Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 117 - EMERGENCY SERVICES › POLICIES AND PROCEDURES › Section 117.41 - Emergency patient care

Current through Register Vol. 54, No. 28, July 13, 2024
(a)
					 Emergency patient care shall be guided by written policies and procedures which
					 delineate the proper administrative and medical procedures and methods to be
					 followed in providing emergency care. These policies and procedures shall be
					 clear and explicit; approved by the medical staff and hospital governing body;
					 reviewed annually; revised as necessary; and dated to indicate the date of the
					 latest review or revision, or both.
(b) Policies and procedures for emergency
					 patient care should, at a minimum, do the following:
(1) Provide for the admission of a patient
					 if, in the judgment of the physician, admission is warranted.
(2) Provide for the referral and placement of
					 patients whose needs cannot be met by the hospital.
(3) Establish procedures to minimize the
					 possibility of cross-infection and contamination.
(4) Provide for the discharge of patients
					 only upon written orders of a physician. Telephone discharge orders may be
					 accepted in accordance with §
												107.62 (relating to oral
					 orders).
(5) Specify explicitly the
					 location and mode of storage of medications, supplies and special
					 equipment.
(6) Establish methods
					 for 24-hour-a-day procurement of equipment and drugs.
(7) Establish procedures for notification of
					 the personal physician of the patient and the transmission of relevant reports
					 to the physician.
(8) Establish
					 procedures on disclosure of patient information. Policies on confidentiality of
					 emergency room records must be the same as those which apply to other hospital
					 medical records. The identity and the general condition of the patient may be
					 released to the public after the next of kin have been notified.
(9) Plan for communication with police, local
					 or State health or welfare authorities as appropriate, regarding accident
					 victims and patients whose condition or its cause is reportable, for example,
					 persons having contagious diseases or victims of suspected criminal acts such
					 as sexual assault or gunshot wounds, see
					 18 Pa.C.S. §
													5106
					 (relating to failure to report injuries by firearm or criminal act), and child
					 abuse, see 23 Pa.C.S. Chapter 63 (relating to Child Protective
					 Services).
(10) Instruct personnel
					 in special procedures for handling persons who are mentally ill, under the
					 influence of drugs or alcohol, victims of suspected criminal acts or
					 contaminated by radioactive material or who otherwise require special care or
					 have other conditions requiring special instructions.
(11) Instruct personnel how to deal with
					 patients who are dead on arrival.
(12) Provide for a review by the appropriate
					 committee of the medical staff of each death occurring on the emergency service
					 or, if there is no service, of each death occurring during the performance of
					 essential life-saving measures prior to transfer to another facility.
(13) Explain the role of the emergency
					 service in the hospital's disaster plan established in accordance with Chapter
					 151 (relating to fire, safety and disaster services).
(14) Delineate medical staff obligations for
					 emergency patient care.
(15)
					 Specify which procedures may not be performed in the emergency area.
(16) Provide for appropriate utilization of
					 any beds used for observation.
(17)
					 Establish procedures to be used when the patient is required to return to the
					 hospital for treatment, for example, when treatment is impossible to arrange
					 otherwise.
(18) Establish
					 procedures for early transfer of severely ill or injured patients to special
					 treatment areas within the hospital, such as the surgical suite, the intensive
					 care unit or the cardiac care unit.
(19) Delineate instructions to be given to a
					 patient or the patient's family, or both, or others as appropriate regarding
					 follow-up care.
(20) Make available
					 to the emergency service current toxicological reference material along with
					 the telephone numbers of the regional poison control center.
(21) Provide for the ready availability of
					 reference materials and charts relating to the initial treatment of burns,
					 cardiopulmonary resuscitation and tetanus immunization.
(22) Provide for effective coordination with
					 outpatient services, where these services are provided.
(23) Establish procedures to clearly inform
					 patients of emergency service billing policies, including prominent display of
					 that information in the emergency service area. This information must indicate
					 whether patients are to be billed separately for physicians' services and other
					 emergency services. Those hospitals having an obligation under section 2 of the
					 Hospital Survey and Construction (Hill-Burton) Act (42 U.S.C.A. §§
													291-291o), shall comply with the
					 provisions of that act as it relates to free and low-cost
					 care.