Emergency
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Improving Mental and Behavioral Health Among Young Patients
Three national organizations offer recommendations for managing children, adolescents, and young adults in medical facilities and in their communities.
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Pediatric Chest Trauma
Pediatric thoracic trauma is the second highest cause of pediatric trauma mortality. It is critical for emergency care providers to be aware of the anatomic and physiologic differences in children, which result in significantly different injury patterns than adults. The authors highlight the essential steps for diagnosis and management of pediatric thoracic injuries.
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Vital Signs Are Unreported During Most EMS Handoffs
EMS holds a wealth of information about a very critical time in the patient’s treatment and evaluation for that episode. Physicians, EMS agencies, and hospital leaders should collaborate to figure out what gaps exist and develop specific tools to close those gaps.
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EHR Flaws Contribute to Diagnostic Errors
Many, if not most, emergency care providers would agree there are some significant downsides to electronic health records, including usability, interoperability, and malfunctions, to name a few. But are these issues merely annoying, or do they actually contribute to diagnostic errors?
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Did Emergency Provider Discuss Sensitive Topics with Adolescent?
Protecting confidentiality is the primary consideration for emergency care providers discussing sensitive topics with adolescent patients, including documentation in the medical record, discharge papers, lab results, and billing. Confidential conversations can be protected in the medical record several ways, including using confidential notes that are not visible to all.
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Prying Eyes Put EDs at High Risk for HIPAA Violations
Ensure policies are in place to protect the privacy of patients’ identifiable health information, train staff on those policies, implement measures to maximize compliance with the policies, and provide supplemental training if there are any incidents of non-compliance by an individual or group.
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Make Headway Against Workplace Violence with Data Tracking, Interdisciplinary Initiatives
Two health systems have started several initiatives that attack the problem from different angles. Data show these systems are making a sizable dent in incidents of violence in their EDs and other vulnerable points. These leaders are sharing their roadmaps and best practices so others can benefit.
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Prioritize Bed Placement for Older Patients to Shorten Stays, Prevent Delirium
A team of emergency physicians gathered data showing that among older patients, there is an association between time spent in the ED and the development of delirium. Researchers found that for every hour spent in the ED, the risk of developing delirium increased by roughly 2%.
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To Alleviate Boarding, Consider Creating Discharge Lounge
Several months into the new process, leaders at Northwestern Medicine Palos Hospital report they have shortened the average discharge process from four hours to one hour, they have halved the ED’s leave-without-being-seen rate, and patient satisfaction scores have begun to rise in both the ED and inpatient settings.
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Consensus Panel Offers Guidance for Pediatric Mental Health Boarding
EDs nationwide continue to see pediatric mental health patients boarded in the department for long periods while awaiting inpatient bed placement. A group of 23 experts from 17 health systems sought to identify what EDs are facing, to learn how departments are handling the problem, and to offer recommendations to standardize practices.