Lessen "Boarder" Risks With These Three Practices
When an ED patient is being held while waiting for an inpatient bed, Rolf Lowe, JD, an attorney with Rogers Mantese & Associates in Royal Oak, MI, says "there is no bright line cut off for liability. Substandard care in the ED that has an effect on the patient's outcome can result in liability for the EP and the ED staff."
If the hospital utilizes a hospitalist for admitting patients, the hospitalist typically will become responsible once the patient is on the floor, says Lowe.
"In hospitals that utilize an 'on call' physician for admissions, the EP should have an understanding of the hospital policies," he adds. "In most instances, it can be presumed that the patient becomes the admitting physician's patient upon transfer to the floor."
To reduce risks of lawsuits involving boarded patients, Lowe recommends these practices:
1. The EP should make a conscious effort to be informed about the patient waiting to be transported to the floor.
"The patient's condition will dictate the type of attention the EP should give the patient while they are waiting to be transferred," he says, such as performing periodic reassessments.
2. EPs should make a point of asking nurses to inform them when the patient has left and that their condition was unchanged.
"There is no sure-fire way to eliminate potential exposure for claims following a patient's admission," says Lowe.
However, he says that compliance with the hospital policies and procedures and acceptable standard of practice and care for the presenting condition and eventual diagnosis, along with good documentation, will reduce legal risks for EPs.
3. Oncoming EPs should make sure they are aware of the patient's presenting condition, diagnosis, and current status.
While there is no need to question the diagnosis they are given from the EP they are relieving, oncoming EPs should consciously perform their own exclusions based on the information they have, and after having seen and/or examined the patient, says Lowe.
"Charting this is an important factor," he says. "It will show that the EP didn't just accept the patient and push them on to the floor."
When an ED patient is being held while waiting for an inpatient bed, Rolf Lowe, JD, an attorney with Rogers Mantese & Associates in Royal Oak, MI, says "there is no bright line cut off for liability. Substandard care in the ED that has an effect on the patient's outcome can result in liability for the EP and the ED staff."You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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