Blog & Articles

[4 MIN READ]

Child physical abuse exists in all corners of the country and affects children of all ages, ethnicities, and socioeconomic groups.

Consider the following facts:

• More than 2 million reports of suspected child maltreatment are investigated each year in the United States. These reported cases represent only a fraction of the abuse that children experience.
• Child maltreatment includes neglect and abuse that may be physical, sexual, emotional, or psychological.
• There are more than 650,000 substantiated cases of child maltreatment annually.
• About 18% of child maltreatment involves physical abuse.
• More than 1,500 children die each year due to abuse or neglect. 80% of these deaths are children under 4 years old.
• The incidence of child abuse is underestimated since 17% of adults in the U.S. report that they were physically abused as a child.

[6 MIN READ]

Physicians, nurses and other “healers” have had special relationships with patients for centuries. This unique bond between those who provide medical treatment and those who receive their care is currently being endangered by a massive and impersonal healthcare delivery system that is becoming more dependent on automation and technology with each passing year. The good news is that patient attitudes, impressions, and subsequent compliance with treatment plans can be positively influenced when healthcare professionals improve their communication skills with their patients.

Studies show that there is a clear relationship between high patient satisfaction and healthcare organizations that provide safe, quality care. A report by Health Grades (May 2012) noted that hospitals that were ranked (by patients) in the top percentages for nursing and physician communication had lower rates of adverse patient safety events. For example, bed sores occurred approximately 46% more frequently in hospitals that patients had ranked in the lowest 10% for provider communication.

[3 MIN READ]

Headache is a common reason for a visit to practitioners in primary care, urgent care, and emergency medicine. Patients with the chief complaint of non-traumatic headache comprise 3% of all emergency department visits.

The vast majority of these headaches will have a benign etiology such as tension or migraine. Unpredictably interspersed among these benign presentations are patients with a serious cause of headache such as hemorrhage or CNS infection.

Malpractice cases involving headaches frequently involve the missed diagnosis of subarachnoid hemorrhage (SAH). The reasons the diagnosis of SAH is missed include the following:

[2 MIN READ]

Your organization might find itself hiring more new, inexperienced nurses for your emergency department due to the national nursing shortage. While these new hires arrive with a nursing degree, you need to be sure that each has a baseline set of knowledge to effectively treat patients in your ED.

Our RSQ® Solutions – Nursing Clinical Excellence Program was designed to help level-set the knowledge base of your clinical workforce. Our team of experienced ED nurses and educators compiled the blueprint below as a foundation for what an effective continuing education program might look like for your ED staff in their first three years of employment.

[5 MIN READ]

Despite the wake-up call given almost 20 years ago by the Institute of Medicine’s report “To Err is Human,” medical errors still occur at alarming rates.

The landmark publication estimated that up to 98,000 Americans die each year from medical errors, and one out of every twenty-five hospitalized patients is harmed by a medical mistake.

There is, however, cause for guarded optimism. Many organizations, agencies and legislatures have stepped forward and created solutions and educational programs targeted at reducing medical errors.

[4 MIN READ]

Patients with chest pain are a common and constant challenge to clinicians, whether in the office, clinic, urgent care or emergency department. The clinical presentations may be confusing, the differential diagnoses are myriad, and not all patients with chest pain will have a serious underlying etiology.

Lawsuits involving the care of patients with chest pain are frequent and make up the costliest group of malpractice cases in Emergency Medicine. The cornerstone of high-quality, defensible care consists of a systematic approach coupled with comprehensive documentation.

[3 MIN READ]

Malpractice claims related to the chief complaint of chest pain continue to plague clinicians. Foremost among these claims is the allegation of “missed MI,” which has now been expanded to include missed unstable angina as well as missed actual myocardial infarction.

Although the evaluation of the adult with chest pain is fraught with many pitfalls, one of the most glaring yet avoidable errors is the reliance upon “bedside maneuvers” to exclude the diagnosis of coronary etiology.

[1 MIN READ]

As you start an emergency medicine training program, it can be overwhelming deciding where to start with your coursework.

Here we'll outline our recommendations for both how to approach topic selection, as well as course timing, based on our experience working with the largest healthcare systems in the country over the past twenty years.

[5 MIN READ]

In prior blogs, I reviewed the bare-bones of EMTALA, highlighted recent studies of EMTALA investigations, and summarized recently settled cases of EMTALA violations. In this installment, I outline the requirements of EMTALA as they relate to the role of the on-call physician.

EMTALA was passed to prevent the dumping of “non-paying” patients between hospitals. With the enactment of EMTALA, the dumping problem has diminished. The on-call physician plays a key role in patient management under EMTALA.

The “emergency medical system” depends upon emergency department access, availability of specialist physicians through the on-call roster, hospital bed and staff availability, and a referral system for tertiary or highly specialized care.

[9 MIN READ] 

Hospital discharge is cited as a vulnerable point in a patient’s care transition.

Its effective execution has significant implications on a patient’s recovery trajectory.

The most effective tool in a clinician’s toolbox to promote patient healing is the effective delivery of communicating discharge instructions for patients.

The Wrong Way to Communicate Discharge Instructions

Before discussing best practices for reviewing discharge instructions with patients, let us review what patient discharge should NOT look like: