• Disclosure & Early Resolution Programs
• Communicating Bad News
• Handoffs, Transitions & Discharges: Key Moments in Patient Care - LAUNCHED! 
• Workplace Violence, Disruptive Behavior & Hostile Environment in Healthcare
• 7 Simple Strategies to Reduce Readmissions

Faculty Speaking Engagements

Dan Sullivan, MD, JD, FACEP, Tom Syzek, MD, FACEP, and Doug Finefrock, DO, are all speaking at ACEP.

• Disclosure and Apology: Fundamentals
• Disclosure and Apology: Just-In-Time Trainer

Improving the Experience of Care

Doug is passionate about improving the patient experience. Not only has he produced a comprehensive program called PatientSET™ for healthcare organizations to easily implement and record measurable changes in patient satisfaction scores, he is out on the road speaking on the subject. Doug's two lectures at ACEP this year (10/17/13) are:

"Decrease Your Liability by Increasing Your Patient Satisfaction Scores"

"Win-Win: How Improving the Patient Experience Improves Your Job Security"

Click here for Doug's introduction to the PatientSET™ program: http://www.youtube.com/watch?v=ea0VyQaLpOA

• PatientSET™ #1: Introduction for All Healthcare Providers
• PatientSET™ #2: Hospital Best Practice High-Risk Videos
• PatientSET™ #3: Office Best Practice High-Risk Videos
• PatientSET™ #4: Introduction for Nurses - in development
• PatientSET™ #5: HCAHPS Videos for Nurses - in development
• PatientSET™ #6: Healthcare Customer Service Videos for Nurses - in development
• PatientSET™ #7: Healthcare Customer Service Videos for Other Employees - in development
• PatientSET™ #8: Healthcare Customer Service Videos for Triage Nurses - in development

Achieving Triage Consistency

Online triage continuing education was the focus for The Sullivan Group exhibit at the recent Emergency Nurses Association conference in Nashville, Tennessee. TSG has now delivered more than 16,000 triage nursing courses, and this conference offers an unparalleled opportunity to meet and interview learners to ensure needs are met and to assess opportunities for new educational offerings. Several nurses stopped by the booth to express gratitude for the reality-based approach to triage education.

Many attendees voiced the need to improve triage consistency as a focus for continuing education, specifically citing the need to continue clarifying the level 3 triage category. There i s a clinical practice gap; a variety of factors influence the triage nurse's decision to not place some of these patients as a level 2 triage, even when they meet the criteria. 

Some of the reasons cited include:

• Lack of leadership support to comply with either ESI or CTAS guidelines
• Peer pressure to not overload with "too many level 2 patients"
• Lack of consistency in triage education to direct nurses to accurate triage decisions
• Non-collaborative working environments 

The decision to assign a triage category has a direct impact on patient outcomes. Drivers for patient satisfaction, staff retention, and rapid identification of patients with highest potential for demise necessitate ongoing triage education and competency validation.

Protect your patients with strategies and techniques to ensure safe handoffs, transitions and discharges! 

Improving healthcare handoffs and transitions can reduce medical errors, improve quality of care, and avoid Medicare reimbursement penalties related to excessive readmissions. There is no question that healthcare handoffs and transitions create temporal windows for error; here are just a few eye-opening statistics:

• "An estimated 80 percent of serious medical errors involve miscommunication between caregivers when patients are transferred or handed-off." Joint Commission Center for Transforming Healthcare
• 4,000 handoffs per day can take place in a hospital setting
• 29 million handoffs per year are estimated to transpire between ED staff and inpatient providers
• Inadequate handoffs have been implicated as factors in 24% of ED malpractice cases for missed diagnosis

There are many factors that contribute to a successful handoff, but in almost all cases, effective communication is paramount. In response to the growing need for targeted solutions, The Sullivan Group is offering the following CME/ CE activities; each delves into specific threats to successful handoffs, transitions and/or discharges:

• Handoffs, Transitions & Discharges: Key Moments in Patient Care 
• 7 Simple Strategies to Reduce Readmissions - coming soon!
• Communication Strategies to Improve Patient Safety in High-Risk Situations
• 11 Simple Strategies to Prevent Medication Errors
• Technology Revolution: Improving Patient Safety, Reducing Liability
• Essentials of Patient Safety
• Prevention of Medical Errors

One of the most common questions asked by risk managers is how they can get physicians to participate in new patient safety initiatives. Whether it involves attendance at simulation programs or completing online courses, it often seems that busy physicians in private practice are immune to attempts to engage them in patient safety activities.

While such frustration is understandable, there are means to overcoming physician intransigence. Physicians, like all individuals, respond to incentives and seek to avoid disincentives. The trick is to find the right combination of these that will motivate the physicians in your institution without creating a backlash of resentment.

Here are several tools that can be used to motivate physicians to participate in the patient safety programs that you have worked so hard to provide for them:

1. Exhortation. Include in your announcement to physicians about new patient safety initiatives a reminder about how such programs will improve the quality of care that they as physicians are able to give their patients. Remind them that their patients trust them to be safe, knowledgeable, and up-to-date care providers. Explain that by participating in your safety programs, they as physicians can fulfill their moral obligation to provide the safest possible care to those patients who have entrusted them with their care. 
2. Fear. Remind your physicians that when bad outcomes do occur, the care they provide will be reviewed to assess if it complies with the general national standards of care in their specialty. Care that is outdated, inappropriate, or does not follow current best practices will often be prima facie judged evidence of causation. Likewise, physicians are often questioned during malpractice trials regarding their preparation and training for  emergencies or complications. Lack of participation in such preparatory programs may be perceived by the jury as a physician's indifference toward providing the best care for their patients.
3. Money. Even small amounts of insurance premium credits for participation in patient safety programs go a long way to ensure participation. Even if the physician is not stirred to act by the prospect of saving premium dollars, the practice or office manager certainly will provide needed motivation. A premium surcharge for non-participation is also a possible tactic, but it is one more likely to breed resentment along with disingenuous compliance.
4. Credentialing. Institutions have every right to make certain that those who practice within their walls are in fact delivering the highest quality medical care and following best practices. Many institutions therefore require participation in ongoing education and patient safety programs for continued departmental and/or hospital privileges.

Risk managers, education leaders and hospital administrators often report being fearful that if they impose too stringent requirements on their physicians, they will move their patients to other institutions. This sort of fear is almost always exaggerated. In the first place, physicians choose to work at a certain hospital for many reasons: convenience, quality of the institution, access to services, and patient demand. It is not easy for physicians to uproot their pattern of practice and move to another institution. Certainly having to take a few courses or participate in learning programs does not rise to the level of inconvenience that would force a physician to change long-standing practice patterns. Moreover, it is often patients that drive the decision as to where they wish to be treated. Such decisions are not always solely in the hands of physicians. Furthermore, careful selection of courses mapped to the core competencies may help physicians meet CME requirements for licensure - this will likely be viewed as a valued service, not an imposition.

Bottom line: sugar always attracts more flies than vinegar. The vital importance of obtaining physician participation in patient safety activities is irrefutable. Tools to motivate physicians are available and compelling. Moreover, physicians by and large understand their obligation to practice the best quality medicine they can, and given programs that are interesting, useful, and time efficient, they will embrace them, especially when sweetened with the sorts of incentives outlined above.

• Neonatal Emergencies 
• Postpartum Hemorrhage
• Neonatal Asphyxia
• Ectopic Pregnancy in Obstetrics & Gynecology
• Pitfalls & Liability Risks in Labor - in development
• Pitfalls & Liability Risks in Prenatal Care - in development
• Shoulder Dystocia
• Anatomy of a Medical Negligence Lawsuit in Obstetrics & Gynecology