http://symtym.disqus.com/...a physician meandering medicine, law and technology...enSat, 30 Oct 2004 08:08:00 -0000http://symtym.com/2004/10/ratios_war/#comment-1889704I agree with all three of your statements. I'm also concerned about the potential interplay of the staffing ratios and the EMTALA mandate. There is the EMTALA mandate to provide a medical screening exam and provide emergency stablizing care for all comers and often that mandate forces significant impaction of Emergency Departments (ED) and volumes that often exceeds staffing ratios. The relief either comes in ED closures (by diversion of ambulances) or remaining open and "violating" the ratios.symtymSat, 30 Oct 2004 08:08:00 -0000http://symtym.com/2004/10/ratios_war/#comment-1889703I'm not sure, but this might be a situation where a little bit more liability exposure on the part of the hospitals would be helpful. When you have 85% of the hospitals in the state out of compliance, either the regulations are unreasonable (doubtful), or the perceived risks of noncompliance aren't serious enough.<br><br>Perhaps (I'm just speculating) the hospitals know that it's virtually impossible for a patient to prevail in a malpractice action against the hospital based on respondeat superior or "ostensible agency."<br><br>In that case, the malpractice suits that are filed might focus exclusively on the physicians, who will be held responsible for errors caused by inadequate nurse staffing ratios--over which the physicians had no control.CareySat, 30 Oct 2004 05:21:00 -0000