Comply with new standard for disaster volunteers
Have you wondered how to handle volunteers if a disaster occurs in your community? A new emergency privileging hospital standard from the Oakbrook Terrace, IL-based Joint Commission on Accreditation of Healthcare Organizations provides clear instructions for this scenario. The standard, which is effective immediately, provides for the privileging of volunteer licensed independent practitioners (LIPs) during emergencies. It allows the hospital chief executive officer, medical staff president, or a designee to grant emergency privileges when the emergency management plan has been activated.
The standard will help appropriately credentialed clinicians respond in an organized manner so they can be used appropriately, says Suzanne Pugh, RN, nurse manager of the ED at St. Vincent’s Manhattan in New York City. The following are given as acceptable sources of identification:
- a current license to practice;
- a current picture hospital identification accompanied by the LIP’s license number;
- verification of the volunteer practitioner’s identity by a current hospital or medical staff member.
Joint Commission officials say that health care personnel during last year’s flood in Houston and the terrorist attacks in New York City and Washington, DC, identified a need for rapid access to clinicians to meet patient care demands in emergencies.
On Sept. 11, hospitals were overwhelmed with physicians and nurses showing up at the hospital ready to assist, Pugh says. "We were and are extremely grateful for their willingness to volunteer. However, even with a license in hand, these are unknown’ clinicians. In addition, we had more volunteers than patients at one point." She points to an example of appropriate use of volunteer clinicians on that day, when a hospital chairman contacted her facility asking if ophthalmologists were needed. "He was told we could use three physicians, which were quickly dispatched," she says.
Laura Guerrieri, RN, BSN, director of emergency services at Gottlieb Memorial Hospital in Melrose Park, IL, says the new standard will be of tremendous help to emergency departments (EDs). "Ideally, it would be preferable if volunteer physicians were board-certified in emergency medicine," she says.
Guerrieri suggests that volunteer physicians who are not board-certified could be used to evaluate and treat less severely injured and noncritical patients in the ED. She explains that specialty physicians such as orthopedic surgeons would be extremely valuable to hospitals in disaster situations because they could be utilized in the operating room rather quickly, thereby giving the ED the advantage of being able to accommodate a greater number of victims.
Here are ways to comply with the standard:
• Develop a policy to handle volunteer clinicians. Guerrieri’s ED has developed a policy for credentialing of nonstaff physicians in the event of an emergency or disaster, based on the Joint Commission standard. The policy is as follows:
— The following information will be obtained and verified in order for a physician to be granted emergency privileges:
- Valid professional license to practice in any state in the United States, currently holding active staff privileges.
- Photo identification.
- List of current hospital affiliations where practitioner holds staff privileges.
- Malpractice face sheet (obtained from primary hospital, if available).
— Verification of the above information will be done as soon as possible by the medical staff office.
— The practitioner will be paired with a currently credentialed Gottlieb medical staff member and will act under the direct supervision of a Gottlieb medical staff member.
— The practitioner’s emergency privileges will be for the period during the duration of the disaster only.
• Have volunteers report to their own facility first. Pugh says that the main issue with disaster volunteers is determining who is needed and when. She recommends reporting to your own facility to be dispatched as needed. "Communication should be at the chairman or administrative level of an institution," she adds. The clinicians dispatched then would be known entities, vouched for by their "home" department and institution, she explains. Then, emergency privileges could be granted as outlined by the Joint Commission, she says.
• Create a pre-established list of local physicians willing to help in a disaster. Guerrieri recommends arranging for mutual aid agreements with other local hospitals. "This way, you will know which specialty physicians you can count on," she explains. "This is something that we are working toward."
Sources
For more on the emergency privileging standard, contact:
• Laura Guerrieri, RN, BSN, Director, Emergency Services, Gottlieb Memorial Hospital, 701 W. Melrose Park, IL 60160. Telephone: (708) 450-4988. Fax: (708) 681-1545. E-mail: [email protected].
• Suzanne Pugh, RN, Nurse Manager, Emergency Department, St. Vincent’s Manhattan, 153 W. 11th St., New York, NY 10011. Telephone: (212) 604-2513. Fax: (212) 604-2339. E-mail: [email protected].
The Medical Staff Standard on Emergency Privileging of LIPs for Hospitals — MS.5.14.4.1, can be accessed at the Joint Commission Resources web site, www.jcrinc.com. Search for "MS.5.14.4.1."
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