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Increasing numbers of EDs are implementing electronic medical records (EMRs), including computerized physician order entry (CPOE), with the goal of improving patient safety. However, not much is known about the liability risks of these new tools.
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The ED physician has some liability to care for these tremendously ill patients, "and you are doing so in a unit that is not really designed for ICU patients," says Robert Shesser, MD, professor and chair of the Department of Emergency Medicine at George Washington University Medical Center in Washington, DC.
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When you are faced with more patients than resources, and a lawsuit results, one possible defense argument that would encompass the hospital and the emergency physician is that everyone did everything that could be reasonably expected under bad circumstances.
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Crowding is increasingly becoming a factor in litigation involving ED care and is putting nurses and physicians at increased risk for being named in a lawsuit.
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When an ED is forced to close due to a disaster and requests delivery of a mobile unit called the Carolinas Mobile Emergency Department-1 (MED-1), "we like to think we can be mobile in 72 hours," says Tom Blackwell, MD, medical director for the Center for Pre-Hospital Medicine, Department of Emergency Medicine, at Carolinas Medical Center, Charlotte, NC, and one of the two physicians who spearheaded the development of the mobile unit.
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When a flash flood hit Columbus, IN, in June, Columbus Regional Hospital had to be evacuated. But just two weeks later, the ED was able to reopen, thanks to a mobile unit called the Carolinas MED (Mobile Emergency Department)-1, which was first deployed in New Orleans in the wake of Hurricane Katrina.
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When an Aero Med helicopter crashed and burst into flames on the roof of an 11-story tower at Spectrum Health Butterworth Hospital in downtown Grand Rapids, MI, on May 29, 2008, during a training run, the ED team swung immediately into action to get to the two victims and prepare the department to receive them.
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ED managers have the opportunity to increase reimbursements under the proposed 2009 rule for the Outpatient Prospective Payment System (OPPS), but they also will come under greater scrutiny by the Centers for Medicare & Medicaid Services (CMS) for the quality of their care.
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A woman suffering from headaches went to the hospital, where she was diagnosed with a tension headache and discharged with muscle relaxation and pain medication.
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Risk managers have a new concern that will require a close review of human resources policies and procedures in order to avoid the improper use and disclosure of genetic information.
