Recent studies demonstrate that about 7% of all emergency department (ED) patients present with a mental health condition. Because of the unique risks associated with psychiatric patients, coordinating their care and admission has proven to be a challenge for emergency practitioners. Here we present a case that highlights the risks of boarding patients in the ED.
Triage is an essential part of any busy emergency department (ED), but it is often undervalued. While triage is not designed to determine the cause of a patient’s symptoms, it prioritizes the patient’s need to be seen by a provider. EDs often assume (possibly erroneously) that triage assessments are being performed correctly or that any errors in triage can be corrected when the medical screening is done. Both assumptions can lead to serious adverse patient events.
Acute ischemic stroke affects about 800,000 patients a year in the U.S.; 600,000 of these cases are a first stroke. Stroke is a leading cause of permanent cognitive and function-limiting disability, and it ranks fifth among all causes of death.
Effective solutions to combat diagnostic error exist today. Why haven't more institutions implemented programs with a focus on diagnostic error reduction?
[9 MIN READ]
Remember paper T sheets? Your patient has back pain, so you grab a paper T sheet from the anatomical rack, walk into the exam room, get your history, make some circles and slashes, and your history and physical is all but complete by the time you get back to your desk. Write in (remember writing?) some MDM and ‘ba-da-boom’, the chart is done. The focus was on easy documentation and receiving appropriate reimbursement for the care provided.
[6 MIN READ]
The overwhelming majority of malpractice lawsuits in emergency medicine and other acute care venues involve the failure to diagnose. In most cases, these patients are discharged home where the missed diagnosis results in an adverse outcome or death. Fortunately, the patient “bounces back” in some cases, creating another opportunity to make the right diagnosis.
I want to take a collective pause with you for a moment to recognize a very special individual in The Sullivan Group’s world, Dr. Tom Syzek. Tom has decided to step down from his position as TSG’s VP of e-Learning. I hesitate to say retire because Tom has a long list of things that will keep him busy, including swimming across Tampa Bay regularly in support of our veterans, long treks at high altitudes, family activities, and who knows what’s next!
I know that whatever the next chapter is for Tom, he will approach it with the same energy, thoughtfulness, creativity, friendliness and loving spirit that defines him. If you have had the great fortune of working with Tom over the years, you definitely know what I am talking about.
[12 MIN READ]
While the mission of clinical research is to advance the practice of medicine, it is an extremely daunting task to not only manage clinical trials, but to also oversee them to keep patients safe and reduce risk. In a review of numerous malpractice cases related to clinical research, I have found several common denominators and opportunities to improve patient safety.
The issues that arise from clinical trials are not typically intentional; they are simply intrinsic to the complexities of the system. Under the best of circumstances and in many cases by design, patients have significant problems and are randomized to receive a trial drug. This population is inherently at risk. Additionally, many medical professionals are not trained to conduct appropriate, safe, well-organized clinical trials. These factors along with others I will outline have led to an increase in patient injury, federal and legal scrutiny, and obviously, litigation.
