The most frequent vascular-related violations specifically involved lack of vascular specialist availability. Developing specialist networks and maintaining adequate call coverage can help improve patient access to emergency services.
Shutting out dermatologists can leave a gap in specialty care. This might lead to other specialists consulting and managing conditions outside their scope, or they might transfer patients to a different, distant center.
When someone requests an ethics consult, the patient’s social and clinical history is important to know. So is the history of ethicists’ involvement. It is not uncommon for a consult service to be called multiple times over several to assist with a care question that resurfaces.
In one review, researchers found only five ethics consults were documented during a three-month period. Yet, 63 staff members reported having an ethical concern during that same period. Notably, most of these issues involved moral distress in some way.
Somewhere in the ED chart, somebody recommends involvement of a particular specialist, or that a specific study should be conducted. When this kind of recommendation is documented but never acted on, it can mean legal trouble for the EP.