Incomplete Patient Understanding of Risks Complicates Surgery
This case study was made available to MIEC through our partnership with CRICO. It was written by Kathy Dwyer, MSN, RN, CRICO Description A patient undergoing elective surgery suffered severe anoxic brain injury due to complications from a pre-existing condition. Key Lessons Elective surgery should not proceed when the team does not have a thorough understanding of the patient’s medical history. A patient's memory and understanding of complex clinical facts is not a substitute for reviewing the medical record or consulting with clinical colleagues. Clinical Sequence A 56-year-old female met with the anesthesia resident 10 days before she was scheduled...
Gaps in Clinical Workup Lead to Young Patient’s Missed Colorectal Cancer
This case study was made available to MIEC through our partnership with CRICO. It was written by Melissa DeMayo, CRICO Description A 33-year-old woman was diagnosed with colon cancer more than two years after her initial complaint of rectal bleeding. Key Lessons Gaps in clinical workup can lead to flaws in medical decision-making. Sub-optimal surgical/invasive procedures can lead to missed diagnoses. Clinical Sequence A 31 -year-old woman with no significant medical history complained of rectal bleeding to her primary care physician, a cardiologist. At this visit, she also described hard stools with hematochezia and possibly hemorrhoids. The cardiologist performed a...
This case study was made available to MIEC through our partnership with CRICO. It was written by Melissa DeMayo, CRICO Description Six days after his initial visit to Urgent Care for ear pain and facial paralysis—and after three CT scans—a 28-year-old man was diagnosed with bacterial meningitis. Key Lessons A patient’s return for care with worsening symptoms should trigger a diagnostic questioning protocol Fragmented patient care increases the need for concurrent communication among providers Clinical Sequence A 28-year-old man presented to Urgent Care with complaints of right ear pain and right-sided facial paralysis. At this visit, impacted ear wax was...
DEA Likely to Further Extend Flexibilities on Controlled Substances and Telehealth Prescribing Beyond 2024
During the first year of the COVID-19 pandemic, the provision of medical care through telehealth increased by 154%, and much of that increase occurred in behavioral health. This trend, combined with COVID risk mitigation strategies and temporary flexibilities in licensure and regulatory requirements, resulted in substantial growth in virtual-only medical practices. In the field of behavioral health, temporary flexibilities allowing telehealth-only prescribing of controlled substances has allowed these practices to flourish by allowing them to treat a full spectrum of conditions through remote-only care. However, as the COVID pandemic ended, an important question arose as to whether telehealth-only prescribing of...
Outpatient Care’s Safety Gaps: A System-wide Call for Change
This article was made available to MIEC through our partnership with CRICO. It was written by Hannah Tremont, MPH Approximately 25 percent of adults in the U.S. receive care in an outpatient setting each month. Despite the progress made in improving inpatient safety, outpatient care remains a significant area of concern, as highlighted by a recent study, “The Safety of Outpatient Health Care” published in the Annals of Internal Medicine. The CRICO-funded study reveals that adverse events in outpatient settings are not only common but often preventable. With the increasing complexity of outpatient care, this gap in patient safety presents...