Once you have allocated resources toward your performance improvement initiative, the next best practice in initiative implementation involves getting your clinicians to support it.
Engaging clinicians early in any initiative is crucial to success. If they decide against participating in the program, morale can suffer. Conversely, clinicians who embrace the program have testified to its worth in improving their practice, saving patient lives and enhancing morale.
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.
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:
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.
Infants and children with acute abdominal pain present to emergency departments, urgent care centers and physician offices with a variety of signs and symptoms. Since infants can’t localize pain and pre-school children are often imprecise in their responses, the healthcare practitioner may find it difficult to ascertain the actual dilemma.
Intoxication! Talk about a red flag! Let’s consider two “flavors,” if you will. First, the patient with an actual chief complaint AND who happens to be intoxicated. Next, the patient who presents with apparent intoxication and no other immediately obvious issues. And for those of you who have not had a busy shift in an urban emergency department, the number of patients with altered mentation secondary to alcohol can be remarkable. Unfortunately, many of these patients get to be regular visitors; they are well known by the emergency providers and are often on a first-name basis.
We hear the overhead announcements all the time in the hospital … Code Blue … Code Red … and more recently, Code Trauma … Code STEMI … Code Stroke … and Code Sepsis. From the standpoint of risk and safety, these latter four are the “Codes” that practitioners and nurses must master in order to deliver the best possible care in the safest manner, thereby reducing risk to patients and clinicians alike. Previous blogs featured two time-sensitive emergencies: Code Stroke and Code Sepsis. Today I will highlight a third time-sensitive “code” — Code STEMI (ST-elevation MI.)
