ED management : the monthly update on emergency department management
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All patient complaints should be addressed appropriately, with the goal of improving care and boosting patient satisfaction. Address complaints immediately, while the patient is still in the ED. ⋯ Have a policy to address complaints. Make verbal contact with every patient who complains.
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According to a new report from the General Accounting Office, increased liability risks stemming from EMTALA regulations have made specialists reluctant to take call for the ED. If a consultant can't be reached or refuses to report to the ED, staff should not hesitate to call the chief of staff or administrator. Your policy should address obligations of on-call specialists for acceptance and refusal of transfer patients. To ensure adequate coverage, fee-for-service arrangements may be more effective than stipends.
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If you don't comply with new guidelines for pediatric emergency care jointly developed by the American College of Emergency Physicians and American Academy of Pediatrics, you risk adverse outcomes and lawsuits. When transferring a critically ill or injured child, use transport services with specific pediatric training. Have a physician and nursing coordinator ensure compliance with the guidelines. Ensure that staff are trained in pediatric resuscitation, and provide age-specific competencies for neonates, infants, children, and adolescents.
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During on-site surveys in 2001, surveyors will be asking about your use of infusion pumps. The ED is at higher risk for errors and adverse outcomes than other departments because of the types of drugs given and time constraints. Do not use pumps without protection from the free-flow of intravenous fluid/medication into the patient. If your hospital is considering a change in infusion pumps, make sure someone from the ED is involved in the product evaluation.