Triage is an essential part of any busy emergency department (ED), but one that is often taken for granted. While triage is not designed to determine the cause of the patient’s symptoms, it prioritizes the patient’s need to be seen by a provider. EDs often assume (possibly erroneously) that triage assessments are being performed correctly or that any errors in triage can be corrected when the medical screening is done. Both of these assumptions can lead to serious adverse patient events.
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“It’s all about communication!”
The world of medicine has changed by leaps and bounds over recent decades. Computers are part of our daily lives, and technological advances have significantly improved our ability to diagnose and treat diseases that were once thought incurable.
Despite this incredible progress, healthcare providers continue to commit far too many medical errors. And unfortunately, many of these mistakes are simply caused by “poor communication.”
Violence in Healthcare Part 1: Risk Factors & Warning Signs
Once you have an understanding of the risk factors and warning signs that may lead to workplace violence in a healthcare setting, it’s imperative to implement a plan to prevent and intervene in these situations to provide a safe environment.
Pinched, pushed, punched, or even stabbed, shot or killed. Nearly every healthcare worker has been a victim or knows a coworker who has been a victim of workplace violence.
Workplace violence represents a serious health and safety concern for all employees, but healthcare workers in particular face significant risk. Health and social service industries account for 48% of all non-fatal injuries from occupational assaults and violent acts.
Many practitioners view the process of informed consent in healthcare to be a nuisance and a hindrance. It is often simply one more hoop to jump through so that the patient can get the care he or she needs. This is not true. If the provider was negligent in providing the service and a bad outcome occurred, the patient has a cause of action for medical malpractice.
Is there a reliable way to predict which physician will be sued for malpractice? Researchers, insurers and healthcare professionals have wrestled with this question for decades.
A recent study in the New England Journal of Medicine and a follow-up response by the Physician Insurers Association of America (PIAA) provide more data points, but admittedly do not answer the question definitively. Perhaps they are trying to answer the wrong question.
A 78-year-old man, Mr. S, came to the emergency department with the chief complaint of abdominal pain. He was an active person, residing in the independent living section of a retirement complex. He described the pain as an ache in the mid and lower abdomen that had been present for several days. The pain did not radiate. He denied any fever, nausea, vomiting or diarrhea. He claimed having no appetite or bowel movement “for days.”
There is a new risk and safety issue in the world of appendicitis. In this issue of TSG Quarterly, we explore the issue of conservative, antibiotic-first management of acute appendicitis with appendectomy reserved for treatment failures. Is it the new standard? Have you proactively addressed this issue with your emergency medicine and surgical practitioners? It is important to get out in front of this issue to keep our patients safe!
Current strides in improving patient safety in hospitals and medical facilities provide clear evidence that the healthcare industry has the capacity for meaningful change. However, providers continue to face significant obstacles; perhaps the biggest obstacle of all revolves around developing and expanding a vigorous “safety culture.” Indeed, much of the focus has been on technology and incremental process improvement, but building a “culture” is the foundational contributor to ensuring patient safety.
The practice of pediatrics is relatively unique from a risk management perspective. One study placed the risks associated with the practice of pediatrics relative to other specialties as 25th out of 26 specialties with regard to the risk of being sued. However, although the risk of being sued is relatively low, another study found that the risk that a pediatrician may be sued in a given year was 3.1% as compared with 7.4% for all physicians.
