Emergency Medicine Topics
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Why Navigators Are Essential to CA Bridge
While not all participating EDs in California have a Bridge clinic on their campus, the essence of the model is to make it easy for patients to receive the care they need. To do this, each ED should designate a champion to drive the program and a navigator to facilitate treatment access.
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Health Systems Look to Duplicate California Substance Use Disorder Treatment Model
Administrators in several states want to leverage their EDs as a critical point of access to identify and treat substance use disorder.
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California Lawmaker Pushes for More Mental Health Professionals in Hospitals
Employing trained mental health providers on site is important, but are there enough resources to meet the need?
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Emergency, Radiology Groups Suggest Best Practices for Incidental Findings
Better reporting, communication needed when troubling lesions appear on images.
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Facilities Require ‘Medical Clearance,’ But Evidence Suggests It Is Unnecessary
A patient may present with new delusions, but an otherwise normal physical exam. Why keep that person in a regular ED treatment space or hallway for hours while waiting for a CT scan? Instead, this patient can avoid exposure to radiation, be “cleared” for evaluation by an acute care psychiatrist or social worker, and receive access to treatment hours earlier.
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Challenges in Accessing Resources Lead to ED Psychiatry Consults
Difficulty identifying the “right” level of care for patients, understanding how insurance plays a major role in post-ED care options, and needing help with the operational process of making referrals to outside treatment facilities all are administrative and bureaucratic headaches with which clinicians could use assistance.
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Emergency Clinicians’ Emotional Reactions to Psychiatric Patients Affect Care, Well-Being
Survey participants painted a picture of negative healthcare experiences, for both patients and clinicians, that are adversely affecting the quality of care and staff well-being. Change is badly needed to ensure these vulnerable patient populations receive care — and to support ED providers.
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Restraint Use Can Put Provider, Hospital in a Jam
Personal animus or emotion on the part of an emergency provider should never be a rationale for the use of restraints. EDs are at risk for allegations of unlawful restraint or assault in circumstances where the use of restraints is not justified.
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There Could Be Trouble if Providers Board Children with Psychiatric Complaints
If parents disagree with a hold, convey that staff are keeping the child safe, explain the steps they are taking to find an accepting hospital, and detail how the ED cannot discharge a patient who is on an involuntary hold. When families are informed and given space to vent, the situation can de-escalate.
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Psychiatric Patients Pose Many Legal Risks for EDs; Creative Solutions Needed
Crisis stabilization units, peer support specialists, and targeted screening tools can help leaders fill some gaps.