ED Management – July 1, 2023

ACEP, ENA Push Congress to Act on Workplace Violence, Expand Mental Health Resources

The threat of violence against healthcare workers compromises the ability of emergency clinicians to deliver the highest-quality care. Meanwhile, there is a lack of resources to provide patients struggling with mental health concerns with the proper treatment or to place them in a setting where the right care can be provided.

EDs Need Clarity on Policies for Law Enforcement Interactions

Any hospital policy related to patients who are in custody or incarcerated should be developed in conjunction with the relevant law enforcement agencies. Leaders should establish that patients in custody with capacity are their own medical decision-makers. The policy also should include how to identify an appropriate surrogate decision-maker, if necessary.

What Happens if Police Bring a Child to the ED?

Try gathering healthcare providers, quality officers, the legal department, security, and local law enforcement monthly to discuss disagreements about minors in custody. These conversations can inform efforts to revise policies, with the goal of preventing future disputes.

Shorten Lengths of Stay, Reduce Revisit Rates for Pediatric Patients Who Present with Behavioral Health Needs

EDs might rely on telemedicine from a third-party company, a sister hospital with pediatricians on staff, consult services from local pediatricians, or ensure at least one provider in the department is trained in pediatric care.

Some ED Malpractice Lawsuits Hinge on Security Camera Footage

Security footage of ED waiting rooms is relevant to claims alleging delayed triage, failure to re-assess the patient during a long wait, or failure to intervene if a patient deteriorated in the waiting room. However, many claims involve allegations of delayed treatment or diagnosis. What happened in the waiting room, before the patient was brought back for evaluation, could have contributed to a poor outcome.

Emergency Nurse Criminally Charged for Diverting Pain Medications

There are specific malpractice risks for EDs in this situation. Risks for patients include inadequate pain relief and infectious disease transmission. There also are patient safety issues related to receiving care from an impaired provider. For leaders, there are processes to put in place that can help them identify patterns or trends indicating potential diversion.

Tackling Bias in Healthcare Requires Awareness, Data-Gathering, and High-Level Commitment

Healthcare systems have collectively turned their attention to promoting equity and rooting out bias. The results of a recently published study of how emergency nurses experience and react to bias suggests much work remains. Further, the authors maintained significant change is likely to require a firm commitment from the upper ranks of institutions to ensure equity is not just a slogan.

Patient Progression Hub Optimizes Throughput, Centralizes Decision-Making

Children’s Mercy in Kansas City aims to leverage an impressive array of artificial intelligence-driven tools, predictive analytics, and other feats of engineering to hone patient flow to new heights of efficiency.

When ED Is Packed, Keep Patients Moving with Triage Hallway, Dedicated Staff

Since Pull to Infinity was implemented in June 2022, the average time it takes to see a provider in the ED has dropped from 22 minutes to seven minutes. This, despite continually expanding volumes. The average patient arrival-to-discharge time has improved to 175 minutes, down seven minutes. Also, the leave-without-being-seen rate declined from 3.5% last year to 1.6% in the first four months of 2023.