INDEX: MS1
EFFECTIVE: 04/30/15
Page 1 of 5
SUPERSEDES: 01/01/15
SUBJECT: Admitting, Dismissal
POLICY STATEMENT: All patients admitted to Hendrick Medical Center must be admitted to the service of an Active Staff Member.
RULES:
A. The Attending Physician.
1. Each patient will be attended by a Member of the Medical Staff with mutual agreement between the patient and Physician except in cases of emergency and then only until arrangements may be made for the patient's private Physician, if such previous relationship exists.
2. Unless they are call partners, Medical Staff Members may not admit to the service of another Medical Staff Member without notifying and obtaining agreement from such Member.
3. Patients will be discharged only on the order of the attending staff Member or authorized agent except in cases where patients sign out of the medical center against medical advice.
B. Miscellaneous.
1. All patients admitted for scheduled surgery will enter the medical center at such a time as to allow completion of appropriate preoperative procedures prior to surgery.
2. Except in the case of emergencies, no patient will be treated in the operating room until that patient, or legal representative, has signed the proper consent authorization for necessary surgery. When conditions exist preventing obtaining valid consent forms, it will be the responsibility of the admitting physician to document the conditions.
3. All sections will be responsible for maintaining continuous coverage for emergency services in each of the specialties and subspecialties represented in the section. Medical Staff members may be exempted from taking unreferred ER call at the age of sixty (60). For additional information including coverage in specialties of less than four (4) Medical Staff members, refer to the following Appendix A. The MEC, at its discretion, may make periodic adjustments to call schedules and requirements.
4. Changes of staff status, including the voluntary resignation of Medical Staff membership, and changes of clinical privileges by Medical Staff Members must be made in writing to the Medical Staff Office. Changes of staff status, including the voluntary resignation of Medical Staff membership, and changes of clinical privileges by Medical Staff Members that affect a section's unreferred call schedule, as determined by Hospital, for the provision of emergency services will not be implemented for at least a minimum of thirty (30) days from the receipt of the written request by the Medical Staff Office.
Recommended by Medical Executive Committee: 08/29/14
Approved by the Board of Trustees: 10/02/14
Initially Approved 06/01/98
Amended: 09/24/04 06/24/05 04/25/08 04/01/10 10/02/14 (implemented 01/01/15) 04/30/15
Reviewed: 02/22/13
Appendix A
Rules for Physicians Taking Unreferred E.R. Call
1. The following specialties are required to take unreferred E.R. call:
· Cardiology
· Cardiothoracic and Vascular Surgery
· Dentistry
· Gastroenterology
· General Surgery
· Nephrology
· Neurology/Teleneurology
· Neurosurgery/Spine Surgery
· OB-Gyn
· Ophthalmology
· Oral Surgery
· Orthopedic Surgery
· Otorhinolaryngology
· Pediatrics
· Plastic Surgery
· Pulmonology
· Urology
2. The following specialties are required to maintain call schedules for continuous coverage:
· Anesthesiology
· Hospitalist
· Pathology
· Radiology/Teleradiology
Rules 3 – 6 listed below apply to the specialties listed in Rule 1.
3. ONE PHYSICIAN IN THE SPECIALTY:
If there is only one Active Staff physician under age 60 in a specialty, then this one physician will take unreferred E.R. call a minimum of 7 days per month. One Saturday and one Sunday per month must be included as 2 of the 7 days of required call. Day is defined as a 24 hour period.
Nothing would preclude the one physician from taking more than one week of call per month.
4. TWO PHYSICIANS IN THE SPECIALTY:
If there are two Active Staff physicians under age 60 in a specialty, then each physician will take unreferred E.R. call a minimum of 7 days per month. For each physician, one Saturday and one Sunday per month must be included as 2 of the 7 days of required call. Day is defined as a 24 hour period.
For both physicians combined, a minimum of 14 days per month of unreferred call will be worked in schedules that do not overlap. Four of these 14 days must include 2 Saturdays and 2 Sundays.
Nothing would preclude the two physicians from taking more than one week of call per physician per month. By mutual agreement of the two physicians, as long as 14 days of coverage is provided for the specialty each month, it would not matter how many days each physician covered.
5. THREE PHYSICIANS IN THE SPECIALTY:
If there are three Active Staff physicians under age 60 in a specialty, then each physician will take unreferred E.R. call a minimum of 7 days per month. For each physician, one Saturday and one Sunday per month must be included as 2 of the 7 days of required call. Day is defined as a 24 hour period.
For all three physicians combined, a minimum of 21 days per month of unreferred E.R. call will be worked in schedules that do not overlap. Six of the 21 days must include 3 Saturdays and 3 Sundays.
Nothing would preclude the three physicians from taking more than one week of call per physician per month. By mutual agreement of the three physicians, as long as 21 days of coverage is provided for the specialty each month, it would not matter how many days each physician covered.
6. FOUR OR MORE PHYSICIANS IN THE SPECIALTY:
If there are four or more Active Staff physicians under age 60 in a specialty, then 24/7 unreferred E.R. call will be provided 365 days per year. The amount of unreferred E.R. call taken by each physician will be determined by the physicians in the specialty with the understanding that the specialty is responsible for continuous coverage for emergency services.