Blog & Articles

A steady increase in maternal mortality and morbidity in the U.S. prompted a comprehensive, collaborative response by the federal government and leading medical organizations focused on maternal health to improve outcomes. The Prevention of Maternal Death Act of 2018 directed DHS to develop programs that support the states in their work to save and sustain the health of mothers during pregnancy, childbirth, and in the postpartum period; to eliminate disparities in maternal health outcomes; and to identify solutions to improve health care quality and health outcomes for mothers.

[5 MIN READ]

In recent years, emergency department providers have regularly faced an expanding volume of patients with mental health needs. Then COVID-19 happened, dramatically taxing the healthcare system and increasing demands on providers while also challenging patients’ mental health across the board. In response, it is essential that ED providers increase their knowledge and comfort with the assessment, treatment, and disposition of mental health patients in order to improve timely care for these patients, many of whom require behavioral healthcare in the ED.

EDs Need Tools and Resources for Assessment and Treatment

Psychiatric and substance abuse issues had already more than doubled prior to COVID-19 disrupting our lives more than doubled, rising from 6% to 15% 1. And while traditional visits to the emergency department decreased during the pandemic, visits requiring care for adult psychiatric and substance abuse issues increased substantially. This often presented as anxiety or depression diagnoses, trauma, and stress-related disorders, and increased substance use. Some of these problems manifested as an increase in suicide ideation and attempts.

In 2019, the World Health Organization categorized burnout as a syndrome resulting from chronic workplace stress that has not been successfully managed. While burnout was a concern before COVID-19, its onset has exacerbated the problem.

According to an ACEP October 2020 poll, 87% of emergency physicians reported feeling more stressed since the start of the pandemic, and 72% reported experiencing more burnout on the job.

On the surface, burnout may be classified as a workforce issue; however, its far-reaching effects can threaten patient safety. In fact, research suggests that physicians experiencing burnout are twice as likely to make a medical error. Burnout should absolutely be considered one of the root causes of medical error.

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. 

Despite almost two decades of attention and study, diagnostic error continues to be a main issue in healthcare, affecting an estimated 12 million people each year and causing harm in one-third of these cases.

The most comprehensive literature on this topic comes from “Improving Diagnosis in Health Care,” in which the first recommendation is to “facilitate more effective teamwork in the diagnostic process among health care professionals, patients, and their families.” Specifically, it calls for increasing nursing engagement in the diagnostic process; no longer is the diagnostic process the sole purview of a physician. Here we use a case review to demonstrate the importance of nurses in reducing diagnostic error and saving patient lives.

[3 MIN READ]

When most people think of triage, they think of nurses making sense of the chaos caused by 141 million annual visits to the ED.

Patients who are part of this massive onslaught of unscheduled care arrive daily at any hour, and the first person they see is someone in triage, usually a nurse, whose job is to quickly figure out who needs to be seen in what order.

In my early practice years, my ignorant impression was that triage was for dummies – all one had to do was just sit there and assign patients to a room.

Many years of experience and observation have taught me otherwise – that triage is where the best and brightest nurses should be. 

[6 MIN READ]

Any discussion of communication in healthcare must include the process of transferring patients and their vital medical information from one provider to another and/or from one healthcare setting to another.

Such transfers are known as healthcare handoffs.

Examples include when a patient is transferred from an ambulance to an ED or when a surgical patient is moved from the recovery room to a surgical floor.

A person-to-person handoff takes place when, for example, a physician going off duty signs off to the evening on-call doctor or when nurses report to each other at shift changes.

Handoffs are specific circumstances in healthcare that are prone to medical errors.

Updated: May 27, 2021

The emergence of the COVID-19 pandemic caused by SARS-CoV-2, a highly transmissible virus that can be spread by asymptomatic people, requires providers to make innovative changes in how patients are seen and treated in the ambulatory setting. Prenatal care requires frequent face-to-face visits, so it is particularly challenged to adapt to protect patients, providers and office staff. Ultrasound testing and fetal monitoring usually also require in-office visits. However, innovations in care such as increased use of telemedicine and self-monitoring at home by patients are being implemented to change the norm for prenatal care. This article will discuss the innovations offices and patients can implement to provide safe, comprehensive prenatal care to pregnant patients with COVID-19.

[5 MIN READ]

Before the COVID pandemic, the medical community in general, and physicians in particular, were dealing with and continue to deal with a pandemic of its own: Burnout. In 2019, burnout was categorized as a disease by the WHO. It is characterized as:

“…a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed.”

There are 3 dimensions of burnout:

Updated: April 30, 2021

Pregnant women who have known or suspected COVID-19 infection need to be evaluated quickly to determine the severity of their symptoms and if they have risk factors that put them at risk for severe disease. New data on the outcomes for pregnant women have shown that pregnancy is a risk factor for increased severe mortality and morbidity; for example, respiratory distress requiring intubation and admission to ICU, maternal death, and obstetric complications such as preterm birth and stillbirth (Jama Intern Med 2021).

Seven percent of pregnant women who underwent testing for COVID-19 were found to be positive, with 75%-85% asymptomatic and 90% stable enough to be treated outpatient. Thus, most women diagnosed with this infection can be treated without hospitalization, but all known or suspected infected patients must be closely monitored.