Hospital topics
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Public health emergencies may result in mass casualties and a surge in demand for hospital-based care. Healthcare standards may need to be altered to respond to an imbalance between demands for care and resources. ⋯ The authors propose health care organizations deploy a Triage and Scarce Resource Allocation Team to over-see and guide ethically challenging clinical decision-making during a crisis period. The authors' goal is to help healthcare organizations and clinicians balance public health responsibilities and their duty to individual patients during emergencies in as equitable and humane a manner as possible.
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St. Joseph Hospital of Orange implemented a new emergency department (ED) program, the Rapid Assessment and Discharge in Triage (RADIT) program, designed to reduce patient waiting time and improve overall patient satisfaction. ED visitors presenting nonurgent problems were served by a roving RADIT team. ⋯ After 6 months, results indicated that RADIT patients were discharged on average in 97 min; however, there was a slight increase in average time in ED. A patient satisfaction survey indicated that about 96% of RADIT patients rated the quality of service received as either good or excellent. The authors provide the background and context that resulted in the decision to implement RADIT.
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Medical errors and patient safety are urgent healthcare management challenges. To date, not enough has occurred to provide a systematic organizational design framework for reducing medical errors and improving patient safety. The authors offer such a framework by integrating multiple organizational factors and using well-accepted organization theory, citing relevant empirical research studies of medical errors and patient safety to support specific organizational factors. They discuss organizational design implications and recommendations for healthcare executives.