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Enhancing Consultations in the ED

In EDs nationwide, consultations between emergency physicians (EPs) and other doctors or specialists for advice or intervention regarding patient care occur on a daily basis. Emergency medicine (EM) consultation is an important aspect of patient care, but few studies have analyzed the consultation process and efforts to improve communication and patient outcomes during such consultations. In most situations, consultation is not a focus of medical student or resident training, even though the importance of improving these processes is critical to patient safety and societal cost. Recent studies have shown that communication failure appears to be at the heart of most errors when patients are transitioned from ED to inpatient settings. Some investigations estimate that poor communication occurs in 14% to 24% of inpatient consultations. These events can increase direct costs to patients, pose a financial burden on the healthcare system, and result in poorer patient care and patient satisfaction. “In all fields of medicine, it’s paramount to communicate effectively with other personnel during consultations,” explains Chad Kessler, MD, MHPE. “More efforts are needed to educate physicians and consultants on effective communication techniques.” For EDs, this may lead to improved communication between physicians, fewer resources utilized in patient care, and decreased length of ED stays. Evaluating Consultation Processes In the June 2012 Journal of Emergency Medicine, Dr. Kessler and colleagues had a study published that evaluated EM consultation processes by analyzing strategies used by EPs. The study also sought to create a framework for EM consultation that can be taught and learned in the ED setting. Data from EPs were collected from informal interviews, surveys, and 1-hour group interviews to...
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