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Jason Rinehart presented to the emergency department (ED) of Akron General Medical Center with nausea, vomiting, and back pain.1 No definitive diagnosis was made, and the patient was discharged with medications to control his symptoms. He died hours after discharge, and an autopsy revealed an aortic dissection as the cause of death.
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Some EDs have adopted the practice of documenting overcrowding, either
by flagging patient charts or electronically recording the
information with software, to pinpoint exactly how busy—and
possibly, how understaffed—the department was on a given time
and day. But is this going to help or hurt the ED physician in the
event of a malpractice lawsuit?
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Dr. Janiak has served as an emergency medicine medico-legal consultant for over 30 years, and has reviewed hundreds of malpractice cases. In the process, he has recognized common patterns and mistakes that emergency physicians make that set them up to be sued. This article takes a tongue-in-cheek approach to pointing out potential mistakes and ways that lawsuits might be avoided.
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Being served with papers indicating a patient has sued you is a
shocking and upsetting moment. However, this doesn't necessarily mean
the case is valid—or even that it will go forward at all.
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The Joint Commission has put a one-year moratorium on its National Patient Safety Goals (NPSGs), as it reviews current goals with input from the field. One goal in particular, Goal 8 regarding medication reconciliation, will no longer be scored as part of the accreditation decision until a more refined goal is set forth in 2010.
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According to a recent study in the New England Journal of Medicine, "data suggest that at least half of all surgical complications are avoidable."1 The article goes on to say that teamwork in surgeries has been shown to lead to improved outcomes.
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Preparation for Joint Commission surveys and measuring performance improvement at St. Vincent's HealthCare in Jacksonville, FL, involves all staff. And it seems to be a method that works. The hospital was just recognized for the fifth consecutive year as a Distinguished Hospital for Clinical Excellence by HealthGrades.
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Five years after implementing the Adverse Health Care Events Law, which requires hospitals and ambulatory surgery centers to report on 28 quality measures, the Minnesota Department of Health published a retrospective report: "Adverse Health Care Events Reporting System: What have we learned?"
