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Homeless Pediatric Patients Use EDs Frequently
Homeless children frequently use EDs, defined as four or more visits in a calendar year, compared to housed children. These patients require hospitalization more often than housed children when they visited the ED, including to ICUs. This underscore the critical influence of housing as a social determinant of health.
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Remote Facilities Can Avoid Unnecessary Pediatric Transfers by Leveraging Telemedicine
When critically ill children present to EDs in rural or community hospitals that lack access to specialty pediatric care, the solution often is to transfer them to a regional pediatric facility, which could be hours away from a patient’s home. This creates travel burdens and added expense for families and payors. But new research suggests that at least some of these interfacility transfers can be safely avoided by incorporating telemedicine consultations with pediatric specialists.
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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.
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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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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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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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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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Legal Exposure for EDs if On-Call Consultant Refuses to See Patient
There are multiple tactics to secure a consult, even if a specialist is busy. However, if a bad outcome occurs because there was no consult, clinicians should not play the blame game.
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Endotracheal Intubation Lawsuits Often Name ED Providers
After analyzing 214 relevant claims, researchers reported payments averaged $2.5 million. Intubation injuries occurred in the operating room most often, followed by the ED (16.3% of cases). Most cases involving the ED resulted in some type of payout (either a settlement or a jury award). Anesthesiologists were most likely to be named in the lawsuits (59.8%), and EPs were second most likely (19.2%) to be named. The vast majority of claims (89.2%) alleged permanent deficits, half the cases involved death, and 37.4% of the cases involved anoxic brain injury.
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Pediatric Mental Health Crisis Is ECRI’s Top Safety Concern for 2023
The ED assessment should include appropriate triage: screening for harm of self or others, a thorough assessment, and consideration of social determinants of health.