Escalation of Care in Healthcare: Ensuring Timely and Appropriate Care Delivery

Timely delivery of appropriate medical treatment is at the heart of high-quality medical care. The ability to assess, diagnose, plan, intervene, and escalate care stands at the core of nursing assessment and is a duty of all medical providers entrusted to care for people that seek treatment. Today we delve into the significance of escalation of care, and how it profoundly impacts the delivery of healthcare services, and how it can impact a legal case.

At it’s core, healthcare delivery revolves around a singular mission: ensuring that every patient receives the care they need precisely when they need it. Yet, the landscape of healthcare is far from static, and situations can evolve rapidly. When a facility or department can no longer provide the necessary level of care for a patient, it becomes a shared responsibility of healthcare providers and the hospital to ensure that the patient’s needs are met promptly and effectively. Healthcare providers have a duty to continuously assess their patients for acute changes and escalate care in a timely manner when appropriate.

Why Escalation of Care Matters

The importance of escalation of care becomes most evident when considering critical medical scenarios. Conditions such as myocardial infarction (heart attack), stroke, childbirth complications, and many others demand immediate attention. In these cases, every second counts, and delays in care can lead to delayed treatment, worsened prognoses, or even tragic outcomes such as loss of life.

So, what does this mean when it comes to reviewing medical records for legal cases?

Key Considerations When Reviewing Medical Records

EMS Transport Destination: When a patient is transported via Emergency Medical Services (EMS), it’s crucial to ascertain whether they were taken to a facility equipped with the appropriate resources to address their condition. For instance, a patient with a suspected acute heart attack must be transported to a hospital with a cardiac catheterization lab. Each transport decision should be guided by patient condition, available facilities, and local protocols.

Timely Specialty Consultations: If a patient’s condition takes a turn, it’s imperative that the appropriate medical specialties are consulted without delay. A stroke patient, for example, requires the immediate involvement of a neurologist or neurosurgeon to evaluate and initiate treatment.

Chain of Command and Documentation: The healthcare system relies heavily on established protocols and a clear chain of command. Was this chain followed appropriately, and is it documented in the medical records? This documentation is critical for assessing if the standard of care provided in a timely manner.

Rapid Response Initiation: In general medical-surgical (med-surg) or telemetry units, where patients may not have the close monitoring seen in critical care, recognizing signs of deterioration is vital. Was a rapid response called promptly when a patient’s condition warranted it?

These are just a few of the critical points to scrutinize when reviewing medical records to evaluate the standard of care. The details within these records can often hold the key to understanding whether the patient received timely and appropriate care.

At times, navigating the intricacies of medical records can be a challenging task, and that’s where we come in. If you’re seeking assistance in examining the nuances of healthcare documentation, we are here for you.

Valerie Creel

Valerie Creel

Valerie Creel is the owner of Bridge Point Legal Nurse Consulting. Valerie has been an RN since 2013 and has extensive experience with Critical Care, having been in ICU for the entirety of her Nursing career. Valerie has worked with Trauma, Neuro, and Medical ICU patients including providing care through the Covid-19 pandemic. In addition to her nursing experience, she worked providing prehospital care in the 911 system of San Mateo County from 2007-2014. She had the opportunity to work with complex trauma and multi-casualty incidents including the Asiana Airline Crash at SFO in 2013. Valerie holds her board certification in Critical Care and earned her Bachelors Degree from Grand Canyon University. She has been working in the legal nursing field since 2021 and has completed her coursework to specialize in Strangulation. She will also complete her Forensic Nurse Certification by the beginning of 2023. In her spare time, she loves spending time with her family and two young daughters and husband. She also enjoys being outdoors, fitness, and cooking.