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Robert Latino, vice president of The Reliability Center, a risk management consulting firm in Hopewell, VA, recommends a tool developed by his firm calls the "logic tree" for investigating chronic problems or adverse events.
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A concerted effort to standardize the way central lines are introduced has reduced infections by 50% and resulted in nearly perfect adherence to evidence-based practices at 10 hospitals in the Cincinnati area.
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An adult patient, who had been diagnosed with diabetes at age 11, was admitted for surgery to repair his retina due to injuries related to diabetic retinopathy.
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The Duke University Health System in Durham, NC, has responded to patients' efforts to gain more information about how two hospitals mistakenly washed surgical instruments in used hydraulic fluid instead of detergent and failed to notice the mix-up for weeks. Approximately 3,800 patients were exposed to the contaminated instruments during surgery.
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A Pennsylvania hospital reports that it is seeing tremendous results from a computerized order entry system (CPOE), with an 85.7% decrease in improper doses and a 76.8% decrease in medication omissions.
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When officials with the Everett (WA) Clinic wanted to change the organization's culture to emphasize patient safety, they realized that a key strategy was getting physicians and employees to report their concerns freely and without fear of backlash. Simple encouragement wasn't enough, so they turned to a more sophisticated solution that not only encourages more candid reporting but also consolidates what used to be a hodgepodge of data-collection methods.
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News: A patient on Coumadin therapy was admitted after suffering from a fall. The attending physician prescribed Toradol and Phenergan, and the next day the patient was discharged home. The following day she fell into a coma and was readmitted. She died several days later. Her estate claimed that all the treating providers were negligent in their care and treatment of the decedent. The jury concurred and awarded her estate $2.5 million.
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News: A middle-aged woman presented at the emergency department with flu symptoms. She was also disoriented. After initial tests were performed principally a spinal tap, in which blood was found she was admitted and was eventually transferred to the intensive care unit. It was suspected that she had suffered from a heart attack, so heparin was initiated. Approximately five days later, she was noted to have bilateral paralysis and was subsequently transferred to another facility, where she was also diagnosed as having lung cancer. She sued the hospital and attending physicians for failure to properly monitor her care and treatment, specifically claiming that the continuance of heparin was contraindicated.
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Question: We're uncertain about whether the 250-yard rule still applies with EMTALA. When the final rule came out in 2003, we heard conflicting opinions about whether we were still responsible for providing emergency care within 250 yards of the hospital. Is there a definitive answer yet?
