---
title: Blog & Articles - The Sullivan GroupThe Sullivan Group | Emergency Medicine (2)
description: Emergency Medicine | (2)
---
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# Blog & Articles
## [Spinal Epidural Abscess: 5 Things You Should Know](https://blog.thesullivangroup.com/rsqsolutions/spinal-epidural-abscess-5-things-know)
December 10, 2019
[](https://blog.thesullivangroup.com/rsqsolutions/spinal-epidural-abscess-5-things-know)
\[3 MIN READ\]
The incidence of [spinal epidural abscess](https://www.merckmanuals.com/professional/neurologic-disorders/spinal-cord-disorders/spinal-epidural-abscess) (SEA) has doubled in the past 2 decades due to the epidemic of MRSA infections, the spread of IV drug use, and the increased number of spinal and vascular access procedures. Delayed or missed diagnosis of SEA leads to profound disability or death; lawsuits in this arena are exceptionally costly.
- [Tweet](https://twitter.com/share)
## [Differential Diagnosis for Abdominal Pain & Documentation Pearls](https://blog.thesullivangroup.com/differential-diagnosis-for-abdominal-pain)
November 26, 2019
[](https://blog.thesullivangroup.com/differential-diagnosis-for-abdominal-pain)
\[3 MIN READ\]
Patients with abdominal pain are a common and constant challenge to practitioners in primary care, pediatrics, [urgent care](https://info.thesullivangroup.com/urgent-care-training), and [emergency medicine](https://info.thesullivangroup.com/emergency-medicine-cme-training). During the period of 2006 to 2014, there was a 32% increase in ED visits for the complaint of abdominal pain, so that as of 2014, abdominal pain is the most frequent diagnosis for an ED visit. The clinical presentations may be confusing; the differential diagnoses for abdominal pain are myriad; and not all patients with abdominal pain will have a serious underlying etiology.
[Medical errors](https://blog.thesullivangroup.com/rsqsolutions/malpractice-claims-medical-errors-one-real-target) and litigation involving the care of patients with abdominal pain are all too frequent and can be costly for both patients and physicians. The cornerstone of high-quality, defensible care consists of a systematic approach coupled with compulsive documentation. The essence of liability reduction in the care of patients with abdominal pain is to construct a medical record that provides a thorough, clear and logical explanation for your thoughts and actions. Here are a few key items to address in the chart documentation.
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## [How to Recognize Child Abuse](https://blog.thesullivangroup.com/how-to-recognize-child-abuse)
November 12, 2019
[](https://blog.thesullivangroup.com/how-to-recognize-child-abuse)
\[4 MIN READ\]
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.
- [Tweet](https://twitter.com/share)
## [Strategies to Improve Provider-Patient Communication](https://blog.thesullivangroup.com/strategies-to-improve-provider-patient-communication)
October 29, 2019
[](https://blog.thesullivangroup.com/strategies-to-improve-provider-patient-communication)
\[6 MIN READ\]
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](https://blog.thesullivangroup.com/rsqsolutions/improve-hcahps-patient-satisfaction-survey) 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](https://info.thesullivangroup.com/case-study-patientset-landing-page) 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.
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## [Headache Differential Diagnosis & Documentation](https://blog.thesullivangroup.com/differential-diagnosis-for-headache-documentation-pearls)
August 27, 2019
[](https://blog.thesullivangroup.com/differential-diagnosis-for-headache-documentation-pearls)
\[3 MIN READ\]
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:
- [Tweet](https://twitter.com/share)
## [Framework for a Nursing Clinical Excellence Program](https://blog.thesullivangroup.com/framework-for-a-nursing-clinical-excellence-program)
August 19, 2019
[](https://blog.thesullivangroup.com/framework-for-a-nursing-clinical-excellence-program)
\[2 MIN READ\]
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](https://info.thesullivangroup.com/emergency-department-nursing-training) 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.
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## [Preventing Medical Errors: 7 Things Every Provider Needs to Know](https://blog.thesullivangroup.com/preventing-medical-errors-7-things-every-provider-needs-to-know)
August 12, 2019
[](https://blog.thesullivangroup.com/preventing-medical-errors-7-things-every-provider-needs-to-know)
\[5 MIN READ\]
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.
- [Tweet](https://twitter.com/share)
## [Chest Pain Differential Diagnosis & Documentation](https://blog.thesullivangroup.com/chest-pain-differential-diagnosis)
July 16, 2019
[](https://blog.thesullivangroup.com/chest-pain-differential-diagnosis)
\[4 MIN READ\]
Patients with [chest pain](https://blog.thesullivangroup.com/common-errors-in-chest-pain-diagnosis) 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](https://blog.thesullivangroup.com/rsqsolutions/malpractice-claims-medical-errors-one-real-target) in Emergency Medicine. The cornerstone of high-quality, defensible care consists of a systematic approach coupled with comprehensive documentation.
- [Tweet](https://twitter.com/share)
## [Chest Pain Malpractice Claims & "Bedside Maneuvers"](https://blog.thesullivangroup.com/rsqsolutions/chest-pain-malpractice-claims)
July 15, 2019
[](https://blog.thesullivangroup.com/rsqsolutions/chest-pain-malpractice-claims)
\[3 MIN READ\]
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.
- [Tweet](https://twitter.com/share)
## [Framework for an Emergency Medicine Training Program](https://blog.thesullivangroup.com/framework-for-an-emergency-medicine-training-program)
June 13, 2019
[](https://blog.thesullivangroup.com/framework-for-an-emergency-medicine-training-program)
\[1 MIN READ\]
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.
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