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A 30-year-old man presented to an ED with complaints of fever, joint pain, a severe headache, and shaking chills. The ED physician further determined that the man was suffering from a rapid heart rate and some paresthesia. The man did not undergo any further testing and was sent home with instructions to take acetaminophen and drink fluids.
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In addition to the other ways that the country's economic downturn is affecting health care providers, emergency departments (EDs) are now seeing an increase in the number of patients leaving the ED early, because they do not want to be hit with a big medical bill when they are without health insurance and possibly without a job.
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Health and Hospital Corp., the parent company of Kings County Hospital in Brooklyn, NY, has settled a lawsuit filed by the family of a woman who died on a waiting room floor - but went unnoticed for more than an hour.
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Risk managers may participate in the management of a facility building or remodeling project by overseeing the myriad hazards and liabilities that can crop up along the way, but you may be missing a great opportunity to advance your own concerns if you don't immerse yourself in the earliest stages of the design process.
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Eric Hess, vice president of Children's Hospital of Pittsburgh of the University of Pittsburgh Medical Center (UPMC), provides these examples of how risk management concerns were incorporated into the hospital's recently completed $625 million redesign:
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A man presented at an emergency department (ED) complaining of shortness of breath and chest pain. He was seen by an ED physician who ordered blood studies and an EKG.
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When patients leave the ED early, what your staff do afterward can make the difference between insulating yourself against a lawsuit and encouraging one, says Robert A. Bitterman, MD, JD, FACEP, a lawyer and emergency physician who is president of Bitterman Health Law Consulting Group in Harbor Springs, MI, and also vice president of Emergency Physicians Insurance Company (EPIC) in Auburn, CA.
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Most hospitals already have against-medical-advice (AMA) forms they use when the patient gives the staff a chance, but Helenemarie Blake, JD, a shareholder with the law firm of Fowler White Burnett in Miami, says risk managers should remember that merely having an AMA form and procedure does not guarantee they will be used correctly.
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The recent settlement by the University of Medicine and Dentistry of New Jersey (UMDNJ) in Newark has some legal experts concluding that the hospital ended up with a relatively light punishment considering the extent of the alleged billing fraud and the long, contentious litigation that was prompted by a whistle-blower lawsuit.
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A pregnant woman contacted her doctor with complaints of decreased fetal movement. He advised her to go to the triage outpatient obstetrical department, where she was placed on a fetal heart monitor and underwent a biophysical profile. The monitor showed a nonreactive fetal heart rate pattern, and the profile confirmed that the fetus was in distress.
