You have recently finished a review of incidents that have been flagged in your ED. You have chosen a pertinent issue to tackle, formed a core group to work on the project, and formulated a SMART aim statement after reading our last HiQuiPs post. The median time for obtaining 12-lead ECGs is 13 minutes, while guidelines recommend less than 10 minutes.1 Your aim is to decrease the initial 12-lead ECG acquisition time by …
HiQuiPs: Preparation Part 1 – General Considerations for ED Quality Improvement Projects
You are in the middle of a busy night shift and you see a 73-year-old female with diffuse abdominal pain who is hemodynamically stable. You have a wide differential and order a CT scan to aid in the diagnosis as you begin empiric management. Three hours pass by and the CT has not been performed. This is the third time this week that this has happened. In light of this, you feel strongly …
HiQuiPs: Quality of Care and the ED
You have just finished a busy ED shift on a warm summer evening and feel that you have been able to help a lot of people today. You plan to visit a patio and relax as you have earned it! On your way out you overhear a patient and their family members saying that they came to this ED because they heard it was “the best”, and they would never go back to …
Blame-shifting ER Wait Times onto Patients.
It recently came to my attention that the UK has been deploying a public health message with regards to ER wait times; more specifically, it looks like a public education campaign aimed at redirecting “inappropriate” visits away from emergency rooms. The premise is that many minor and non-life-threatening conditions can be (and should be) treated outside the ER, and that the onus is on the patients themselves to basically triage their own ailments. …
The case for Healthcare Workers to get mandatory flu shots.
It is a very interesting social phenomenon how some healthcare workers have come to put up such an emotionally charged and adamant fight against getting vaccinated. This issue reached a head with the recent battle in British Columbia over trying to make it mandatory for frontline nurses to get the flu shot. I call this a “social phenomenon” because the surprising resistance is exponentially spurred by forces beyond any solid scientific evidence, despite …
Should we be punishing medical errors?
An interesting story came across my desk recently. Apparently, some states in the U.S. have moved towards a punitive model in trying deal with medical errors and adverse outcomes – this particular story describes how Utah will no longer fund healthcare providers and hospitals for dealing with illnesses that resulted from avoidable errors and infections. On the surface, it kind of makes sense – one should be punished for making a mistake, right? …