Blog & Articles

Our mission at The Sullivan Group is to positively change clinical practice, improve patient safety and reduce malpractice litigation. Because of this, we are often asked by clinical leaders and clients to explore the impact our RSQ® Solutions platform may have on other areas of the healthcare business. A Chief Nursing Officer with whom we have worked for the past several years connected with me at the 19^th Annual NPSF Patient Safety Congress in Orlando, FL, with a similar inquiry. She asked if we had any evidence to support a relationship between our work with improving nursing competency/patient safety and nursing retention rates. 

As electronic medical records have evolved, so have physician documentation methods. Based on our observations in recent years, we have noticed that as organizations migrated away from paper templates, many only developed two or three generic electronic documentation templates for physicians to use (Adult Template, Pediatric Template, Trauma Template).  

Although most of The Sullivan Group’s RSQ® Solutions platform is delivered online via CME/CE courses and clinical performance assessments, there is another major component to the RSQ® Cycle, which involves building clinical risk mitigation strategies directly into the EMR. In 2010, one of our largest clients requested that we develop a library of physician documentation templates for their enterprise EHR system, which happened to be MEDITECH. After several years of development with their medical leadership team, we deployed 137 chief complaint-specific templates with clinical decision support to all 163 emergency departments. Below we have included 2 videos from our President & CEO, Dan Sullivan, MD, JD, FACEP, that outline a few different workflows that can be used by providers to complete their documentation with our PDoc Templates.

Over the last 19 years, clients have watched TSG’s library of online courses grow from 10 courses focused on Emergency Medicine to over 275 courses that span the spectrum of healthcare. We are often asked by clients, “Which courses should we focus on first?” While this answer varies greatly based on the specifics of each client, we have taken the liberty of creating a list of courses/topics that we feel are critical for all patient safety initiatives and tend to resonate with clinicians.

Anything and everything that improves patient safety is important. The sheer weight of that sentence can be overwhelming to healthcare professionals. Consider one conclusion from the Institute of Medicine (IOM) report “Improving Diagnosis in Healthcare” that states, “Advancing patient safety requires an overarching shift from reactive, piecemeal interventions to a total systems approach to safety in which safety is systematic and is uniformly applied across the total process.”

Provider perception of a positive hospital safety culture receive the lowest score for questions concerning the presence of non-punitive response to errors, effective handoffs and transitions, and adequate staffing.

These results are detailed by the AHRQ in the “Hospital Survey on Patient Safety Culture 2016 User Comparative Database Report.” The AHRQ has been measuring data on patient safety culture since 2004. Surveys are now available for medical offices, nursing homes, community pharmacies, and surgery centers.

Physician workflow frustrations are cited by several studies as a significant contributing factor to physician burnout, an epidemic estimated to impact 51% of the physician population according to Medscape’s 2017 study. Because burnout can be tied to risks in patient safety, improvements in physician workflow are key components in the patient safety movement. 

Over the decades, physicians have worked with various medical record documentation styles. While this evolution is thought to improve patient care with each step, the majority of physicians and health systems have yet to maximize the potential of their documentation to improve patient safety. Moreover, each evolution might also be cited as being more complicated and time consuming for the physician, thus adding to their workflow frustrations.

Pain management in the acute care setting (ED, Urgent Care, office) has once again catapulted to the top of the list of hot topics. Years ago the conversation centered on recognizing pain as a “fifth vital sign” and navigating the tricky crossroad of patient satisfaction and the provision of timely, sufficient pain medication. In the Emergency Department, I witnessed every extreme of practitioner and patient behavior.

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As practitioners, we like to think our charm and skills are so valuable that no patient would possibly consider leaving the ED or hospital against our sage medical advice!

However, no matter how hard we try or how fast we work, a few patients will always choose to leave before an evaluation is complete—and against medical advice (AMA). Available data shows that about 1.2% of ED patients leave AMA.

The chief complaint of chest pain is common among patients presenting to the office, clinic, urgent care or emergency department. While heart disease is the leading cause of death in the U.S., medical error is the third leading cause. Furthermore, missed or delayed diagnoses are responsible for 57% of malpractice claims in emergency medicine, according to a 2007-2013 closed claims analysis from The Doctors Company.

This infographic outlines common errors in chest pain diagnosis that can lead to an adverse event. Download as a PDF.