The emergency department (ED) is a high-risk area of liability for the hospital. This session will focus on legal and risk management issues that healthcare providers face while caring for patients in this high-risk environment. 

This program will also discuss how to comply with selected CMS hospital CoP and Joint Commission standards problematic for emergency department staff. It includes how the visitation law affects the ED and the CMS anesthesia standards on the use of deep sedation or moderate sedation in the emergency department and CMS hospital requirements regarding the use of standing orders in the ED. The issue of alarm fatigue and the impact in the ED including the Joint Commission NPSGs and sentinel event alert.

The Joint Commission standard on patient-centered communication will be discussed including the interpreter, low health literacy, and collecting race and ethnicity data in the ED. Also to be discussed is the OCR Section 1557 requirements. There must be a sign in the ED, a revised patient rights statement, qualified interpreters, auxiliary aids, and more.

Medication errors are the most common medical error and the common medication errors that occur in the ED will be discussed and how to avoid them. CMS made changes to medication management and opioid use and this is currently an area where hospitals are still struggling to meet compliance. The importance of discharge instructions will be covered and are important to prevent unnecessary readmissions and returns.

• Discuss legal and risk management issues in the ED and recommendations including how to reduce the most common medication errors that occur in the ED.
• Describe the importance of documenting the use of interpreters for patients with limited English proficiency
• Describe that the visitation law requires the ED to give the patient written information on their rights including information on the hospital’s advance directive policy

• Negligence principles
• EMTALA  
• High-risk patient presentations
  •  Key ED risk guidelines
•  Protocols and standing orders
  •  CMS interpretive guideline
• Patient rights
  • CMS and Joint Commission standards (TJC)
• Interpreters
• Diagnostic errors and communication errors
• OCR Section 1557 law and how it impacts the ED
• TJC Patient Communication standard
  • Interpreters
  • Issue of low health literacy and use teach-back
• Intoxicated patients (substance use disorder)
• Safe opioid use and CMS standards
• CMS Medication management
• Alarm fatigue
• CMS standing orders and protocols
• TJC medication reconciliation
• Abnormal x-ray and lab results
• Discharge instructions
• Discharges current issues and discharge instructions
• ED policies and procedures
• Reducing medication errors
• ED TJC Patient Tracers
• CT scan interferences
• Resident orders

• ED Physicians
• ED Nurse Managers
• ED and Clinic Nurses
• Charge nurses
• Nursing supervisors
• Risk Managers
• Consumer Advocates
• In-House Legal Counsel
• Compliance Officers
• Nurse Educators
• Patient Safety Officer
• Joint Commission Coordinator
• Director of Regulatory Affairs
• Anyone involved with the care, treatment, and liability concerns of the ED patient