Issue link: https://beckershealthcare.uberflip.com/i/1076559
50 CMO / CARE DELIVERY 30% of hospitals have violated EMTALA, investigation finds By Mackenzie Bean N early one-third of U.S. hospitals have violated emer- gency department care standards set by the Emer- gency Medical Treatment and Labor Act in the last decade, according to an investigative report from Web- MD and Georgia Health News. WebMD and Georgia Health News reporters secured a list of all EMTALA violations reported between 2008-18 from CMS via a Freedom of Information Act request. They also request- ed full reports for violations that took place in the last 27 months. The geographic information systems company Esri helped analyze the data. Here are five findings: 1. Reporters found 4,341 EMTALA violations occurred at 1,682 hospitals nationwide between 2008-18. 2. EMTALA violations occurred more often at hospitals with fewer than 100 beds, with these hospitals accounting for 34 percent of violations. 3. Violations were also more likely to occur at hospitals in the Southeast region. Investigators found 1,175 violations oc- curred at hospitals in this region. 4. The three most common violations were failing to con- duct thorough medical screenings (1,353 violations), not transferring patients properly (701) and not following ED log standards (607). 5. Between 2016-18, EMTALA violations were linked to at least 34 patient deaths. "EMTALA is fundamentally the Golden Rule of emergency care, codified by Congress. Every hospital should strive to pro- vide every person who presents symptoms in an emergency department with the best care. There should be one standard of care — their best care," Richard Wild, MD, a regional CMO at CMS, told WebMD and Georgia Health News. n Fitbit data could help hospitals battle nurse fatigue By Megan Knowles A University of Wisconsin-Madison School of Nursing professor is using fitness trackers to monitor nurse movement in hospitals and re- veal what causes nurse fatigue during hospital shifts. Linsey Steege, PhD, a human factors engineer and UW-Madison nursing professor, became interested in improving how health systems support nurses so they can provide the highest quality patient care. "[But] when I looked around, there was a lot of research on physical fatigue [and] sleep deprivation for medical residents, but much less on how nursing work is con- tributing to fatigue and how fatigue is contributing to stress, burnout, and worst of all, medical error," she said. Although Dr. Steege's research involves some direct nurse feedback during shifts, her study primarily involves passive data collection through Fitbit activity trackers. The nurses in the study wear the trackers, which record steps, heart rate and sleep information. Dr. Steege then analyzes this data to find how work demands af- fect fatigue levels. The goal is to collect as much information about nurs- es' work environment and how they interact with it to see what factors contribute to fatigue, when these fac- tors are most problematic during a hospital shift and how much fatigue is too much. Dr. Steege eventually wants to help health systems develop staffing policies and schedules that recognize what causes fatigue and minimize its effect on nurses and patients. "If health systems do not account for the burden of fa- tigue on their nurses, medical errors and turnover will both increase, along with cost," Dr. Steege said. n 15 physician specialists most in-demand By Kelly Gooch F amily medicine is the most common and in-demand medical specialty for physicians, according to a study from Doximity, a social network for clinicians. For the study, researchers examined data on 15 common medical specialties based on about 8,000 open physician jobs posted on Doximity in 2017 and 2018. Here are the most common specialties, ranked from most in-demand to least in-demand, ac- cording to the study: 1. Family medicine 2. Internal medicine 3 Emergency medicine 4. Psychiatry 5. Obstetrics and gynecology 6. Neurology 7. Radiology 8. Gastroenterology 9. Geriatrics 10. Pediatrics 11. Anesthesiology 12. Urology 13. General surgery 14. Orthopedic surgery 15. Pulmonology