Clinical Communication and Risk Management Strategies for Emergency Medicine
Risk Management Overview


  • This section discusses the nature of "true" medical emergencies, legal obligations toward the patient,the likelihood of participating in a legal claim and the use of documentation and interpersonal communication to reduce claim frequency and improve defensibility.


Clinical Communication
  • A variety of communication techniques that facilitate rapid rapport with the patient and their family are presented. Properly used, these not only reduce patient dissatisfaction but also improve the patients experience of care.
Patient Management 1
  • The physician must care for two patients: an uncooperative teen with abdominal pain and an adult with chest pain. Neither is as simple as they at first appear.The physician must appropriately mobilize consultants and document interaction with them. Along the way the physician must also deal with the family members, the hospital staff and the disease process. Dealing with a hostile family in the face of a poor outcome provides a challenge to the physician. The role of differential diagnosis in the care of these patients is presented in detail.
Patient Management 2
  • The physician must care for a patient with chest pain. Although she appears stable initially,the patient has a acute myocardial infarction. The physician must treat the patient appropriately (including correct interpretation of EKGs and rhythm strips), deal with her and her husband in deteriorating circumstances and demonstrate leadership skills with the emergency department staff.
The Medical Record
  • The requirements of the medical record and it's role in medical-legal disputes are presented. Emphasis is placed on the construction of a defensible record. Samples of comprehensive documentation are provided and discussed.


Discharge and Disposition
  • The critical importance of the physician presenting a viable discharge plan for the patient is developed including both verbal instructions and written documentation. The importance of including the patient's family in the discharge process is emphasized.

COBRA Law and Patient Transfers
  • The COBRA/EMTALA transfer laws are explained in detail with illustrative examples from actual case law. The physician is educated about what constitutes a violation of the law and the need to avoid improper transfers.
  • There are over 260 references to published material, some of which include additional information in the form of abstracts for the interested physician. A complete listing of the reference material for each section is provided for later retrieval.