“By computerizing health records, we can avoid dangerous medical mistakes, reduce costs, and improve care.” -- President George W. Bush, State of the Union Address, January 20, 2004
The move towards the electronic health record (EHR) has been under way for more than a decade now. Hospital administrators, healthcare insurers, IT vendors and government officials are touting the benefits of transitioning from paper to electronic records.
Many diagnostic errors involve some degree of cognitive bias or errors; here is an actual case that illustrates this point.
L.B. is a 46-year-old man with onset of illness 12 days prior that started with cold symptoms, sore throat, rhinorrhea, cough, and fever up to 100.7°F (38.1°C). Since then, he has been getting progressively weaker, to the point that he could not walk to the EMS vehicle.
There have been some interesting, and some frightening, developments in case law relating to healthcare risk management since the last annual meeting of the American Society for Healthcare Risk Management (ASHRM). While these cases may not have national importance (yet), they have concerning implications for healthcare.
Failure to diagnose is the most common medical error in the practice of emergency, urgent care and primary care medicine. Spinal epidural abscess (SEA) is one of the most difficult conditions to diagnose, but there are common threads among failure to diagnose spinal epidural abscess cases. This case is presented to provide perspective and to increase our vigilance for catching this disabling and possibly even fatal diagnosis.
The uncommon but lethal infection known as necrotizing fasciitis continues to be in the news. This is a devastating disease that can be difficult to diagnose in the early stages. The first presentation is often nothing more than arm or leg pain that looks very much like garden-variety musculoskeletal discomfort. By the time the diagnosis is made, the disease process is often too far along to reverse it, resulting in severe disability or death. However, there are usually a few clinical clues that a more dangerous process is under way.
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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.
Only the common cold prompts more people to see a practitioner than acute low back pain. Most people will suffer with low back pain at least once in their lives, and it is estimated that 2% to 3% of all ED visits are for acute non-traumatic back pain. With costs exceeding $90 billion per year, the far-reaching implications are clear. Acute low back pain affects men and women of all ages; it is a common cause of disability in those less than 45 years of age due to work-related injury. Patients experience pain and lost wages; employers are impacted by loss of productivity in the workplace; and there is a major financial burden to society in general.
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.
