Video recording in the emergency department: a pathway to success

From the BMJ:

At the Royal Infirmary of Edinburgh in Scotland, we video record all patients who are admitted into the ED resuscitation rooms as part of our continuous video audit system. Since installation in late 2015, numerous EDs from across the UK and abroad have repeatedly asked us the same questions: how did you do this; how did you ‘get past ethics’; how do you get consent.

The consistent problem for EDs wishing to integrate video is not the lack of supportive studies reporting video use; video-based studies have assessed the full spectrum of ED care, including communication during consultations, family–staff interactions and time-critical resuscitations. The problem is that there is scarce guidance on how EDs can navigate the processes that will allow them to progress with their own programme of work.

Here, we report on our experience of the practical issues associated with video implementation, such as legality, ethics, data protection and staff acceptance, as these are the issues that are regularly cited as reasons why video is not used.5 6 By focusing on these, we can start to answer the questions above that are pertinent to all EDs that pursue video audit and move towards video becoming an essential part of care delivery.

Returns After Observation Admissions

From Reuters:

When elderly patients stay in U.S. hospitals for “observation” but aren’t officially admitted, there’s a high likelihood they’ll soon be back for more hospital care, a new study shows.

One in five patients covered by Medicare, the federal insurance program for people over age 65, who were observed in a hospital but not admitted returned for a repeat visit within a month, researchers found.

Financial incentives and disincentives have led to an increase in the number of Medicare patients who spend up to 48 hours being observed in the hospital without being admitted. Today, 1.5 million Medicare beneficiaries are observed in hospitals each year, according to Dr. Kumar Dharmarajan, who led the study.

The new findings suggest that clinicians might need to focus more attention on caring for patients once they return home after being observed in the hospital, said Dharmarajan, a geriatrician and cardiologist at Yale School of Medicine in New Haven, Connecticut.

House Seeks To Cap Malpractice Awards As Part Of Health Care Update

From Kaiser Health News:

Last week, a jury awarded a Pennsylvania man $620,000 for pain and suffering in a medical malpractice lawsuit he filed against a surgeon who mistakenly removed his healthy testicle, leaving the painful, atrophied one intact.

However, if a bill before the House of Representatives passes, the maximum he would be able to receive for such “non-economic” damages would be $250,000.

Out-of-hospital cardiac arrests fell under the Affordable Care Act

From Reuters:

In Oregon, the rate of cardiac arrests happening outside of hospitals fell significantly after implementation of the Affordable Care Act and its expansion of health insurance coverage, researchers report.

“The degree of benefit was most surprising: a 17 percent reduction in risk of cardiac arrest (a life-threatening condition where the heart stops pumping) among the middle-aged population for whom health insurance was expanded,” lead author Dr. Eric C. Stecker from Oregon Health and Science University (OHSU) in Portland said by email.