emergency Nurses' Association (ENA) was huge: Significant barriers still remain to compliance with National Patient Safety Goals (NPSGs) in the ED.
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While a recent severe ice storm in Owensboro, KY, held most of the city in a standstill for several days, well-laid plans for just such a disaster helped keep ED staffing at adequate levels in the Owensboro Medical Health System.
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Keeping costs under control is always an important consideration for ED managers, but in these challenging economic times, it has become critical.
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Telemedicine has long been recognized for improving access to care as well as access to specialist expertise, particularly in rural facilities. Now, in an unpublished study just completed in Rochester, NY, the lead author says it also can offer a possible solution to overcrowding when it comes to pediatric ED patients, many of whom, he asserts, easily could be treated by a primary care physician.