The Chief Complaint of Pain: A Pain for You and Your Patient!
October 31, 2016
A chief complaint of pain is one of the most common encountered by practitioners in any specialty. The pain may be acute or chronic. It may be located in the abdomen, chest, head or any other body part. It may be spontaneous in onset or may be due to an injury. It can range from…Read More
Trick or Treat? Halloween in the Emergency Department
October 24, 2016
It should be no mystery to anyone that EDs see more than their share of fireworks injuries on July 4th and hangovers on New Year’s Day. But what about on Halloween? Will there be a deluge of patients with candy overdoses? Since I couldn’t recall any specific cases from my own Halloween emergency department shifts, I…Read More
Using Physician Engagement to Improve Hospital Profitability
October 10, 2016
It appeared to be a typical, run-of-the-mill board meeting at Hospital System “X.” Patient admissions had been slowly on the rise; healthcare teams seemed to be handling the increasing demand for services as the hospital facility continued to display an inviting appearance. Early in the meeting, the hospital CFO presented the data requested by board…Read More
Cognitive Bias: The Near-Miss Case of “Lazy Boy”
October 3, 2016
Many diagnostic errors involve some degree of cognitive bias or errors; here is an actual case that illustrates this point. Case Presentation L.B. is a 46-year-old man with onset of illness 12 days prior that started with cold symptoms, sore throat, rhinorrhea, cough, and fever up to 100.7°F (38.1°C). Since then, he has been getting…Read More
The ABCs of Risk Management
September 26, 2016
One of our goals at The Sullivan Group is to bring you practical pearls to reduce risk, improve patient safety, and enhance quality in your everyday practice. To that end I thought I would share with you this “alphabet soup” of risk management and patient safety tips assembled from years of observation and experience. Abdomens…Read More
5 Tips for Physician Engagement in Practice Change
September 12, 2016
Physician engagement is sometimes cited by organizations as a challenge on its path to implementing a successful practice change initiative. Below are five tips for engaging physicians using continuing medical education (CME): Identify the goals of your organization/physician leaders and align education with those goals. Understand the physician population you are trying to engage and select formats…Read More
Case: Failure to Diagnose Spinal Epidural Abscess
August 29, 2016
Failure to diagnose is the most common medical error in the practice of emergency, urgent care and primary care medicine. Spinal epidural abscess (SEA) is one of the most difficult conditions to diagnose, but there are common threads among failure to diagnose spinal epidural abscess cases. This case is presented to provide perspective and to increase our vigilance for catching this disabling and possibly even fatal diagnosis.
Necrotizing Fasciitis is Still Lurking Out There
August 8, 2016
The uncommon but lethal infection known as necrotizing fasciitis continues to be in the news. This is a devastating disease that can be difficult to diagnose in the early stages. The first presentation is often nothing more than arm or leg pain that looks very much like garden-variety musculoskeletal discomfort. By the time the diagnosis…Read More
3 Pediatric Heat-Related Illnesses
August 1, 2016
The temperatures are rising, and school sports are starting long practices in all kinds of weather. During intense exercise, people can lose up to 1.5 liters of fluid per hour. Summer is prime time for pediatric patients to sustain heat-related illnesses, and these patients may present to the emergency department in some distress. Defining the…Read More
Spinal Epidural Abscess: 5 Things You Should Know
July 25, 2016
The incidence of spinal epidural abscess (SEA) has doubled in the past 2 decades due to the epidemic of MRSA infections, the spread of IV drug use, and the increased number of spinal and vascular access procedures. Delayed or missed diagnosis of SEA leads to profound disability or death; lawsuits in this arena are exceptionally…Read More
