EMTALA Keep it Short and Simple (KISS) Principles
For the hospital staff and emergency physicians inquiries:
• Do you want to see a doctor?
• I’ll take you to the ED.
ED:
• Log ALL patients.
• Medical screening exam for all patients by physician.
— If not, document why
— Left without treatment
— Refused
• Treat all patients to a reasonable disposition in the ED.
Transfers:
• Obtain acceptance from the receiving facility and complete a transfer form on ALL patients not otherwise being routinely discharged.
• Accept ALL transfers if the hospital has the capacity (bed available and ever done it before) to treat the presenting problem. If not, document why.
Reporting:
• Set up a system for reporting suspicious transfers.
• Report ALL suspicious transfers to you and ALL suspicious refusal to accept outgoing transfers.
• Document ALL incoming and outgoing transfers.
For the medical staff physician
If you are called — you are chosen if on-call for the ED:
• Respond appropriately: No excuses, no complaints.
• The emergency physician dictates appropriateness unless or until you assume care of the patient.
Transfers:
• Accept ALL transfers if the hospital has the capacity (bed available and ever done it before) to treat the presenting problem. If not, document why.
• Obtain acceptance from the receiving facility, and complete a transfer form on ALL patients not otherwise being routinely discharged.
ED Patient Follow-Up:
• Do what you agreed to do later or come to the ED.
• Do not demand payment up front or refer back to the ED if unable to pay or a non-contracted health plan.
Reporting:
• Set up a system for reporting suspicious transfers.
• Report ALL suspicious transfers coming to you and ALL suspicious refusals to accept outgoing transfers.
• Document ALL incoming and outgoing transfers.
How can I help you with this patient?
Source: Todd Taylor, MD, FACEP, Good Samaritan Regional Medical Center, Phoenix.
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