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Hi
all,
You all have probably discussed this before but... I am in a Level
III center. We have had some intermittent issues with coverage in Neurosurgery
and Orthopedics. For the most part we have been covered 100% since the issue
arose where we were without coverage in these two specialties sometimes as
long as 16 hours. We are a sole community provider and our nearest center is a
Level I and about 1 hour away.
Obviously I can not divert what comes in straight off the street -
we can stabilize and ship. We don't accept transfers in when we are without
coverage.
In the
development of a policy about call / coverage what are some important
things that you all have found to have included? How much notice must the
section provide us with prior to an uncovered period?
The
other issue that arose with Ortho - was because there were several practices in
town - who we referred patients to when no one was taking the call was an issue.
Also, with Ortho - what happens during a period of uncovered call when one of
their patients came in with say a septic hip or some complication related to the
procedure that was done? Most of the time other facilities won't take other
facility problems. How do I cover this in the policy? Do we admit to a
hospitalist and post-pone operative debridement until after the 12 hours? That
hardly seems ethical - but I don't know? We have never had these things happen
during the uncovered call periods - but the potential exists and I want to
provide the hospital with some feedback on how to perhaps resolve this potential
issue.
With
neuro - there is only one practice - so we refer to them for outpatient issues.
We haven't seen any returns that were requiring urgent O.R. - but how do we
anticipate and cover this in a policy type format?
I
appreciate any feedback that you all can provide.
Lisa
McLaughlin, RN
Trauma
Nurse Coordinator
St.
Vincent Hospital
Santa
Fe, NM 87501
505-820-5708
505-995-4921 (fax)
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