December 16, 2007
JUST A REMINDER TO PROFESSIONAL STAFF MEMBERS
I have had conversations with at least two professional staff members
about emergency department call responsibilities and consultation
standards. It is worth reminding everyone of the policies. First, whenever
Dayton Children’s offers a service, we are obligated to provide emergency
room coverage for the same service. Thus, if we have an infectious disease
service, we are obligated to cover emergency department infectious disease
needs. If we provide ENT services, the same is true. We are obligated to
evaluate any patient, if requested to do so by the emergency department
staff, even if the patient has been disengaged from the particular clinic
in question. The law (EMTALA) requires us to evaluate, stabilize and treat
any emergency that presents to Dayton Children’s, even if the patient is
no longer seen in the clinics. Thus we often evaluate, stabilize and
either admit and treat or transport adults, our own employees and patients
no longer seen in our clinic. The law is clear. No on-call physician
should ever refuse to evaluate and treat any emergency department patient.
To do so is to risk potential fines.
Secondly, I am often asked if we have a standard regarding the timely
completion of consults. The policies and procedures are silent on this
issue, specifically how quickly a consult must be performed. What is clear
is that the clinical needs of the patient take precedence. Thus a patient
in the Almost Home unit might well warrant an emergent consult by any
service, if the clinical need is real. In contrast, a PICU patient might
have a consult for “chronic constipation, recurrent otitis media or advise
for international travel,” deferred to the respective clinic. For the
record, every service will provide emergent consults regardless of
location. As usual, physician-to-physician communication is the best plan.
Questions? Call Tom Murphy, MD, at 937-641-5871.
DAYTON CHILDREN’S ADDRESSES VENDOR POLICIES
A committee of hospital staff and professional staff members met this past
week to re-evaluate the hospital policy toward vendors (particularly
pharmaceutical and biomedical/equipment). As you no doubt know, the press
(both locally and nationally) has recently reported significant episodes
in which physicians have received substantial financial support from
pharmaceutical companies. In a Cincinnati case involving a child
psychiatrist, the physician received at least $180,000 in “fees” from two
companies over two years. We will keep you posted on the status of this
work. If you would like to provide any information for the committee to
consider, please send it to Cindy Asher, Tom Murphy or Greg Huff.
PARKING GARAGE OPEN
The parking garage opened for use by patients on December 3. This provides
significant new parking options, making it easier for families to access
Dayton Children’s. At some point in the future, there is the possibility
that the emergency department lot will be gated and restricted for use by
emergency department patients. That also would facilitate access.
PROFESSIONAL STAFF PARKING
We are aware of the challenges accessing the lot outside the laboratory.
We continue to examine ways to make access easier and safer, including
proximity readers, changing the actual site of entry or re-engineering the
angle of the entry. Stay tuned for more information.
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