This is the first in a series of promotional exam scenarios you all sent in to help me prepare for my Captain's exam. Each and every one helped me and I thank you very, very much for taking the time to write and help me out.
Since I am on vacation as of today, I thought I would share some of the best scenarios that really got me thinking.
There are no right answers to these issues, each system is different.
SCENARIO 1-
You are riding EMS Battalion 34 today and are called to the local hospital well known in the system for making units wait longer than necessary to register patients.
Inside is an irate attending physician screaming that his hospital is not your dropping grounds and demands you start diverting to other receiving facilities.
Write your response to him, citing local and department policies and protocols.
Since I am on vacation as of today, I thought I would share some of the best scenarios that really got me thinking.
There are no right answers to these issues, each system is different.
SCENARIO 1-
You are riding EMS Battalion 34 today and are called to the local hospital well known in the system for making units wait longer than necessary to register patients.
Inside is an irate attending physician screaming that his hospital is not your dropping grounds and demands you start diverting to other receiving facilities.
Write your response to him, citing local and department policies and protocols.
Comments
In the meantime, I will see what I can do about reminding our crews that you're not the only hospital in the area. While I'm here, is there anything we can do about the long handoff times? Our crews can't transport to other facilities if they're tied up waiting to offload their patients in your ED."
In the meantime, I will see what I can do about reminding our crews that you're not the only hospital in the area. While I'm here, is there anything we can do about the long handoff times? Our crews can't transport to other facilities if they're tied up waiting to offload their patients in your ED."
When the administrator comes down, include the attending MD in the conversation regarding placing the hospital on a diversion status. Make sure to point out that while this status is in effect non-critical patients wanting to come to their facility will be directed elsewhere, casually mention that the facility will be possibly losing insured admissions, but in the case of a critical patient (such as a respiratory or cardiac arrest) their facility will still be expected to accept them.
You may also want to point out to the doctor with the administrator present that if units are held up greater than (insert number of minutes here) continually then you will be forced to place them on diversion and advice your superiors that the status remain indefinitely. While the administrator does the calculations on their potential income loss and census drop in their head, smile.
When the administrator comes down, include the attending MD in the conversation regarding placing the hospital on a diversion status. Make sure to point out that while this status is in effect non-critical patients wanting to come to their facility will be directed elsewhere, casually mention that the facility will be possibly losing insured admissions, but in the case of a critical patient (such as a respiratory or cardiac arrest) their facility will still be expected to accept them.
You may also want to point out to the doctor with the administrator present that if units are held up greater than (insert number of minutes here) continually then you will be forced to place them on diversion and advice your superiors that the status remain indefinitely. While the administrator does the calculations on their potential income loss and census drop in their head, smile.
When the administrator comes down, include the attending MD in the conversation regarding placing the hospital on a diversion status. Make sure to point out that while this status is in effect non-critical patients wanting to come to their facility will be directed elsewhere, casually mention that the facility will be possibly losing insured admissions, but in the case of a critical patient (such as a respiratory or cardiac arrest) their facility will still be expected to accept them.
You may also want to point out to the doctor with the administrator present that if units are held up greater than (insert number of minutes here) continually then you will be forced to place them on diversion and advice your superiors that the status remain indefinitely. While the administrator does the calculations on their potential income loss and census drop in their head, smile.
Doc,
If you have an issue with the ER or other parts of the hospital filling up, please let us know and you will be put on divert status. However, you should know that while our crews will do their best to take patients to other ER's, their first responsibility will be to take patients to the most appropriate facility. As well, you should understand that while we inform the patients that your ER is overcrowded, in the end if they insist on coming here, here is where we will take them. We have very little choice in the matter.
If there are any other concerns, please have your attending or department head contact the EPAB and I'm sure this situation can be worked out.
Doc,
If you have an issue with the ER or other parts of the hospital filling up, please let us know and you will be put on divert status. However, you should know that while our crews will do their best to take patients to other ER's, their first responsibility will be to take patients to the most appropriate facility. As well, you should understand that while we inform the patients that your ER is overcrowded, in the end if they insist on coming here, here is where we will take them. We have very little choice in the matter.
If there are any other concerns, please have your attending or department head contact the EPAB and I'm sure this situation can be worked out.
Doc,
If you have an issue with the ER or other parts of the hospital filling up, please let us know and you will be put on divert status. However, you should know that while our crews will do their best to take patients to other ER's, their first responsibility will be to take patients to the most appropriate facility. As well, you should understand that while we inform the patients that your ER is overcrowded, in the end if they insist on coming here, here is where we will take them. We have very little choice in the matter.
If there are any other concerns, please have your attending or department head contact the EPAB and I'm sure this situation can be worked out.
Doc,
If you have an issue with the ER or other parts of the hospital filling up, please let us know and you will be put on divert status. However, you should know that while our crews will do their best to take patients to other ER's, their first responsibility will be to take patients to the most appropriate facility. As well, you should understand that while we inform the patients that your ER is overcrowded, in the end if they insist on coming here, here is where we will take them. We have very little choice in the matter.
If there are any other concerns, please have your attending or department head contact the EPAB and I'm sure this situation can be worked out.