Here are sample surveyor questions
Accreditation surveyors who come to the ED at night may ask you the following questions, according to Kathleen Catalano, RN, JD, director of administrative projects at Children’s Medical Center of Dallas. "These were actual questions asked during an after-hours survey by a physician surveyor," she adds.
• Is this the triage for both fast track and the ED?
• Do you have triage guidelines? Where are they?
• Do patients receive any medications here? Are there criteria or guidelines you follow for that?
• If a child arrives without his/her parents, when do you see them? Can you treat them? Under what conditions? What about those who say, "I think I’m pregnant?"
• Do you perform developmental assessments on patients?
• Where do you keep your medications in this area?
• What if you have an HMO patient, and the physician says to send the patient over to his/her office?
• How many monitors do you have here?
• Can we go to one of your trauma rooms?
• How many physicians do you usually have on duty?
• Do you have all the equipment and supplies you need here?
• Is that camera used to video your codes?
• Do you have narcotics here? Who can get into them?
• How often does housekeeping come?
• How many rooms do you have altogether?
• Do you shift staff between the fast track and the ED? What about medical staff?
• How many attendings are there?
• How many residents?
The surveyor then gave a potential case scenario and questioned about that situation:
• What orders probably would be given?
• What fluids?
• What dose?
Back to regular questioning:
• Do you have any plugs that are not red?
• Are you aware of any performance improvement studies done in the ED? Do you have the results of those studies?
• What is your typical age range?
• Do you have an OB pack here? (Surveyor mentioned that there should be two OB packs — one for backup.)
• What would you do if a patient’s father came in and pulled a gun?
• There are tornados on the rise, what do you do? Do you evacuate? Where do you evacuate to?
• What happens if someone calls and says there are computer problems? Are you so dependent on computers that you have no other ways to run the ED?
• Do you allow home medications to be given? Under what circumstances? What about inhalers?
• Do you ask the patient about herbal and oral medications he/she is on?
• When patients are in the ED, where do the parents stay?
• Do you do any procedures here in the ED? What procedures can you do here?
• When setting broken bones, what medications do you use?
• Who reads the X-rays? Which physicians? ED or radiology?
• What about child abuse? How is the patient handled?
• Where is the chain of evidence kept?
• When you have a child abuse situation and it’s after hours, what do you do?
• Do you have an obligation to report suspected child abuse? How do you do that?
• What about violent patients? How do you handle that?
• Do you have to use restraints? When was the last time? Who assesses the patient to see if the patient’s needs are met? When the patient is in restraints, who checks the patient? Do you remain with that patient? Orders for restraint are written for how long? Restraints are released when? Do you educate the patient about restraints? What if the patient is a child — do you educate the parents as well?
• If you have a trauma case here, how is the blood provided?
• How do you get the blood?
• Do you require consents for blood?
• Do you require consents for anesthesia (sedation)?
• Do you require consents for procedures?
• Do you do any clinical research here? Do patients have to sign a consent for research?
• If a patient does not have a physician, how are they followed?
• How are second-degree burns handled if on a patient’s hand?
• If a patient has had a seizure, where and when is follow-up done?
• If a patient comes in and has no money to pay for medications, what do you do?
• What splinting materials do you use?
• What tests do you perform in this soiled linen room?
• Do you have competency reviews?
• Is every staff member performing that type of test colorblind tested?
• What happens if a patient needs chemotherapy in the middle of the night?
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