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If an emergency physician (EP) decided not to prescribe opioids for a patient after learning from a prescription drug monitoring database that the patient had just received a two-week prescription for the same medication from another provider, could the EP be successfully sued for failure to treat?
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Forty percent of hospital readmissions within 30 days come through the ED, according to an analysis of data from the Healthcare Cost and Utilization Project state inpatient and ED databases on 4,028,555 patients discharged from acute care hospitals in California, Florida, and Nebraska between July 1, 2008, and September 31, 2009.1
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Not surprisingly, if a consultant is unavailable and a bad outcome occurs, the emergency physician (EP) is potentially a defendant in any subsequent medical malpractice lawsuit, says Damian D. Capozzola, JD, an attorney with Crowell & Moring, LLP, in Los Angeles, CA.
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Whenever an individual enters an ambulance (or medical helicopter) owned and operated by a hospital, the federal government deems the person to have come to the hospitals emergency department for purposes of triggering the hospitals obligations under the Emergency Medical Treatment and Labor Act (EMTALA).1
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A redesign of the care coordination department at Riverside Medical Center in Kankakee, IL, assigns utilization review tasks to dedicated nurses, freeing up case managers to spend more time with patients and develop a close working relationship with physicians to facilitate smooth and timely progression of care.
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In the past, case managers and discharge planners have concentrated on how to get patients out of the hospital, but now they also need to focus on how to keep them from coming back, says Deborah Hale, CCS, CCDS, president and chief executive officer of Administrative Consultant Service, a healthcare consulting firm based in Shawnee, OK.
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Just eight months after Sycamore Medical Center emergency department in Miamisburg, OH, launched a Lean project to improve patient flow in the emergency department, the percentage of patients who left without being seen dropped dramatically and the departments patient satisfaction scores rose to the 90th percentile.
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Recognizing that the inpatient staff can do only so much during a three-to-five-day hospital stay, the heart failure readmission reduction team at the University of California San Francisco Medical Center collaborates with post-acute providers and outpatient treatment centers to develop ways to improve transitions between levels of care and ensure that patients receive the same education on managing their conditions regardless of where they are receiving care.