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If you want to convince your hospital administration to approve case managers in the emergency department, you have to put together a plan that outlines why doing so would be in the hospital's best interest, suggests Toni Cesta, RN, PhD, FAAN, senior vice president, operational efficiency and capacity management at Lutheran Medical Center in Brooklyn, NY, and health care consultant and partner in Case Management Concepts LLC.
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By providing care coordination throughout the continuum for patients with multiple chronic conditions, the Sacramento Sierra Region of Sutter Health has significantly decreased emergency department visits and hospitalizations.
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Increased communication among the multidisciplinary patient care team has increased patient throughput at Duke University Hospital, a 924-bed acute care facility in Durham, NC.
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Given the complex tasks of the physician scribes at Tri-City Medical Center in Oceanside, CA, you'd think that the technology they use to interface with the department's electronic medical record (EMR) from Cerner Systems would be anything but user-friendly.
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(Editor's note: In this special issue, we highlight an all-important topic: avoiding litigation. We cover issues such as department-level risk assessments, preventive actions to reduce risk; key areas of risk; a three-step strategy for risk management; changes in your department's culture to reduce risk; the use of patient satisfaction as a best practice; best practices and tools for physician, nurses, and other practitioners; admission of mistakes; and the critical role of patient advocates. We know you'll find a host of important strategies to hone your risk management program.)
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How can an ED manager reduce the risk of lawsuits once problem areas have been identified? Experts agree you've got to get to the root cause of those problems. Sometimes, they say, it might take the use of formal quality improvement tools such as root-cause analysis. Other times, it can be a simple as listening to patient complaints.
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ED experts agree that when patients feel they have been treated poorly, or that medical mistakes have been made, the most effective way of diffusing the situation and avoiding litigation is to listen carefully to the complaint, admit mistakes if they have been made, and then take concrete action to demonstrate your desire to prevent such mistakes in the future.
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Risk assessment might be a critical strategy to use in your effort to minimize lawsuits, but it shouldn't be the first, says Tom Syzek, MD, FACEP, director of risk management for Dayton, OH-based Premier Health Care Services.
