Half of EDs overcrowded, leaders report -AND- Docs spend years defending malpractice claims

Mon May 21 09:59:11 PDT 2012

May 10, 2012

Half of EDs overcrowded, leaders report

FierceHealthcare

Almost half (46 percent) of healthcare leaders say their emergency department (ED) is overcrowded--and 51 percent of those worry it will jeopardize patient safety, according to a HealthLeaders Media report released yesterday.

In a survey of nearly 300 respondents in operations, clinical work, finance and information, 43 percent of health leaders reported that ED patient flow was their biggest strategic challenge, followed by physician alignment and adherence to quality goals and reimbursement challenges, each at 13 percent. An overwhelming 95 percent said they are working on efforts to improve throughput, including a fast-tracking area for less acute illnesses or injuries (65 percent), a triage medical evaluation process (56 percent), coordination with inpatient floor nurses (55 percent) and a streamlined registration process (54 percent). Only a quarter saw enlarging the ED as a solution to addressing efficiency.

"We need to examine how we look at the ED and try to find ways to relieve pressure from it that cascades through the hospital systems," Philip A. Newbold, President and CEO of Memorial Hospital & Health System and Elkhart General Healthcare System in South Bend, Ind., said in the report. Newbold said that solutions include express care or around-the-clock urgent care services. 

The report confirms conventional wisdom that the industry is biting its nails over ED overcrowing. As one healthcare leader noted in the report, some patients see the ED as their only care option--whether hospitals like it or not. The report also offers some solutions, such as tending to the most urgent cases first, creating separate areas or freestanding buildings for less acute cases and improving coordination among providers--all with the patient (and experience) in mind.

May 16, 2012

Docs spend years defending malpractice claims

FiercePracticeManagement 

The latest research about medical malpractice cases against physicians reveals both good news and bad--but even the good isn't particularly rosy. According to a research letter published this month in the Archives of Internal Medicine, the vast majority (95.5 percent) of plaintiffs' claims never even reach a jury, with the court dismissing cases 54.1 percent of the time across specialties. Of those that do proceed to court, physicians prevail 79.6 percent of the time, Anupam Jena of Massachusetts General Hospital and colleagues reported.

But even with the likelihood of physician victory, all litigated cases come with steep costs of money and time. The researchers' analysis found that cases in which physicians won took 3.25 years to reach a verdict, and the process stretched even longer in cases in favor of the plaintiff. "The substantial portion of litigated claims that are not dismissed in court and the length of time required to resolve litigated claims more generally may help explain why malpractice claims undergoing litigation are an important source of concern to physicians," the researchers wrote.

In an effort to reduce the time and expense of malpractice litigation, as well as improve patient safety, a pilot program in Massachusetts is testing the University of Michigan's model of "disclose, apologize and offer" in addressing preventable adverse events. Under this alternative model, when unanticipated adverse outcomes occur, institutions, healthcare professionals and their insurers disclose that information to the patient and family, FierceHealthcare reported. They then investigate and explain why it happened and establish systems to improve patient safety and reporting. When appropriate, they apologize and offer fair financial compensation without the patient having to resort to legal action.

Bryan Sloane
Deputy Editor, CAL/AAEM News Service

Brian Potts MD, MBA
Managing Editor, CAL/AAEM News Service

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