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Using solutions targeted to the specific causes of an inadequate hand-off, organizations participating in an initiative headed by The Joint Commission Center for Transÿ
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If an EP was caring for a patient while visibly intoxicated and a bad outcome occurred, you can probably imagine how that information would affect the outcome of a trial alleging medical malpractice. But what if an EP has a history of substance abuse, a criminal record, or a psychiatric history?
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Emergency physicians have been "deluged with ever-increasing responsibilities and higher performance expectations," according to Andrew Garlisi, MD, MPH, MBA, VAQSF, medical director for Geauga County EMS and co-director of University Hospitals Geauga Medical Center's Chest Pain Center in Chardon, OH. Garlisi points to electronic health record physician order entry, patient satisfaction ratings, and increasing medical record documentation, as some examples.
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Patients with psychiatric illness who present to the ED "are frequently a challenge," according to Robert B. Takla, MD, FACEP, chief of the Emergency Center at St. John Hospital and Medical Center in Detroit, MI. "Trying to determine if a patient is truly suicidal or a real danger to themselves or others is not always straightforward."
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Tennessee Supreme Court says hospital is directly liable for failure to enforce its emergency department policy that required all patients be seen by an emergency physician.
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Does your ED have policies that leave no room for nursing judgment, and instead, require specific timeframes for procedures such as re-assessments and checking of vital signs?
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It may be in the best interest of your ED patient with chest pain, seizures, or transient ischemic attack (TIA) to be admitted, but this may not occur due to factors beyond your control.
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