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Process improvements typically take center stage whenever hospital administrators decide that patient throughput and patient satisfaction are not where they need to be.
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Christiana Hospital in Newark, DE, averages between 315 and 320 patients per day. It's a huge ED, taking up a lot of space, explains Amy Whalen, RN, BSN, SANE-A, the assistant nurse manager in the ED.
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There is nothing like working on the front lines in a busy emergency department to learn about the impact of traumatic injuries. Consider, for example, the experiences of Brent Parry, NREMTP. Serving as a paramedic for LifeFlight, and as a tech for the ED at Geisinger Wyoming Valley (GWV) Medical Center in Wilkes-Barre, PA, Parry is often among the first to see patients who have been seriously injured.
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An elderly man presented to an emergency department (ED) with new-onset chest pain. In reviewing the patient's electronic medical record (EMR), the emergency physician (EP) noted a history of "PE," but the patient denied ever having a pulmonary embolus.
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In one case involving the death of a 9-year-old girl from a reaction to metoclopramide, misdiagnosed as gastroenteritis, the patient and her 16-year-old brother were called on in the ED to interpret for their Vietnamese-speaking parents.
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If the hospital isn't named in a medical malpractice lawsuit, an emergency physician (EP) defendant can sometimes take advantage of the "empty chair" defense strategy, says Joseph P. McMenamin, MD, JD, FCLM, a partner at Richmond, VA-based McGuireWoods LLP and a former practicing EP.
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Whether an emergency physician (EP) has deviated from the accepted standard of care on the basis of timeframe depends on the facts of the individual case, says Robert D. Kreisman, JD, a medical malpractice attorney with Kreisman Law Offices in Chicago.
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The most significant legal risks in the ED are not those associated with boarding patients or high-acuity traumas, but rather, those associated with relatively stable patients with undifferentiated diagnoses, according to an analysis of malpractice cases occurring from 2006 to 2010 from Crico Strategies' Comparative Benchmarking System database.