Emergency Department Management & Law
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California Lawmaker Pushes for More Mental Health Professionals in Hospitals
Employing trained mental health providers on site is important, but are there enough resources to meet the need?
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Emergency, Radiology Groups Suggest Best Practices for Incidental Findings
Better reporting, communication needed when troubling lesions appear on images.
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Facilities Require ‘Medical Clearance,’ But Evidence Suggests It Is Unnecessary
A patient may present with new delusions, but an otherwise normal physical exam. Why keep that person in a regular ED treatment space or hallway for hours while waiting for a CT scan? Instead, this patient can avoid exposure to radiation, be “cleared” for evaluation by an acute care psychiatrist or social worker, and receive access to treatment hours earlier.
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Challenges in Accessing Resources Lead to ED Psychiatry Consults
Difficulty identifying the “right” level of care for patients, understanding how insurance plays a major role in post-ED care options, and needing help with the operational process of making referrals to outside treatment facilities all are administrative and bureaucratic headaches with which clinicians could use assistance.
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Emergency Clinicians’ Emotional Reactions to Psychiatric Patients Affect Care, Well-Being
Survey participants painted a picture of negative healthcare experiences, for both patients and clinicians, that are adversely affecting the quality of care and staff well-being. Change is badly needed to ensure these vulnerable patient populations receive care — and to support ED providers.
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Restraint Use Can Put Provider, Hospital in a Jam
Personal animus or emotion on the part of an emergency provider should never be a rationale for the use of restraints. EDs are at risk for allegations of unlawful restraint or assault in circumstances where the use of restraints is not justified.
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There Could Be Trouble if Providers Board Children with Psychiatric Complaints
If parents disagree with a hold, convey that staff are keeping the child safe, explain the steps they are taking to find an accepting hospital, and detail how the ED cannot discharge a patient who is on an involuntary hold. When families are informed and given space to vent, the situation can de-escalate.
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Psychiatric Patients Pose Many Legal Risks for EDs; Creative Solutions Needed
Crisis stabilization units, peer support specialists, and targeted screening tools can help leaders fill some gaps.
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Experts Detail Remaining Barriers to Facilitating Evidence-Based Treatment for OUD
A lack of universal education in medical school and residency programs might perpetuate a reluctance to engage, diagnose, treat, and appropriately refer patients with opioid use disorder. Silos that keep substance use treatment outside mainstream healthcare can limit the collaboration and streamlined referral processes needed between EDs and outpatient providers.
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Is an EmPATH-Style Unit Right for Your ED?
When deliberating, remember the busy, noisy environment of the ED often makes symptoms worse for patients who have presented with psychiatric emergencies. Many EmPATH units consist of designated open spaces where patients are free to roam while under observation.