Q. I’m sure I should have certain processes in place in my practice – just in case an emergency arises – so, could you offer some suggestions?
A. From time to time, unexpected patient crises may occur in the typical office setting. On such occasions, there are several steps risk managers suggest you follow, and certain protocols they recommend you put into place, to ensure any crises are handled effectively.
The first step in managing crises situations is to have operational procedures in place to determine how an emergency will be handled. The procedure could include the responsibilities of all personnel likely to be present. For example, identify the employee who will:
- Meet EMS in the parking lot
- Assist the physician in stabilizing and protecting the patient
- Staff the telephone and front desk during the emergency
Once identified, those individuals should develop procedures that address their assigned tasks. The person responsible for answering the telephone should have a list of all emergency numbers on hand. The staff member responsible for meeting EMS should be familiar with all routes of access to and from the office – and so forth.
Risk management experts recommend these activities be formalized in a comprehensive written procedure, and they suggest that regular drills be conducted so that when an emergency occurs, actions of the staff involved are automatic.
Further, experts recommend that telephone protocols be developed to help staff members recognize medical emergencies and know what to do. That might include instructing a patient to go immediately to the emergency department (ED) or immediately call the physician to the telephone, etc.
Occasionally, a patient will refuse to be transported to the ED by ambulance, or go to the ED at all. If this occurs, risk management experts recommend physicians explain to the patient the seriousness of the condition and associated risks of not following medical advice. This conversation should be thoroughly documented. It is also helpful for the physician to obtain a patient’s signature, acknowledging any refusal to follow the physician’s medical advice.
Though not comprehensive, these guidelines may provide a starting point for physician practices in attempting preparations for the infrequent medical emergency.
Physicians insured by ProAssurance may contact our Risk Management department for prompt answers to liability questions by calling (800) 292-1036 or via email.