The RSQ® Solutions – Emergency Medicine Assessment is a retrospective chart review tool providing a granular analysis on physician practice patterns. The online tool focuses on the 10 highest risk chief complaints in emergency medicine and measures clinical alignment around best practice and documentation compliance with these high-risk patients.
On the journey to improve the quality of patient care, initiatives to enhance clinical performance are necessary. Nevertheless, they can seem to be a daunting task; in fact, these initiatives require several well-orchestrated steps to ensure the program reaches its full impact potential.
Over the past decade, The Sullivan Group has partnered with some of the largest health systems in the country to successfully implement clinical performance improvement programs proven to change clinical practice. While every organization is unique, we have developed a system of best practices for initiative implementation.
Physician burnout is as epidemic as the plague once was, as malignant as the most devastating cancer, and as silent an assassin as hypertension. The topic has garnered much attention not only because of its impact on the healthcare practitioner, but also due to its detriment to the patient.
While a search for the term “physician burnout” produces massive amounts of data, self-help tips, and advice on prevention, the conversation lacks organization, uniformity and a standardized approach to the management of burnout.
According to ENA, retrospective chart review is a critical element of ongoing triage competency validation. The RSQ® Solutions – Triage Assessment tool is built upon triage best practices and provides a mechanism through which your organization can implement and execute a scalable and sustainable chart review process.
Using this tool, nursing management can easily assess triage competency on an ongoing basis; it allows them to:
There seems to be a widespread misperception among freestanding psychiatric facilities that the Emergency Medical Treatment and Labor Act, 42 U.S.C. § 1395dd (EMTALA), does not apply to them. This may or may not be true depending upon the licensure and the configuration of the facility. It is not as simple as a yes/no calculation.
There are three criteria that must be met before a facility can be held liable for a violation of EMTALA:
Because every patient entering the emergency department needs to be triaged, it is imperative to ensure that every triage nurse maintains accurate clinical decision-making skills that support optimization of patient flow. While the Emergency Nurses Association (ENA) has historically recommended ongoing triage competency validation to ensure safe practice in the ED, the organization updated itsTriage Qualifications and Competency Position Statementin 2017 to place greater emphasis on the use of retrospective chart review as a means to ensure accurate clinical decision-making in triage.
In addition to the ENA recommendation, here are five more reasons retrospective chart review is an effective part of a triage competency validation process:
[10 MIN READ]
Have you ever wondered as an Labor and Delivery RN how many hours during your shift you spend staring at fetal heart tracings?
I’ll bet you have never tried to tally such a figure, but I’d venture to guess it encompasses not only a large portion of your daily practice, but an enormous part of your career as well.
During a 12-hour shift of managing labor induction, you could easily spend approximately 5-6 hours or more actually staring at the monitor. That’s 50% of your shift! This translates into the possibility that half of your intrapartum career is immersed in FHR tracings!
This enormity speaks volumes to expectations of your ability to understand and manage the fetal tracing. Your knowledge base should be solidly comprehensive and your ability to articulate standardized definitions rapid. If litigation were ever to knock at your door, would you be able to defend your actions surrounding your interpretation and analysis of the FHR tracing?
Failure to recognize, failure to act, and failure to communicate have been cited as three litigious areas of concern regarding FHR monitoring. Let’s take a look at six common “pitfalls” that can get you into trouble regarding tracing analysis.
In today’s case presentation, we will navigate the difficult waters of patient refusal of life-saving care based upon religious beliefs. In this actual case, a woman’s life hung the balance. There was little time for formal mental status evaluation or communication with legal counsel or a local judge.
It was around 8:30 pm during a busy shift in the Cook County Emergency Department. A young woman had been rolled into the department with low blood pressure.
Providing care to psychiatric patients in the emergency department is a challenge for many reasons.
For the ED, however, the greatest risk and safety issue related to behavioral health is the appropriate evaluation and protection of the suicidal patient in the ED. We present 2 case studies to illuminate the uncommon but preventable catastrophe of suicide in the ED.
Clinicians issue tens of millions of warfarin prescriptions each year in the U.S., despite the increasing use of alternative anticoagulant medications. Practitioners will continue to encounter warfarin, known both for its irreplaceable value and potential for life-threatening complications. Due to the propensity for permanent disability and death from hemorrhagic complications, litigation is common and costly. Knowledge of the pharmacology, indications, monitoring, drug interactions and complications of warfarin is an essential tool to avoid patient harm, medical errors, and the medical-legal vulnerabilities associated with its use.
