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The holiday season often leads to a rise in accidents and injuries. As people engage in travel, cooking, setting up decorations, and rushing for holiday shopping, emergency departments (EDs) nationwide brace for higher patient volumes due to these seasonal activities.
In this article, we discuss several methods and ED workflow enhancements to manage the holiday patient surge effectively, offering relief to your medical staff, and, hopefully, something to be thankful for this holiday season.
The overlap of personal and professional responsibilities is a significant factor in physician stress during the autumn and winter. Additionally, poor handling of the seasonal influx can negatively impact an emergency department's performance metrics with the Centers for Medicare & Medicaid Services (CMS), leading to repercussions that linger beyond the bunting.
As we approach the festive season, it's crucial for Chief Nursing Officers (CNOs) and ED directors to prioritize solutions for handling the expected increase in ER visits. We have identified three primary areas for improving patient flow efficiency:
Improving patient flow starts with enhanced visibility. A comprehensive understanding of patient, staff, and resource statuses is essential for identifying optimization opportunities.
Typically, admissions coordinators may physically check for updates, but during the holiday rush, they're more likely to be anchored to their workstations. Busy clinicians moving between patients may not have time for regular updates.
Adopting an EHR-integrated analytics solution allows staff to monitor real-time workflows and utilize predictive analysis. This approach enables EDs to anticipate bed availability during peak times and adjust staff allocation to alleviate congestion.
Efficient communication is vital when handling everything from minor injuries to critical emergencies. Traditional paper-based methods often lead to delays; documents can get misplaced or misinterpreted. Reliance on handwritten notes or verbal updates is inefficient and prone to errors.
Emergency departments should review their communication methods, especially in preparation for the holiday season. Identifying and addressing communication barriers at each treatment stage is crucial. Implementing standardized communication protocols can effectively eliminate these barriers.
While automation isn't a panacea for all ED challenges, it can significantly reduce the impact of human error in emergency procedures.
An advanced EDIS with predictive technology integrates a unified platform for streamlined communication and process visibility. An effective system demands minimal manual intervention, enhances time management, and optimizes care delivery.
MEDHOST EDIS is designed to optimize communication, automate workflows, increase patient throughput, and enhance patient satisfaction. Developed with input from physicians and nurses, our system is tailored for workflow efficiency and patient safety, eliminating cumbersome interfaces and unnecessary steps.
Discover how MEDHOST EDIS can elevate your ED's performance during the holiday season and beyond. Contact us at 1.800.383.6278 or email inquiries@medhost.com for more information.
When we talk about the patient experience, the conversation often centers around providing amenities and service quality. However, creating a positive encounter for healthcare consumers can be challenging in the inherently hectic and fast-paced environment of the ED.
ED professionals must excel in triaging patients, managing life-threatening injuries, and maintaining order in a high-stress environment. Additionally, the ED is subject to regulatory pressures related to hospital management and performance metrics, both of which directly impact the bottom line.
But despite these challenges, the ED sees higher patient volumes than other departments and often serves as the front door for arriving patients. Efforts to improve the patient experience at this critical touchpoint have the potential to massively impact how people view your facility.
While each hospital and healthcare provider has its unique obstacles, here are three overarching strategies that encourage and facilitate the delivery of high-quality patient care:
In the ED, elevated standards of customer service are imperative, particularly in patient interactions. Patients and their families, often scared, confused, or overwhelmed, evaluate your facility not only based on clinical procedures and outcomes but also on how they were treated during the care process.
Online check-in tools may help streamline patient intake and reduce wait times, helping physicians triage patients and avoid delays.
ED managers and hospital leadership play a pivotal role in shaping the patient experience. By promoting effective communication among all staff members, including doctors, nurses, and administrators, ED managers can cultivate positive working environments where staff feel empowered and supported.
Overcoming ED-related challenges without the full support of your hospital's C-suite can be an uphill battle. Engaging leadership and securing top-down management commitment is crucial. Implementing accountability mechanisms ensures that strategic initiatives do not falter or fade into obscurity.
As a leader within your facility, assess the strengths and areas for improvement within your ED. Seek validation from colleagues who can collaborate with you in addressing concerns. Remember to celebrate and recognize the achievements of your ED and the dedicated staff responsible for each positive patient journey.
For further insights into creating more positive ED experiences for your patients, please contact us at inquiries@medhost.com or call 1.800.383.6278 to connect with one of our specialists, who can introduce technology-driven solutions to prioritize the patient experience in your ED.
If you’ve ever been stuck in an ER waiting room for hours, you know that it can be a downright miserable experience.
Unfortunately, this is becoming more and more common. ER wait times are on the rise. Resources are saturated, staff workloads are high, patient acuity is higher, and many facilities are way beyond capacity. Some of these factors are out of staff control. However, certain workflow processes and EHR tools can alleviate the pressure.
Today, we're diving into something that might just revolutionize how emergency rooms operate and, ultimately, save lives: ED Online Check-In.
Besides potentially compromising patient safety and jeopardizing health outcomes, excessive wait time is frustrating for patients, physicians, and hospital administration. In addition to providing safe, cost-effective, and efficient care, it’s important for hospitals to ensure healthcare consumers have a satisfactory experience.
There are also considerable financial consequences to consider. Meeting these clinical quality measures and patient satisfaction are government mandates. A low score in these areas can impact payer revenue, which ties back to value-based pricing.
With regard to Medicare, plan reimbursements are determined by comparing compliance with clinical performance guidelines and patients’ perception of care quality. If a hospital gets lower scores, it may get lower reimbursement rates.
Solving ED backlog problems starts by addressing systemic issues that delay moving patients from the ED to inpatient floors. To proactively address patient flow operations, hospital administrators, IT directors, physicians, and nursing staff are looking to web-based EDIS tools.
ED Online Check-In represents a paradigm shift in how patients access emergency medical services. By harnessing the power of smartphone technology and QR code scanning, patients can now pre-register themselves, sidestepping the traditional pre-registration procedures that often entail frustrating wait times.
This solution is also considerate of demographics and user engagement preferences. Whether the patient is a tech-savvy smartphone user or prefers assisted check-in using on-site devices, ED Online Check-In fosters a more intuitive overall experience.
Online Check-In solutions hold the power to transform emergency care access. The benefits ripple across clinics and hospitals, creating a positive impact at every touchpoint in the care continuum.
Imagine you’ve just rushed into the ED with an emergency. You're greeted at the registration desk and right there, front and center, is a QR code. This QR code isn’t so you can follow someone on social media, it's there to streamline your check-in process by asking some basic questions, like who you are, what's going on, and how severe the issue seems to be.
As soon as you fill out these questions, this QR code becomes your ticket to expedited care. The ED staff can immediately see how critical your situation is compared to others in line. Think of it as a digital triage system.
In busy Emergency Departments, time is of the essence. Those critical patients, the ones where seconds and minutes matter, need to be seen ASAP. But with long registration lines and extensive processes, that can be difficult. With a digital triage system, ED staff can focus on those who need their expertise the most, without the hassle of sifting through stacks of paperwork.
For over 35 years, MEDHOST has been helping healthcare facilities of all types and sizes enhance patient care and operations. Since its inception, the company has provided industry-leading emergency care management through a comprehensive EDIS platform.
To learn more about how MEDHOST helps increase ED efficiency, call us at 1.800.383.6278 or email inquiries@medhost.com.
In a prelude to COVID-19, the winter of 2017-18 saw nearly 80,000 flu-related deaths and 960,000 hospitalizations—a spike that quickly outpaced the number of available hospital beds and put immense pressure on emergency department (ED) clinicians throughout the country.
This year, the CDC is reporting that nearly 70% of states are already experiencing “high” or “very high” rates of flu activity, and admittances have hit levels not seen in over a decade. With numbers rising, emergency departments will soon be inundated with patients, leading to increased wait times, longer stays, stretched resources, and burned-out providers.
Having an emergency department information system (EDIS) and an enterprise EHR to help maximize efficiency and throughput are critical to allow for safe, quality care during times of high patient volumes, like during an outbreak of the flu.
Despite vaccination being one of the most effective ways to prevent the flu, less than half of adults under 65 have received an immunization this year. To make matters worse, public trust in health professionals remains at an all-time low. Once an honored source of advice on preventative care, the family doctor now faces misinformation and mistrust related to vaccines and their potential to improve patient outcomes.
While there’s no magic wand to change public opinion, hospitals utilizing an EHR have access to three simple tools that can serve as a secret weapon in increasing vaccination coverage for their communities:
At the outset of flu season, an EHR decision support rule can be implemented that prompts healthcare providers to ask patients about their flu immunization status before discharge. Between October and March, for example, when nurses log in to the EHR to chart or administer medication, an alert may “pop up” reminding them to ask patients about their vaccine status and spark a discussion over the importance of immunization.
An EHR can communicate with state registries to pull information about immunizations no matter where patients received treatment, including their general practitioner, local pharmacy, or a walk-in clinic, minimizing redundancy and helping to give providers a more complete understanding of health histories.
An effective EHR should allow ED staff to add locations in the system during peak periods when there are more patients than beds. For instance, when beds are set up in the hallways during a disaster or public health crisis, MEDHOST EDIS can add these locations to an intuitive display that tracks patients wherever care is needed.
MEDHOST emergency department information system (EDIS) is an effective tool to help move patients through the emergency department, allowing doctors and nurses to see more patients without sacrificing quality of care.
Our comprehensive EDIS platform provides several critical benefits during times of increased patient volumes:
To learn more about how MEDHOST can help alleviate bottlenecks and better support patients throughout the hospital, get in touch with us at inquiries@medhost.com or call 1.800.383.6278.
If you work in healthcare, you’ve probably watched at least one episode of Scrubs, a sitcom from the early 2000s that followed an ensemble of doctors and staff at the fictional Sacred Heart Hospital.
If you were a fan of the show, you might remember an unusually poignant episode in which a young surgeon named Turk is determined to maintain his holiday cheer throughout a notoriously trying time for hospital staff: Christmas Eve. As the episode progresses, an increasingly downtrodden Turk is called to respond to a litany of worsening medical emergencies, illustrated by a darkly off-beat rendition of “The 12 days of Christmas.”
While Turk’s faith in the holiday spirit is eventually restored, his plight is one all too familiar for emergency department (ED) staff.
As one of the most frenetic times of the year, the holidays often represent a significant uptick in injuries. With millions traveling, cooking, erecting elaborate decorations, and scrambling to buy the latest toys, EDs around the country will begin to see increased patient volumes from all manner of merriment-related calamity.
In this post, we’ll explore some strategies and innovative ED workflow tools to help alleviate the holiday influx and give your staff something to be thankful for.
Personal commitments coming up against professional challenges significantly contribute to physician burnout in the fall and winter months. What’s worse, mismanaging the seasonal rush can reflect poorly on an emergency department’s CMS (Centers for Medicare & Medicaid Services) grades, creating a holiday hangover that can follow your health system long after the mistletoe comes down.
With Christmas just around the corner, a comprehensive solution to the seasonal increase in ER visits should be at the top of every CNO and ED director’s wish list. Luckily, we’ve compiled some helpful info on three key areas where you can streamline patient throughput:
The first place to start improving the flow of your ER is visibility. Without a clear picture of patient, clinician, and bed statuses, it’s challenging to know what areas can or should be optimized.
During the rest of the year, it might be business as usual for the admissions coordinators to get up from their desk to seek out updates. Over the holidays, however, they’ll likely be tied to a workstation, and clinicians will be too busy going between beds to stop for a sit rep.
By implementing an EHR-supported, comprehensive analytics solution, hospital staff can see real-time workflow status updates supplemented by predictive analysis. Examining data trends may also help emergency departments to forecast how many beds will be available during peak times and adjust staffing to reduce bottlenecks.
When contending with everything from falls off rickety ladders to devastating, seconds to minutes emergencies, communication between ED team members needs to be seamless throughout the entire continuum of care. Paper-based and manual systems are notorious for creating congestion; physical documents can be misplaced, lost, or overlooked. Sometimes, figuring out what’s happening in the ED may even boil down to deciphering handwritten notes on a whiteboard.
Emergency departments should examine how information is provided on a regular basis, especially before the holiday season. Emergency directors must identify communication breakdowns and obstructions at each step of treatment. Once recognized, standardized communication protocols can aid in the removal of these impediments.
While automation cannot totally eliminate human error in an ED procedure, it can help to lessen the impact on care completion.
An intelligent platform with predictive technologies incorporated into a digital system can offer a centralized touchpoint for automatic communication and process visibility. An effective Emergency Department Information System (EDIS) demands less hands-on involvement, helps with time management, and optimizes the entire continuum of care.
MEDHOST EDIS can improve communication, automate workflows, improve patient throughput, and boost patient satisfaction scores. Designed by physicians and nurses, the system supports workflow efficiency and patient safety by eliminating drop-down menus, unnecessary screens, confusing dialogue boxes, and excessive keystrokes.
To learn more about how MEDHOST EDIS allows you to unwrap increased ED efficiency, call us at 1.800.383.6278 or email inquiries@medhost.com.
The fluidity at which the healthcare landscape and market evolve can create persistent challenges for healthcare providers. Facilities are continuously reevaluating where to best direct resources while finding new ways to lower operating costs. At the forefront of this venture, they must also ensure those changes do not negatively impact the quality of care they provide.
One of the most critical area's hospitals cannot afford to experience waste is in their operating room (OR).
With so much invested in your OR, it is a key place to reduce supply expenses. Failure to do so can have a significant financial impact on patient care and your facility’s overall operations.
Recent surveys and articles paint a gloomy picture for the healthcare workforce in the US. According to a recent USA poll, 23% of healthcare workers say they are likely to leave the field soon. Medscape’s most recent survey identifies emergency medicine as one of the specialties experiencing the highest burnout rates, jumping from 43% in 2021 to 60% in 2022.
In the face of these workforce challenges, it is also essential to assess the potential impact on patient care and safety. Research suggests that physicians experiencing burnout are twice as likely to make a medical error.
In 2019, the World Health Organization categorized burnout as a syndrome resulting from chronic workplace stress that has not been successfully managed. While burnout was a concern before COVID-19, the pandemic has exacerbated the problem.
According to an ACEP October 2020 poll, 87% of emergency physicians reported feeling more stressed since the start of the pandemic, and 72% reported experiencing more burnout on the job.
Among medical errors, diagnostic error is one of the most glaring safety problems in healthcare today, particularly in emergency medicine.
As outlined in The Sullivan Group’s whitepaper on the dangers of diagnostic error, the frequency of this problem is significantly underestimated by malpractice claims. A recent publication from Johns Hopkins shed light on the diagnostic error rate for specific conditions:
According to a recent Medscape poll, 26% of emergency physicians think they make a diagnostic error every shift.
Diagnostic errors are the leading type of paid medical malpractice claims filed against emergency physicians, costing approximately $288,000 per claim filed. Before the onset of COVID-19, the medical malpractice insurance marketplace increased premiums due to the increased frequency of high severity cases. In fact, the projected loss rate for hospital professional liability increased by 30% (Occupied Bed Equivalent from $2,960 in 2020 to $3,850 in 2021) and increased by ~15% for emergency medicine (from $5.92 per patient visit in 2020 to $6.81 in 2021).
As a result of this market pressure, healthcare organizations are increasing their self-insured retention layer to lower their total cost of risk. Large health systems (>$5B in gross revenue) increased their self-insured retention limits by 34.5% ($8.4M to $11.3M), and medium ($2B–$5B) and small (<$2B) health systems increased their limits by ~8%.
Given the current workforce challenges in healthcare and the impact on the quality of care and cost of care, many hospitals are looking to software to help resolve these challenges. To that point, MEDHOST’s partnership with The Sullivan Group aims to support acute care hospitals in mitigating their openness to medical error risk via MEDHOST’s EDIS platform.
The integration focus on several key areas essential for reducing risk and the potential for patient harm:
Triage: The Sullivan Group defined a series of ‘Seconds-to-Minutes’ emergencies that can often be overlooked by nurses working in triage, especially in the face of COVID.
Nursing Documentation: Helping nurses identify potential key clinical considerations and supporting their documentation practices is critical to facilitating teamwork in the ED.
Provider Documentation: The Sullivan Group’s research into gaps in clinical practice and documentation offers a framework for identifying where providers are at greatest risk for diagnostic errors.
Vital Sign Functionality: During the entire patient visit, clinicians should maintain a front-of-mind awareness around vital signs and their importance on suggesting more severe underlying conditions that occasionally get overlooked.
Discharge: Prior to discharge, the entire ED team should feel confident that they are sending home a patient where all high-risk conditions have been considered and ruled out.
To learn more about how MEDHOST and The Sullivan Group work together to help improve patient safety and alleviate clinician burnout by reducing the likelihood of medical errors, email us at inquiries@medhost.com or call 1.800.383.6278 to speak with one of our specialists.
The Sullivan Group (TSG) has worked with over 1,000 acute care facilities, has been used by 95,000 clinicians, and has an impact on over 20 million patient visits annually. Their RSQ® Solutions platform is used by some of the nation’s largest hospital systems to successfully reduce adverse outcomes. The TSG Innovation Lab partners with organizations in the healthcare technology space, resulting in co-development of new products and greater exposure to solutions that impact patient safety and improve patient outcomes and patient experience. www.thesullivangroup.com
Shorter emergency department (ED) wait times reduce an organization’s medical malpractice risk.
In fact, one study found patients at EDs with an average wait time of more than 60 minutes were 4.16 times more likely to file a malpractice claim than patients at EDs who waited less than 30 minutes.
Seconds-to-minutes in the ED frequently manifest as complicated cases requiring immediate evaluation and treatment. Your team must understand the nature of seconds-to-minutes emergencies so they can attack these cases expeditiously and with confidence. With a plan already in place, each medical team member can accomplish their specific tasks quickly and efficiently.
Seconds-to-minutes emergencies are a great source of angst for the ED team. Often In these situations, the best a practitioner will hope for is organized chaos. It is critical to have a clearly defined list of presentations for consideration in the time frame of seconds-to-minutes.
Goals for the ED team should include early recognition of seconds-to-minutes emergencies, expedited evaluation and treatment, and the assignment of tasks to team members. In addition, early communication with consultants is critical.
The Sullivan Group has identified eight clinical presentations that are seconds-to-minutes complaints in the ED.
Because of the time-sensitive nature of these emergencies, it is critical to have clinical decision support available via your EHR. Access to such rapid response solutions at the bedside helps clinicians quickly identify these high-risk situations and prevent adverse outcomes.
Risk-enhanced triage support – such as that available in MEDHOST’s Risk Mitigation Module, built in partnership with The Sullivan Group – allows the triage nurse to elevate the priority of a seconds-to-minutes emergency quickly. This early identification can lead to significant reductions in door-to-physician time for these high-risk clinical presentations. These are then highlighted on the MEDHOST EDIS Tracking Board and Locator Board, bringing the ED team together around the highest acuity presentations.
Seconds-to-minutes emergencies are high-risk disease processes that clinicians must quickly identify and manage efficiently to avoid devastating consequences to the patient. Recognizing and planning for these presentations before the patient comes through the door will enable you and your team to attack these cases expeditiously and with confidence.
To learn more about how MEDHOST and The Sullivan Group work together to help your ED operate with improved speed, efficiency, and greater accuracy, please reach out to us at inquiries@medhost.com or call 1.800.383.6278.
About The Sullivan Group
The Sullivan Group (TSG) provides trusted clinical content to improve patient safety and reduce diagnostic error. Drawing from 20 years of research into adverse outcomes and analysis of 350,000 high-risk patients, TSG delivers clinical decision support at the bedside aligned with the mental workflow to ensure the highest quality care is delivered to every patient. Their RSQ® Solutions platform has delivered over 1 million courses to 95,000 clinicians impacting 20 million patient visits annually at over 1,000 acute care facilities.
Each year The Joint Commission gathers information about emerging patient safety concerns and sets standards and measurable outcomes to help hospitals improve performance and continue to provide high-quality care.
These standards are applicable to all Joint Commission-accredited hospital and behavioral health care organizations.
In this series, we will focus on ways to address the National Patient Safety Goal (NPSG) 15.01.01 which works to identify patient safety risks. This first blog overviews identifying and reducing the risk of patient suicide, which is the NPSG target for 2021.
According to a study from The Joint Commission Journal on Quality and Patient Safety, there are approximately 30,000 suicides per year in the United States. It is estimated that 5 to 6 percent of those suicides occur in hospitals. In addition, the overall suicide rate is markedly higher in rural areas as compared to urban areas.
To help hospitals effectively meet the NPSG standard for compliance, an R3 Report by The Joint Commission identifies seven elements of performance (EP) designed to decrease suicide rates in this high-risk group.
Element of Performance 1
For effective prevention of suicides in non-psychiatric units in a general hospital, procedures must be implemented to mitigate suicide risk, such as:
For psychiatric units, removing door hinges, hooks that can be used for hanging, and anchor points are important measures. The rationale is that most common patient areas contain hazards that pose a risk for suicidal patients. By removing the hazard, it minimizes suicide risk.
Element of Performance 2
The second requirement asks healthcare providers to screen all individuals being treated or evaluated for behavioral health conditions with a validated screening tool starting at age 12 and above. The R3 report also states patients being treated for behavioral health problems often have suicidal ideation.
Element of Performance 3
An evidence-based process is required for those patients who have screened positive for suicidal ideation. It is important to complete an in-depth assessment in order to determine how to appropriately treat these patients.
Element of Performance 4
This EP requires the documentation of the patient’s overall level of risk for suicide, as well as a plan to mitigate the risk.
Element of Performance 5
To address care for those at risk, written policies and procedures must be followed.
Staff should be properly trained to identify and assess those at high risk for suicide and follow guidelines for reassessment of the patient. These policies should be guided by an evidence-based practice.
Element of Performance 6
Given that the risk for suicide is very high after discharge from the emergency department or an inpatient psychiatric setting, written policies and procedures for counseling and follow-up care at discharge are critical.
Developing a safety plan with the patient can decrease suicidal behavior. One way to provide additional support is to provide the patient with numbers to crisis call centers.
Elements of Performance 7
Processes for monitoring the implementation and effectiveness of policies and procedures tied to the screening, management, and assessment of at-risk patients are required. Strict adherence to protocols is the only way to ensure there is a high reliability of suicide prevention.
COVID-19, and the challenges that communities have faced related to isolation alongside COVID-19-associated morbidity and mortality, have led to an increased number of mental health, substance abuse, and suicidal ideation.
The Centers for Disease Control (CDC) reports that during June 24-30, 2020, 40 percent of adults surveyed reported an increase in mental health symptoms such as anxiety and depression. When compared to a similar 2019 survey in the same timeframe, a significant year-to-year rise in such responses is clear.
In addition, increased substance abuse and elevated suicidal ideation were also reported by younger adults, essential workers, unpaid adult caregivers, and racial/ethnic minorities.
In many cases, high suicide-risk patients present at the emergency room before transitioning to the inpatient setting. The Emergency Nurses Association (ENA) stance as a leading and influential voice on the public policies affecting emergency nursing and suicide screening underscores this point.
On September 29, 2020, the House passed H.R. 4861, the Effective Suicide Screening and Assessment in the Emergency Department Act of 2020. This legislation establishes a competitive grant program to help train up to 40 hospitals with emergency departments to connect patients who are at risk for suicide with treatment and mental health services. This grant can also be used to train emergency department providers, establish policies and procedures, and care coordination for individuals at risk of suicide.
Congruent with the NPSG and ENA, MEDHOST is committed to finding ways to help hospitals and their clinicians quickly identify at-risk patients. By increasing the understanding, knowledge, and preparedness of ED staff and providers over patient suicide risks, patient identification can become more effective, and resources can be readily provided to improve the safety and quality of care for such individuals.
To support emergency departments in these efforts, MEDHOST Emergency Department Information System (EDIS) allows screening tools to be built into the platform per a facility’s needs, along with custom charting options that can be used to help facilities identify patients at risk for suicide.
To learn more about how MEDHOST EDIS can help run your hospital more efficiently with customizable tools, please reach out to us at inquiries@medhost.com or call 1.800.383.6278.
Human trafficking, believed to be the third-largest criminal activity in the world, is a form of modern-day slavery where people are bought, sold, and smuggled, often beaten, starved, and forced to work as prostitutes with little or no pay.1
It is a human rights violation that severely impacts millions of people worldwide. Emergency nurses have a unique opportunity to recognize victims of human trafficking and intervene. A recent study revealed that of 173 U.S. victims surveyed, 68 percent had presented to a healthcare provider at least once while being trafficked, most frequently to an emergency department provider.2
Determining the magnitude of human trafficking has proved challenging for law enforcement, policy makers, and trafficking advocates due to the covert nature of the crime and the prevalence of hidden populations.3 The United States government estimates approximately 17,500 people are trafficked nationwide.4 Researchers found that 87.8 percent of surveyed trafficking survivors were seen by a healthcare professional during captivity and went undisclosed, resulting in a missed lifesaving opportunity.5 63 percent of those surveyed were specifically examined in an emergency department.5
Healthcare access for these victims is limited and most will only have one opportunity to be examined by healthcare professionals. At present, the research is limited concerning the effectiveness of training for the emergency department staff on identification and treatment of human trafficking victims. 6 Additionally, limited availability of emergency department-specific screening tools and limited established reporting requirements, together with the barriers to patients disclosing their involvement in trafficking, make it difficult to identify these patients and provide the proper care and advocacy.
Unfortunately, these victims rarely identify themselves, and the failure to recognize victims reduces the opportunity to provide resources to such victims. Only 40.7 percent of the emergency departments specifically screened adults for human trafficking, with most ED clinical staff using one or more safety questions as their screening tools.7 Of the 59.3% of the emergency departments that did not screen adults specifically for human trafficking, several screened only children; some focused on domestic violence or abuse/neglect screening; others asked questions about safety in general but clarified that it was not specific to screening for human trafficking; and some offered no information on any actions taken in the emergency department related to human-trafficking screening.8
Typically, these victims report a high incidence of health issues such as physical abuse, sexually transmitted infections, undernourishment, and psychological trauma. When a victim seeks medical attention, this presents healthcare staff a rare opportunity to recognize victims. Hence, healthcare facilities, especially emergency departments, become the venue for identifying victims of human trafficking, providing a prospective safe haven for victims. To combat human trafficking, healthcare workers need to be trained on how to identify and approach such victims and understand what actions to take once a victim is identified.
At the health facility, screening begins at the registration desk, where the staff can look for signs of trafficking. Signs may include the patient has no insurance, guardianship information, and personal identification, the patient offers to pay with cash, or the patient may be with another individual who answers all the questions for the patient.7 If registration personnel are successful in identifying a possible victim, or if the screening for human trafficking indicates abuse, the emergency nurse can take further actions to provide help and resources.
Other red flags that may help identify victims of human trafficking include: The patient is unaware of his/her location, the patient exhibits fear, anxiety, depression, and avoids eye contract, and the patient is reluctant to explain his/her injuries.7 In addition, emergency department nurses need to know the common signs that victims of human trafficking present with to the emergency department. The most common signs of trafficking are bruises, broken bones, scars, pelvic inflammatory disease, urinary tract infections, multiple abortions or pregnancies, sexually transmitted infections, malnutrition, feelings of helplessness, shame, humiliation, and confusion.9 As victims may be fearful of the trafficker accompanying them, sometimes a silent visual notification tool can be implemented to notify staff of abuse or unsafe living situations. After that visual tool has been identified, the team members should be alerted immediately, and the patient can be escorted to a designated safe area until further steps can be taken.
If human trafficking, exploitation, or slavery is suspected, an advocate, such as a social worker or case management, should be contacted to assess the victim’s needs and educate the patient about his/her rights. If the victim is an adult, law enforcement should be contacted only after obtaining patient consent. If consent is not obtained, the patient should be given the number to the National Human Trafficking Hotline to memorize and resources should be provided. If the victim is a minor, law enforcement should be contacted to report suspected abuse.
Increasing the understanding, knowledge, and skills of ED staff and providers is essential for accurate identification of such victims so resources can be provided. MEDHOST Emergency Department Information System (EDIS) allows for screening tools to be built per your needs, as well as charting choices that can be created to help your facility identify victims of human trafficking. To learn more about how MEDHOST EDIS can help run your hospital more efficiently with customizable tools, please reach out to us at inquiries@medhost.com or call 1.800.383.6278.
1 U.S. Department of Justice. (2019). Human trafficking/involuntary servitude. Federal Bureau of Investigation. Retrieved from https://www.fbi.gov/investigate/civil-rights/human-trafficking
2 Breuer, G. J. & Daiber, D. (2019). Human trafficking awareness in the emergency care setting. Journal of Emergency Nursing, 45(1), 67-77. https://doi.org/10.1016/j.jen.2018.11.011
3 Hachey, L.M., & Phillippi, J.C. (2017). Identification and management of human trafficking victims in the emergency department. Advanced Emergency Nursing Journal, 39(1), 31-51. https://doi.org/10.1097/tme.0000000000000138
4 Ahn, R., Alpert, E. J., Purcell, G., Konstantopoulos, W. M., McGahan, A., Cafferty, E., … Burke, T. F. (2013). Human trafficking: Review of educational resources for health professionals. American Journal of Preventive Medicine, 44(3), 283–289. https://doi.org/10.1016/j.amepre.2012.10.025
5 Lederer, L. J., & Wetzel, C. A. (2014). The health consequences of sex trafficking and their implications for identifying victims in healthcare facilities. Annals of Health Law, 23(1), 61–91.
6 Donahue, S., Schwien, M., & LaVallee, D. (2019). Educating emergency department staff on the identification and treatment of human trafficking victims. Journal of Emergency Nursing, 45(1), 16-23. https://doi.org/10.1016/j.jen.2018.03.021
7 Egyud, A., Stephens, K., Swanson-Bierman, B., DiCuccio, M., & Whiteman, K. (2017). Implementation of human trafficking education and treatment algorithm in the emergency department. Journal of Emergency Nursing, 43(6), 526-531. https://doi.org/10.1016/j.jen.2017.01.008
8 Dols, J. D., Beckmann-Mendez, D., McDow, J., Walker, K., & Moon, M. D. (2019). Human trafficking victim identification, assessment, and intervention strategies in South Texas emergency departments. Journal of Emergency Nursing, 45(6), 622-633. https://doi.org/10.1016/j.jen.2019.07.002
9 Lamb-Susca, L. & Clements, P.T. (2018). Intersection of human trafficking in an urban emergency department. Journal of Emergency Nursing, 44(6), 563-569. https://doi.org/10.1016/j.jen.2018.06.001
