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Emergency Department Clinical Assessments

On-site clinical assessments focus on the identification of emergency department (ED) risk issues and opportunities for improvement. The assessment process includes the use of an evidence-and consensus-based approach to improvement. A sophisticated proprietary tool developed in consultation with ED physicians, nurses, risk managers, claims experts and attorneys measures compliance to more than 200 indicators representing practices thought to be present in the highest functioning EDs.

Areas of focus include:

  • Operations/leadership/committee participation
  • Environment/security
  • Teamwork, communication and handoffs
  • Clinical systems and patient care
  • Technology
  • Staffing/training/orientation
  • Peer review and quality improvement
  • Throughput
  • Patient satisfaction and customer service
  • Transfer/EMTALA
  • Risk and claims management
  • Medication safety
  • Psychiatric patients
  • Nursing services
  • Medical record review – outcomes

Deliverables

  • On-site review
  • Expert consultation
  • Focus on high-risk areas and outcomes
  • A comprehensive written report and action plan
  • Prioritized list of findings
  • Resources/tools to assist with implementation of the action plan
  • Ongoing consultation to support implementation
  • Benchmarking with other comparable EDs
  • Ongoing measurement to demonstrate improvement

Overview of Most Urgent Opportunities

  • Care of patients with chest pain
    • Delta enzymes
    • Documentation
    • Door-to-EKG
    • Serial EKGs and review of prior EKGs
    • Provocative testing
  • Care of patients with abdominal pain
    • Serial examinations
    • Follow-up care
  • Stroke
    • Use of tPA
  • AMA procedure
  • Radiology
    • Preliminary findings
    • Discrepancy process