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Not Just an ED Problem: How to Solve the Boarding Problem Caused by Staff Shortages
It takes thought, planning, and some amount of money.
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Documenting Understaffing Could Sound Like Blame-Shifting to a Jury
Jurors are going to expect everyone in the ED is working together for the patient’s benefit. If the emergency physician has valid safety concerns, the medical record is not the place to voice those. Patient safety committees or the peer review process are better options, and generally are not discoverable during malpractice litigation.
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The Legal Standard of Care if ED Is Understaffed
Frustrated emergency physicians want to be sure the lack of nursing staff is duly noted in the mistaken belief such a note will change the legal standard of care to which they are held. However, that documentation is ammunition for plaintiff lawyers to use against the provider, and leaves the standard of care unchanged.
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EMTALA Concerns if Patient Harm Is Linked to Staffing Shortage
It is important for administrators to understand an individual emergency physician or facility can be held liable under EMTALA, even if no one is hurt.
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Beware Venting About Staffing Problems
Emergency providers should follow proper channels for making such complaints. There may be a patient safety organization to which staff are directed to submit complaints, or the hospital could view the situation as a human resources issue.
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Inexperienced Nurses Placed in Unsafe Roles Due to Staffing Shortages
Because of staff shortages, inexperienced nurses are placed in roles that may be unsafe for patients — and for the nurses themselves.
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ED Violence Pushes Out Top Employees
While multiple factors can figure into an emergency provider’s decision to leave his or her profession, receiving threats or winding up as assault victims while on the job easily can be the final straw. Those who work in the ED say the violence in this setting is only growing worse.
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Staffing Shortages No. 1 Challenge in Healthcare
Short-staffed EDs mean patients have to wait longer for laboratory and diagnostic testing results, which could lead to delays in administering life-saving treatment.
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Repeat Visits Are Second Chances to Avoid Misdiagnosis
Conditions that start with subtle signs and evolve over time are traps for the practitioner who is too rushed to let the situation unfold.
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Tracking Undertriage Can Help Prevent Medical Errors
Investigators found several issues were important to track using quality improvement methods, including discrepancy in exam or history between the triage and assessment nurses, along with discrepancy between the chief complaint and the physical exam. Also, they found failure to synthesize historic or objective information.