I forget…what did that email say? oh yeah, its at

Corrective Action Plans

We have had several ED cases with poor outcomes over the past year that triggered root cause analysis and resulted in corrective action plans.  The following corrective actions directly or indirectly involve our ED practice. The department may be monitored by the state for compliance with these plans.

• New onset adult seizures, syncope, and chest pain will all be treated as if potential cardiac ischemia:  ECG within 15 minutes.

• Initial dosing of hydromorphone is 0.5 -1.4 mg, initial dosing of Morphine is 4 mg.

• Higher doses of pain medications may be given if there is a note in the chart documenting the medical reasoning for choosing a higher dose.

• More than 3 doses of IV pain medication in 3 hours should prompt a pain consult for consideration of PCA pump, or medical reasoning why there is no consult.

• All transfers of patients with thoracic aneurysm or dissection should be discussed with the MSH ED attending before transfer from another institution.

• CT surgery will use AMION for on call and chain of command contacts.  Non-compliance should be reported to Scot Hill.

• Consultants should respond by phone within 10 minutes, and be present within 30 minutes.  Non-response should trigger a call to the next higher level in the chain of command.

Written by phil

April 8th, 2009 at 7:16 pm

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