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Tom Sharon Comparing safe vs. dangerous hospitals


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Comparing a Safe Emergency Room
with a Dangerous One




Reasonably Safe Emergency Department

Dangerous Emergency Department

Average doctor-to-patient ratio of one to ten

Average doctor-to-patient ratio of one to more than ten

Average nurse-to-patient ratio of one to five

Average nurse-to-patient ratio of one to more than five

Keeps statistics on waiting time and has as goal to average one hour or less

Does not follow waiting time and/or has no formal program to reduce it

Allows nursing supervisor to call for ambulance diversion when filled to capacity

Has unwritten policy against going on diversion to avoid losing revenue

Maintains strict policy on assigning only nurses with proper credentials and orientation

Uses temp-agency nurses without adequate orientation

Has a written protocol for stabilizing and transferring patients with problems requiring treatment at another hospital

No such protocol in place or not reviewed and updated every three months

Keeps a list of on-call specialists and contacts each daily to confirm availability and response time

No calls made to specialists each day to confirm availability

Has strict policy on keeping patients under close observation until medically cleared

No such policy in place

Does not keep new admissions in emergency department for more than four hours; transfers admitted patients without beds to other hospitals

Will keep admitted patients indefinitely in the emergency department until bed opens up; transfers admitted patients only upon demand

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· Hospital mishaps
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