I’ve just read an awesomely thought-provoking article by Paul Levy @paulflevy at his blog, “Not Running a Hospital,” which, by the way, you must subscribe to immediately. He’s by turns sublime and full of candor and always questioning the status quo.
Here is his recent post:
Here’s my response and I (& I’m sure Paul also) would like to hear yours:
My quarrel is with the gap presented by the urgent care center. This is where the breakdown occurred. Simple triage / initial diagnosis and basic treatment would have suited this boy and saved the ED adventure. If we dig deeper, the primary care doctor’s lack of skilled nursing to at least offer intelligent telephone triage and next steps is mind boggling.
How can we say much about the ED’s actions beyond complete service with plenty of empathy for the child? Had the ED provided subpar care, we’d be clamoring for their heads. In this case, they took up the slack for two broken steps that essentially passed this child down to a full work up and greater expense.