ED Management – March 1, 2003

March 1, 2003

• Are pediatric drug errors occurring in your ED? Act now before tragedy strikes

  If you fail to implement effective systems to prevent pediatric medication errors, there can be liability risks for you and your facility.

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• Joint Commission Update: Use these tools to comply with patient safety goals

  Now that the Joint Commission on Accreditation of Healthcare Organizations has announced its 2003 National Patient Safety Goals, what are you doing to comply? Technology could be a crucial part of your strategy.

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• Speed up orders for inpatients held in ED

  What is your No. 1 obstacle to reducing delays and improving patient flow? For many ED managers, the culprit increasingly is inpatients being held in the ED for hours or even days.

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• Deluged with inpatient holds? Avoid violations

  Are you giving admitted patients being held in your ED patients the same level of care they would receive in the critical care units? If not, you are violating standards from the Joint Commission on Accreditation of Healthcare Organizations that require the same standard of care be provided.

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• Guest Column: Work closely with coders or ED revenue may be lost

  Streamlining your ED coding and billing system isnt something you can do alone. It takes the expertise and cooperation of numerous individuals working together on each element of the process. However, the rewards are great both in the areas of improving revenue and assuring conformance with the hospital compliance program.

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• EMTALA Q & A

  Question: Some of our physicians insist on sending their patients to our ED for injections to treat ongoing medical conditions. One patient was scheduled for magnetic resonance imagine (MRI), but due to back pain, he was unable to lie still for the test. The physician ordered a narcotic injection to be given to assist the patient in getting through the test. Even though the MRI was scheduled and the injection order was included with the MRI order, we in the ED refused to administer the medication without a medical screening examination (MSE). The physician was irate, and the patient left unhappy. Did we do the right thing?

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• Journal Reviews

  Bentley PN, Wilson AG, Derwin ME, et al. Reliability of assigning correct current procedural terminology-4 E/M codes. Ann Emerg Med 2002; 40:269-274.

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• Trauma Reports Supplement: Current Strategies for Airway Management in the Trauma Patient

  This article, the second of two parts, deals with the potentially disastrous situation in which either the patients airway presents a substantial challenge or standard intubation methods have failed.

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