Emergency Department Management & Law
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When ED Is Packed, Keep Patients Moving with Triage Hallway, Dedicated Staff
Since Pull to Infinity was implemented in June 2022, the average time it takes to see a provider in the ED has dropped from 22 minutes to seven minutes. This, despite continually expanding volumes. The average patient arrival-to-discharge time has improved to 175 minutes, down seven minutes. Also, the leave-without-being-seen rate declined from 3.5% last year to 1.6% in the first four months of 2023.
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Delays in Acute Stroke Treatment Contribute to Malpractice Claims
Recent research findings underscore the importance of always considering stroke in the differential diagnosis of altered mental status, even when the patient does not arrive by EMS.
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Intervention for Critically Ill Patients Lowered In-Hospital Mortality Rates
Researchers believe their work could be a starting place for emergency clinicians to think about novel care delivery models for seriously ill patients.
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Emergency Providers Intervene to Prevent Suicide Attempts, Ideation
Researchers use quality improvement concepts to help clinicians identify high-risk patients.
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ChatGPT Provides Solid Responses to Virtual Medical Questions
Artificial intelligence tool provided empathetic, quality answers to online queries, which could help clinicians save time on electronic health record documentation work.
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Give Actionable Incidental Findings Proper Attention
New recommendations help health systems implement processes that will preserve patient safety. These tips aim to make it easy for providers to do right by their patients when clinicians identify actionable incidental findings.
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Malpractice Lawsuits Allege ED Missed Intracranial Aneurysms
Failure to image patients is a relatively frequent cause of litigation, but it should be seen in context. It is not so much incorrect interpretations of imaging studies; rather, failure to consider the possibility of an aneurysm, resulting in an inadequate workup, is a more common allegation.
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Does a Clinical Decision Aid Constitute the Legal Standard of Care?
Each emergency physician should undertake the appropriate medical approach to evaluating a patient, regardless of any recommended course of action. The medical record should support using the recommended path or justify another course of action.
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Did EP Decide Not to Follow Recommendation of Computer Decision Aid?
The medical record should demonstrate the clinician saw the recommendation, thought about it, and decided what to do. The clinician still may be wrong. But now, it is more of a judgment error than simple carelessness.
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Med/Mal Claims Focus on Decision Aid Findings from ECGs, Radiology Tests
If the radiologist does not address computer findings directly, the ED clinician is left to make assumptions about what the radiologist has found significant or insignificant. If radiologists are not routinely addressing computer findings, emergency providers will spend resources attempting to sift through reports and images, trying to rule in or out what the computer has found. Radiologists should acknowledge computer findings, and comment on why or why not the finding is accurate and significant to the patient’s care.