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Getting the entire clinical staff on board with a new process for assessing and treating sepsis was a daunting task when administrators at Wake Forest Baptist Medical Center in Winston-Salem, NC, began the effort in April of 2012. However, by eliciting the assistance of department champions, and by mandating that everyone complete an online module that explains the new process, the transition to the new process was smooth. We had a very strong expectation and we followed through, explains Catherine Messick Jones, MD, MS, associate chief medical officer, medical services.
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To reduce mortality and improve the care of patients with sepsis, Wake Forest Baptist Medical Center in Winston-Salem, NC, created a new rapid-response protocol aimed at facilitating earlier diagnosis and treatment. In this approach, clinicians who suspect a patient may have sepsis can call a Code Sepsis, which will fast-track the series of tests and evaluations that are needed to confirm the diagnosis and get appropriate patients on IV antibiotics quickly. Administrators say the approach fits in with the culture of the ED, and it has quickly slashed time-to-treatment in this environment.
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Approximately 5% of patients presenting to EDs have neurological symptoms such as headache, dizziness, back pain, weakness, and seizure disorder, but little is known about the factors that led to misdiagnoses of neurological emergencies in the ED, according to a 2012 review of studies.1
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Did an emergency physician (EP) have a telephone consult without requesting that the specialist see or examine the patient?
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If a patient leaves your emergency department (ED) before the results of any test ordered by the emergency physician (EP) are back, the EP still has an ethical and legal responsibility to the patient to utilize those results in directing their care, unless the EP has passed that patients care on in a very clear manner, according to Robert Suter, DO, MHA, professor of emergency medicine at University of Texas (UT) Southwestern Medical Center in Dallas, TX.
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Some EDs are charging uninsured patients upfront fees for problems deemed nonemergent, with 88% of EDs reporting an increase in the number of self-pay patients seen in 2012, according to the Healthcare Financial Management Association.
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Recent mass shootings have resulted in psychiatrists being sued for failing to prevent one of their patients from harming others. Could the same thing soon occur with emergency physicians (EPs)?
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All right, so technically Im responsible ... or Well, OK, I may be legally responsible, but ... These comments are common responses by emergency physicians (EPs) named in lawsuits involving mistakes made by physician assistants (PAs) or nurse practitioners (NPs) theyre supervising, says David W. Spicer, JD, a health care attorney in Palm Beach Gardens, FL.
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Beta-blockers and noncardiac surgery; prenatal medication exposure and risk of autism; reasons for statin discontinuations; and FDA actions.
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The quality of care provided to patients and their families at end-of-life has become a key element in discussions on U.S. health care system reform.
