Blog & Articles

[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. 

[4 MIN READ]

Every day, ED physicians, physician assistants, nurse practitioners and nurses are confronted with pediatric patients suffering from infections. Thankfully, most are self-limited respiratory or gastrointestinal viral infections.

Symptomatic and supportive care may be necessary, but antibiotics are not usually indicated; minor infections such as otitis media, impetigo, pharyngitis and uncomplicated urinary tract infections usually respond well to either oral antibiotics or a single parenteral dose of an antibiotic.

When treating an infant or a child with an infectious process, it is important to check for and recognize the subtle warning signs and symptoms of a more serious infection – whether viral or bacterial. When overlooked in their earliest stages, several types of infections can progress to life- or limb-threatening situations. Failing to consider and test for the possibility of serious infections in children can lead to serious, even fatal, outcomes.

[3 MIN READ]

Apology laws have always been a quandary. I have repeatedly said they make docs feel more comfortable about apology but have little legal value. Most would assume apology laws reduce medial malpractice claims but a study by Stanford Law Review shows that this is not the case. In states with apology laws, non-surgeon physicians saw higher rates of medical malpractice lawsuits and dollars paid out. Defense lawyers should want to use the evidence created in a disclosure process if a case goes to trial.

[3 MIN READ]

Do your clinicians have a plan for how to address a patient’s family if a medical error occurs?

Consider this true case that was shared with me by a California risk manager – a routine test that goes tragically wrong:

"Mrs. Woods is a 53-year old woman who goes to the hospital for a CT-guided biopsy of the liver. The staff assures Mrs. Woods the test is ‘no big deal’ so she tells her husband to go across the street to do some shopping during the test. The clinical team assures Mr. Woods they will call him when the test is complete. Mr. Woods is standing in Macy’s when his cell phone rings … he answers to hear a nurse frantically screaming, 'Come quickly!' Mr. Woods races across the street to the hospital where he learns his wife is dead."

After reading this case in my training programs, I challenged my healthcare audiences with the following: 

[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.

[1 MIN READ]

If your organization is navigating the onboarding and integration process for newly employed physicians, you're not alone.

The Physicians Advocacy Institute recently reported that U.S. hospitals bought 5,000 independent physician practices between July 2015 and July 2016. The percentage of hospital-employed physicians increased by more than 63% from mid-2012 to mid-2016.

TSG's RSQ® Education - Physician Integration Program is designed to put the best practices of patient safety and risk management at the fingertips of your physicians and systematize your ongoing compliance training.

[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.

[12 MIN READ]

While the mission of clinical research is to advance the practice of medicine, it is an extremely daunting task to not only manage clinical trials, but to also oversee them to keep patients safe and reduce risk. In a review of numerous malpractice cases related to clinical research, I have found several common denominators and opportunities to improve patient safety.

The issues that arise from clinical trials are not typically intentional; they are simply intrinsic to the complexities of the system. Under the best of circumstances and in many cases by design, patients have significant problems and are randomized to receive a trial drug. This population is inherently at risk. Additionally, many medical professionals are not trained to conduct appropriate, safe, well-organized clinical trials. These factors along with others I will outline have led to an increase in patient injury, federal and legal scrutiny, and obviously, litigation.

We've featured a variety of topics, cases, and missed diagnoses on our blog this year, and we hope that you've found the content useful and relevant.

In case you missed some of 2018's most popular posts, here are the top 10 articles from the blog this year, according to our website visitor statistics. Which article is most valuable to you?

Regulations, rules, litigation, and medical errors are not the most popular topics for the busy clinician. Most of us would rather gargle nuclear waste than spend a precious evening reading about these issues that plague the pure and honorable practice of medicine. However, we avoid such matters at the peril of our patients’ safety as well as our own personal and professional well-being.

Since few (if any) of us will invest in a treatise the length of War and Peace on the subject, I have assembled the following short list of “10 Medical-Legal Basics Every Provider Must Know” for the busy physician, nurse, and advanced practice clinician.