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Guidelines for the management of febrile children dating back to 1993 have complicated liability risks for EDs since they were published, and continue to play a role in ED medical malpractice litigation, says Jim Wilde, MD, director of pediatric emergency medicine at the Medical College of Georgia, who also is fellowship-trained in pediatric infectious diseases.
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The introduction of vaccines that prevent bacteremia has significantly reduced the risk of serious bacterial infections associated with Haemophilus influenzae and Streptococcus pneumoniae. How does this impact liability risks when caring for febrile children?
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Do you believe that once your patient is evaluated by an on-call consultant in your ED, you are abdicated from any future liability? "ED physicians frequently believe this, but this is absolutely not true," says James Hubler, MD, JD, assistant clinical professor of emergency medicine at the University of Illinois College of Medicine at Peoria.
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There are, of course, a number of chart documentation methods and the goals of the various methods are all the same: 1) to memorialize the patient encounter for future reference by other caregivers; 2) to provide information for billing purposes; and 3) to create a legal document that allows quality review whether in the medical setting or in the courtroom.
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Since the implementation of National Patient Safety Goals (NPSGs) dealing with medication reconciliation in 2005, The Joint Commission has received a steady stream of feedback from the medical community. Emergency medicine experts and organizations, in particular, have complained that the goals were unclear and made compliance difficult.
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The Joint Commission has added an initial set of seven hospital outpatient measures to its current complement of core measure sets that may be used to satisfy ORYX performance measurement requirements.
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The American Institute of Ultrasound in Medicine (AIUM) in Laurel, MD, and the American College of Emergency Physicians (ACEP) in Irving, TX, have jointly published the Guideline for the Performance of the FAST (Focused Assessment with Sonography for Trauma) Examination.
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A proactive communications effort, before and after the creating of the new ED patient representative position at St. Mary's Hospital in Tucson, AZ, has helped smooth the transition for ED staff, patients, and families, says Cassandra Pundt, RN, CEN. Pundt had been the ED nurse manager for 10 years when she created and filled the new position.
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Good ED managers are adept at identifying problems in their department and coming up with innovative solutions, but how many of those solutions involve a title and position change for the managers themselves?
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After receiving input from several medical organizations and other interested parties during a Sept. 25, 2007, summit on medication reconciliation, The Joint Commission is digesting that feedback and crafting a response.
