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Very few hospitals have policies that allow family access during resuscitation and other treatment in the ED, even though research has shown that the public overwhelmingly desires it and a growing number of emergency physicians and nurses support the idea.
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Flexibility is the key word when developing a policy on family access, says Stephen Epstein, MD, MPP, spokesman for the American College of Emergency Physicians and clinical operations director at Beth Israel Deaconess Medical Center in Boston. Understanding the familys needs is important, but they must be balanced with patient safety.
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Its finally here, and its mostly good news. The government recently released the final rule of the Emergency Medical Treatment and Labor Act (EMTALA), and the 262 pages offer many long-awaited clarifications that mean you no longer have to worry so much about issues such as when you must deliver emergency care within 250 yards of your hospital.
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The Baltimore-based Centers for Medicare & Medicaid Services (CMS) lists these highlights of the final Emergency Medical Treatment and Labor Act (EMTALA) rule:
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Health care providers have access to plenty of flowcharts and algorithms designed to guide the treatment of patients with particular diagnoses, but many of them arent designed for use in the ED. What good is a flowchart for pneumonia if you dont know whats wrong with the patient yet?
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A new report from the Institute of Medicine of the National Academies in Washington, DC, urges EDs to create systems in which staff vaccinated for smallpox can be called up quickly in the event of an outbreak.
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Historically, ED Legal Letter has evaluated the mistakes of physicians after the fact. The diagnosis has been missed, the case has been litigated and decided. The benefit of hindsight provides an essential learning and risk management opportunity for the reader. This months issue will evaluate the thinking and behavior of physicians that lead to errors in diagnosis. An analysis of the cognitive errors in the ED by physicians will provide reflection on future premature or inaccurate diagnosis in the ED. This issue will allow physicians to recognize that certain types of thinking and behavior can be harmful to the patient. Acknowledging these faults will reduce bad outcomes and prevent future litigation.
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"EMTALA: The Essential Guide to Compliance" from Thomson American Health Consultants, publisher of ED Legal Letter and Hospital Risk Management, explains how the changes to EMTALA will affect emergency departments and off-campus clinics. In-depth articles, at-a-glance tables, and Q-and-A discussions of real-life situations are presented, and key differences between the old EMTALA and the new changes are succinctly explained.
