[9 MIN READ]

Standardization is known for reducing variation and increasing consistency; it continues to be a recognized safeguard to decreasing liability and improving outcomes.

High-quality postpartum care includes implementation of both standardized discharge processes and teaching that can improve maternal outcomes.

AWHONN promotes postpartum discharge standardization and encourages that specific components of postpartum discharge teaching align with leading causes of maternal morbidity and mortality.

While we previously outlined best practices in postpartum discharge teaching strategies, here we will discuss specific standardized teaching content that needs to be communicated to postpartum patients and their families at the time of discharge or sooner.

Educating patients and their families to recognize important warning signs and symptoms and clearly understand normal healing versus abnormal symptomatology is strategic in reducing maternal morbidity and mortality.

[6 MIN READ]

An adverse drug event (ADE) is defined as harm experienced by a patient resulting from exposure to a medication. An ADE can be caused by an error or poor care, but it is estimated that about half of ADEs are caused by a medication error; these are known as preventable adverse drug events.

Statistics are staggering; they reveal that ADEs lead to 700,000 ED visits, 100,000 hospitalizations, and between 7,000 and 9,000 deaths every year in the U.S. Even within the “safe” confines of hospital care, about 5% of hospitalized patients experience an ADE. 

Opioid analgesic use in the hospital setting is usually safe, but it is also associated with serious ADEs. In this issue, we present a case of an adverse drug event that illustrates many of the features known to contribute to opioid-related ADEs in the hospital. Whether this ADE was preventable, treatable or unavoidable – you be the judge!

[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:

[4 MIN READ]

ACOG has issued a practice advisory regarding the recent measles outbreak.

It is hard to fathom that a disease once considered eradicated is now in a state of progression across the United States. To date, there are 764 reported cases across 23 states; this number has increased by 60 cases from the previous week as reported by the CDC. No state is immune, and nationwide advancement is probable.

[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.

[6 MIN READ]

The Joint Commission (TJC) defines a Sentinel Event as “a patient safety event (not primarily related to the natural course of the patient’s illness or underlying condition) that reaches a patient and results in any of the following: death, permanent harm, or severe temporary harm and intervention required to sustain life.” TJC adopted a Sentinel Event Policy in 1996 in an effort to assist hospitals in voluntarily reporting, evaluating and reducing risk, and preventing patient harm. The term “never event” was first described in 2001 by Dr. Kenneth Kizer of The National Quality Forum (NQF) in reference to significant adverse medical errors that should never have taken place. The NQF currently uses this term when referring to serious reportable events deemed preventable. Whatever you choose to call these, they are simply events that really should not happen.

[4 MIN READ]

Your Postpartum Patient

Your postpartum patient was not complaining. Her vital signs were stable. She had experienced a prolonged labor, but to your knowledge, her vaginal delivery the previous day went well. Her recovery seemed to be progressing nicely. The morning report did not reveal that she was at any risk.

[2 MIN READ]

The development of tools and resources to guide the busy practitioner in prescription decision-making is a welcome trend in healthcare, particularly when the information is instantly available from valuable sources, including Prescription Drug Monitoring Programs and the patient’s medication history. As outlined recently by Ms. Caldwell on the MEDHOST blog, marrying these resources into the prescription functionality of an EHR is a key component in the effort to combat the opioid crisis.

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?