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Question: Were debating two questions in our hospital regarding when EMTALA applies. First, does the law apply to patients who only are holding in the ED because there are no beds available in the hospital? And does it apply when an air ambulance uses our helipad but does not bring the patient to our ED?
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The first step in formalizing your list of drug seekers or other frequent visitors to your ED is to avoid any disparaging names for them or the list, says Joel Geiderman, MD, FACEP, co-chair of the ED at Cedars-Sinai Medical Center in Los Angeles.
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Whether you use a list or not, the best way to deal with drug seekers in your ED is to get tough with them, says John Burke, commander of the Warren County (OH) Drug Task Force in Cincinnati, and a former police officer.
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To illustrate how EDs set themselves up for malpractice liability when treating head injuries, Diane M. Sixsmith, MD, MPH, FACEP, chairman of emergency medicine at New York Hospital Medical Center of Queens in Flushing, tells the story of a 22-year-old boxer who was knocked out in a training session.
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Patient satisfaction improves dramatically if your staff pay more attention to the soft skills of ED care, such as the way you talk to people, while simultaneously improving the physical surroundings.
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A behavioral health care center in Mississippi is proving that a concentrated effort to reduce restraint can yield great improvements not only for the patients but also for the bottom line of the health care facility.
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Medical malpractice insurance premiums are 17.1% lower in states that have capped court awards, although the lack of such tort reform measures in other states does not fully explain recent jumps in what physicians pay to cover the cost of malpractice suits, says Kenneth E. Thorpe, PhD, chairman of the health policy and management department at the Emory University Rollins School of Public Health in Atlanta.
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A young man went to an emergency department in the afternoon complaining of discomfort in his throat. Surgery was performed to address an abscess. That evening, after his family had gone home, he suffered from cardiac arrhythmia, went into a coma, and died three days later. His wife and two sons brought suit for wrongful death.
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A post-kidney transplant patient was admitted to a hospital with urosepsis and was placed in the intensive care unit. He was intubated; but when his airway became obstructed, efforts to correct the situation were unsuccessful, and he died. The case settled for $800,000.
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Nearly every document that makes any mention of a patient in your facility can be considered protected health information under the Health Insurance Portability and Accountability Act (HIPAA), says Veronica A. Marsich, JD, a shareholder with the law firm of Smith Haughey in East Lansing, MI, specializing in health care issues.
