Corporate Compliance

Tip: Help your facility manage the on-call crisis

Compliance Monitor, March 24, 2004

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Many hospitals have problems getting their physicians to serve on call. Here are some ideas to help manage the problem:

1. Expand hospital bylaws. A provision should indicate that all physicians, regardless of category, must participate in the ED call schedule, as determined by the medical executive committee.

  • Eliminate rules from the existing bylaws that excuse physicians above a certain age, as well as rules that excuse physicians who have served long and faithfully in the ED.
  • If call is more desirable for certain specialties than for others, reserve on-call responsibilities for those specialties to active staff members. For other specialties, where on-call responsibility is less desirable, all physicians who possess expertise in the underlying clinical area would share on-call duties.

    2. Start a task force. When developing bylaws, the MEC, management, and the board should convene a special task force to look into the issue of ED backup and devise short- and long-range solutions. Be sure to review the following material:

  • Applicable state laws and licensure regulations
  • Federal statutes that pertain to the hospital's obligation to provide emergency service, specialty back-up, and stabilizing care, e.g., COBRA and EMTALA guidelines
  • If the facility is designated Level I, II, or III trauma center, the applicable American College of Surgeons guidelines regarding availability of specialty backup
  • Local and state emergency medical services protocols that may apply to any given hospital and its ED

    This tip was excerpted from A Practical Guide to EMATLA Compliance by Joseph Gatewood, Esq., Loren Johnson, MD, FACEP, and Ellen Arrington, RN, BSN. Copyright 2004 by HCPro Inc. For more information, click here.



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