Urgent Care Centers (UCCs) play a critical role in providing timely and convenient healthcare services for patients with episodic, subacute illnesses and injuries. However, it is essential for healthcare providers in UCCs to be able to recognize and appropriately refer cases that require care beyond the center’s capabilities. This article aims to discuss the importance of recognizing emergent cases and implementing risk reduction strategies in UCCs to help ensure patient safety and quality care.
A patient presented to a UCC following a high-speed motor vehicle accident with complaints of nausea, joint pain, myalgia, and neck pain. The patient exhibited bony tenderness and an obvious deformity of the left shoulder, indicating a potential acromioclavicular joint separation. Unfortunately, the healthcare provider failed to perform an abdominal exam or order a CT scan of the abdomen and pelvis, despite the patient’s left rib tenderness.
Approximately seven hours later the patient collapsed at home and was found pulseless by emergency medical technicians. Despite resuscitation efforts the patient ultimately succumbed to his injuries. Postmortem examinations revealed significant injuries to the spleen, liver, and head. The patient’s family sued the UCC physician alleging his failure to identify the patient’s traumatic injuries and refer him to a higher level of care resulted in his death.
Several expert opinions were sought in the case study. While there were varying opinions on the exact cause of death, all experts agreed that the patient’s splenic injuries played a significant role. The failure to diagnose and treat the splenic injury earlier resulted in hemorrhagic shock and subsequent cardiac arrest. Additionally, the delayed recognition of a head injury led to a prolonged period of anoxia and a severe anoxic/hypoxic brain injury.
The case study highlights the importance of recognizing emergent cases in UCCs and promptly referring them to higher-level facilities. While UCCs are not intended to treat medical emergencies, they should be adequately prepared to handle emergencies or conditions that require care beyond their capabilities. This requires a comprehensive evaluation of the UCC’s scope of practice, physical plant, staffing, equipment, information management, and clinical protocols.
To help ensure patient safety and quality care, UCCs should implement the following risk reduction strategies:
Diagnostic errors can have serious consequences for patients and can also lead to medical liability claims. To help prevent diagnostic errors and reduce the risk of medical liability claims, healthcare professionals should implement various strategies.
Recognizing emergent cases and appropriately referring them to higher-level facilities is crucial for patient safety and quality care in Urgent Care Centers. By implementing risk reduction strategies such as improving decision-making, utilizing tools and guidelines, following up on patient outcomes, and ensuring thorough documentation, healthcare professionals can reduce liability risk and provide exceptional care to their patients.