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An emergency physician (EP) diagnoses pneumonia in a 40-year-old male and treats appropriately. Later, the radiologist agrees with the pneumonia diagnosis, but suggests that "a small nodule in the left upper lobe should be evaluated with a chest CT." Somehow, that report never gets read by the ED staff, and the patient's cancer progresses until it is too late for effective treatment. A lawsuit is filed.
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Hospital emergency departments (EDs) interact with police on a daily basis with varying degrees of cooperation, but whether the cooperation is good or bad, many police interactions raise risks of violating federal EMTALA and other regulations.
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There is a growing trend of specialty organizations coming out with guidelines and recommendations, but in some cases, these are inappropriate for ED patientsand may even be harmful.
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Belligerent behavior, communication problems, inconsistent responses to questions, and lack of competency to refuse treatment: Any of these factors can get in the way of obtaining a good history and physical for a patient with psychiatric complaints, according to Barbara E. Person, an attorney with Omaha, NE-based Baird Holm.
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An emergency physician is managing an acute myocardial infarction, arranging for a patient transfer, sewing up a laceration, and putting in a chest tube, with 20 people still waiting to be seen in the waiting room.
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National economic paranoia seems to have taken over, and although ED volumes continue to climb, joblessness combined with the economic downturn promise to make it a rocky 2009 for many. There is a lot of emphasis on patient satisfaction, safety, and security these days, and each requires resources to manage. To sustain our objectives, it will be necessary to ensure the revenue streams to support them.
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While the introduction of new technologies such as computerized physician order entry (CPOE) were lauded by proponents as "silver bullets" that dramatically would improve patient safety, The Joint Commission is warning in a new Sentinel Event Alert that "users must be mindful of the safety risks and preventable adverse events that these implementations can create or perpetuate."
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The best way to avoid (or at least minimize) problems with information technology (IT) implementation in the ED is to take certain steps to make sure you are adequately prepared, advises James Walker, MD, FACP, chief medical information officer of Geisinger Health System in Danville, PA.
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ED managers might breathe a small sigh of relief following the announcement from The Joint Commission (TJC) that there will be no new National Patient Safety Goals (NPSGs) developed for 2010, but experts say that doesn't mean they should pay any less attention to improving patient safety strategies.
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ED managers agree that overcrowding and gridlock, while often manifested most graphically in their department, are decidedly hospitalwide issues, and the experience of Sarasota (FL) Memorial Hospital seems to prove their point.
