Originally Posted by Becca9800 (Post 1952727)

!7-year ER nurse here. OP has some valid points, some misperceptions, and some ER care expectations that will never be met.
1. EDs are for emergencies. i.e. conditions w onset of <24 hours and/or threatening life, limb, or organ function. Admittedly, the misuse of ED services was my biggest complaint w people. We were so busy w true emergencies there simply wasn’t time to devote to conditions that belonged in a physician’s office. Wait time is the #1 complaint from ED patients. Yours simply wasn’t an emergency so your wait time complaint is moot.

2. Rudeness from staff is never acceptable. I wonder what caused the first two people you interacted w to treat you so poorly. I think most people are in health care to help, not to use as an opportunity to mistreat others. But as w all occupations, there are always exceptions.

3. Surely you were not directed by the greeter to go directly to the registration clerk where detailed insurance info was obtained? Were you first triaged for a medical emergency where it was determined none existed? A Federal law called EMTALA requires that any person requesting evaluation receive a medical screening eval (MSE) prior to being asked for detailed insurance info. Had your triage revealed a medical emergency you would have received a MSE before giving detailed insurance info. EMTALA has been in effect for years, so I must assume TV EDs are aware as the fines for violating can be huge. If you were not triaged prior to providing detailed ins info, please advise the hospital’s CEO, Compliance Officer, Risk Manager or Patient Advocate, they will want to know about this.

4. ED doc meeting family in the waiting room could potentially be a HIPAA violation. Did you hear any PATIENT-IDENTIFIABLE info? Were you able to identify the patient by way of any info the doc divulged? If so, go to those in charge at the hospital and let them know they have a problem. If the doc was discussing diagnosis, care plan etc. but you don’t know who he was talking about, it’s not a HIPAA issue, it’s a respect issue.

5. X-rays don’t diagnose soft tissue injuries; ligaments are a soft tissue. MRIs that can diagnose soft tissue injuries are simply not ordered by the ED docs for non-emergent conditions. Standard ED operating process: the ED doc rules out a medical emergency and the patient is told to return to the ED if symptoms worsen, and to follow with PCP if symptoms persist. EDs deal with emergencies.

6. Name of an attorney: IMHO you don’t have a case. Nothing. Sorry. What are your damages? The next day you were diagnosed with an ACL tear, what did that 1-day delay in diagnosis cost you? Surely you had even more delay until repair: you had to wait to see an ortho doc on referral. Then you had to wait until your scheduled surgical repair (ACLs torn in half require surgical repair, in my experience). So how did the initial 1-day delay harm you? The ED doc didn’t cause your ACL tear. You still would have required appropriate treatment for the tear. Was the care required altered by the 1-day delay? Got to have an injury caused directly by a negligent act to have a successful malpractice claim. There is no provision under the law for YOU to sue anyone for any HIPAA violation. It is our government that brings those actions against the covered entity.

While there are deserved malpractice actions brought against care providers, I’m sad that this action is the first thought when something doesn’t go just as you thought it should. I just wish people would give usually well-intentioned people the benefit of the doubt before a public trashing.

Originally Posted by fpmoravcik (Post 1952623)

My wife and I had a similar experience a few years ago. It was so bad that we left after three hours after they took in a young lady for a pregnancy test before my wife. It's sad to see nothing has changed. Worst experience ever.

Originally Posted by lulliedoll (Post 1952692)

I was in my doctor's office in the Sharon Morse Building across the parking lot from The Villages Hospital. I was having what appear to be stroke-like symptoms and my doctor ordered an ambulance to take me to the hospital. I questioned why they could not just wheel me across the parking lot to The Villages ER and was advised that the Villages Hospital is not a level one stroke Hospital. How crazy is that in a community filled with senior citizens. It took the ambulance 45 minutes to get to the Sharon Morse Building despite three different calls from my doctor's office. Another 35 minute drive to Ocala. When is The Villages Hospital going to get up to speed? I thought when it was taken over by the University things were going to improve but obviously not. When you have an emergency, time is critical. I ended up being admitted to the hospital in Ocala. I am so disappointed in The Villages Hospital.

Originally Posted by MandoMan (Post 1952055)

Excess wound infections is a major reason why a hospital might not get an A rating from hospital rating agencies.

Originally Posted by Aloha1 (Post 1952831)

So, my choice if another medical emergency were to occur would not be TVRH until they deal with and fix their front line triage unit.

Originally Posted by Becca9800 (Post 1952842)

Not a sound grading method though, I don't put my eggs in that scorecard basket.

A hospital is dinged for superficial infections (skin) that develop up to 30 days from date of the surgery, and for deep or organ/space infections that develop up to 90 days after the surgery . Too many factors that the doc nor hospital can control once patient is discharged to home e.g. is patient taking antibiotics properly, keeping wound clean/dry, are they smokers, is the diabetic controlling their blood sugars. I dealt w a patient who developed a deep wound infection about 21 days after lumbar surgery, and it was a nasty one. My hospital was dinged for the infection simply bc of the timing. The patient blamed the surgery. We looked at every component of infection prevention utilized in the OR for that case, everyone did everything that was required, still the patient developed a debilitating infection. It is noted in the patient's record that he reported to the Infectious Disease physician, "approximately one week after his laminectomy, he began to use his dog's wire brush to scrape away the scab and scratch his surgical incision". The bug infecting his wound was an odd one (I can't recall its name) but this bacteria is associated with acne and is also found on the coats of dogs. The patient blamed the surgical team, he believed someone had facial acne and dropped bacteria into his open wound. We did look into that, some had blemishes, but no cases of acne amongst the surgical team. The patient wouldn't even consider that his dog's brush transferred the bug into his wound. We'll never know for sure either way but the hospital bears the ding on its scorecard to this day.

Another fault with this grading system, if the patient's initial surgery was at Hospital A and the patient goes to Hospital B for treatment of a post-op wound infection, Hospital A, nor the surgeon performing the surgery, is dinged w the infection on their scorecards. One hand doesn't know what the other hand is up to. I think this gaping hole is a huge problem for a couple of reasons.

Bottom line, you can't put all your faith in publicly reported data, it's a less than perfect system.

You also can't put much stock in what you read on social media sites. IMHO, your best bet is to ask a friend working in your local healthcare facilities, we know which hospitals, or even which units within hospitals to avoid. We know which practitioners deserve your trust, and we def know which practitioners are to be avoided.

Originally Posted by golfing eagles (Post 1952868)

Were you perhaps thinking of corynebacterium???

I agree, many of the metrics that go into the hospital "rating" (which btw is nothing more than to amuse the lay public, real problems are addressed in a different manner), are just plain bogus. My favorite is the "medication error" rate. If I prescribe a Tylenol for 6 PM, the nurse has to administer it between 5:30 and 6:30. if it is 1 minute late, it is counted as a medication "error" . What's worse, is that if the patient goes on to die during that admission from their underlying stage 4 pancreatic carcinoma 2 weeks later, the bean counters call that a death due to "medical error". And that's why they put out these absurd numbers like 500,000 people in the USA die from "medical errors" each year. It is, of course, complete nonsense, but it fits the political narrative that seems to be popular. As Chief of Staff, I always loved to report this crap to NY State:1rotfl::1rotfl::1rotfl:
The other problem is that some hospitals are more diligent in reporting than others, so the whole baseline can be skewed. The conditions the bean counters focus on are myocardial infarction, cerebrovascular accident and pneumonitis. They have so much garbage built into the criteria that it is almost medically meaningless, but again, it "shows the public" that the government is looking out for them.
Another rating metric that I also love is "readmissions within 30 days" for the same problem. A patient is admitted and treated successfully for CHF (congestive heart failure), and discharged home, where they proceed to eat 15 grams of sodium a day, so naturally they are back in 3 days. Somehow the bean counters consider that the fault of the hospital. Go figure!

Originally Posted by golfing eagles (Post 1952868)

Were you perhaps thinking of corynebacterium???

I agree, many of the metrics that go into the hospital "rating" (which btw is nothing more than to amuse the lay public, real problems are addressed in a different manner), are just plain bogus. My favorite is the "medication error" rate. If I prescribe a Tylenol for 6 PM, the nurse has to administer it between 5:30 and 6:30. if it is 1 minute late, it is counted as a medication "error" . What's worse, is that if the patient goes on to die during that admission from their underlying stage 4 pancreatic carcinoma 2 weeks later, the bean counters call that a death due to "medical error". And that's why they put out these absurd numbers like 500,000 people in the USA die from "medical errors" each year. It is, of course, complete nonsense, but it fits the political narrative that seems to be popular. As Chief of Staff, I always loved to report this crap to NY State:1rotfl::1rotfl::1rotfl:
The other problem is that some hospitals are more diligent in reporting than others, so the whole baseline can be skewed. The conditions the bean counters focus on are myocardial infarction, cerebrovascular accident and pneumonitis. They have so much garbage built into the criteria that it is almost medically meaningless, but again, it "shows the public" that the government is looking out for them.
Another rating metric that I also love is "readmissions within 30 days" for the same problem. A patient is admitted and treated successfully for CHF (congestive heart failure), and discharged home, where they proceed to eat 15 grams of sodium a day, so naturally they are back in 3 days. Somehow the bean counters consider that the fault of the hospital. Go figure!

Originally Posted by golfing eagles (Post 1952868)

Were you perhaps thinking of corynebacterium???

Originally Posted by Becca9800 (Post 1952879)

It was acin.... something or another. I'm just happy I can't recall, I thought I'd never forget any detail of that experience.

Originally Posted by Becca9800 (Post 1952846)

ER docs generally do not interpret radiology images. In this 21st century, even images at 0330 can be electronically transmitted to an on-duty Radiologist who provides the interpretation. I don't know that TV hospital has such a contract in place (it's hard to imagine they don't), but before continuing to blame the ED you really should ascertain who misread your images. Misreads do happen, the interpreter is a human being and it isn't a matter of if a human will make a mistake, it is a matter of when. I'm glad you came out of your ordeal unscathed, you surely have a guardian angel, good karma, good juju, or just plain ol good luck.