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BatCom401@... wrote:

Ricky,

I must have missed Brad's reply, so I don't know what law you're talking

about. Generally, there is no magic way of documenting turnover, so

long as you have one. A computer based report is a business record just

like all others. The only difference would be that if you have a signed

receipt for the patient, that's better evidence than your written or

computer report, since it can be attacked for accuracy. Perhaps someday

there will be a fingerprint sensor, or an iris sensor on your computer,

and you can just get them to touch it to sign--or, better yet, hold it

before their face sort of like you do a wooden stake to Dracula! ;~)

It would record the person receiving the report.

In the meantime, maybe you could have just a simple receipt form saying

they have received this patient and your report at ___hours, _____date.

As the technology improves, we'll figure out how to do this better.

Gene

E. Gandy, JD, EMT-P

EMS Professions Program Director

Tyler Junior College

Tyler, TX

ggan@...

Check out our website at: http://www.tyler.cc.tx.us/emmt/

> Hey Brad,

>

> Thanks for the response. I am not familiar with this law so Gene, it's your

> turn. I posed this question initially because we conducting our patient

> reports via computer. Pen based is not up to scale yet, therefore, paramedics

> were having to complete a written report, have the nurse sign it and return to

> quarters to duplicate the report by entering it into the computer. The long

> range goal is to implement pen based computerization. But today, and hence

> the question, I would like to have the medics take the patient in, provide a

> verbal followup from their phone patch, assist if needed, clear the hospital,

> return to quarters, complete the report and send the " FULL DETAILED " report to

> the hospital via fax/modum. As always, I want to entertain your thoughts on

> this because someone will always have a better idea or may shed some legal

> issues on this idea. Look forward to hearing from each of you.

>

> Ricky Black, Battalion Commander

> Southlake Fire Services

>

> ______________________________________________________________________

>

>

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Southwest Texas CISM, Inc serves TDH region 8.

24 hour emergency line 1-

e Kern, EMT-P

SWTCISM Clinical Director

______________________________________________________________________

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E. Gandy wrote:

>

> Jack Pitcock wrote:

> >

> > Good Evening...

> >

> > We do not require our medics to obtain a nurse or physician signature on the

> > patient chart. We do require that a copy of the chart be left with the

> > patient's records in the emergency department.

> >

> > Jack Pitcock, EMT-P

> > EMS Coordinator

> > Baytown Health Dept EMS

> > Baytown, Texas

>

> Jack,

>

> In the event of a legal dispute over when and to whom care of your

> patient was transferred to the hospital staff, how would you prove it?

> If the patient claimed abandonment by your employees, do you have a

> legally sufficient and admissible record showing who received the

> patient and when?

>

> Gene

>

> --

> E. Gandy, JD, EMT-P

> EMS Professions Program Director

> Tyler Junior College

> Tyler, TX

> ggan@...

>

> Check out our website at: http://www.tyler.cc.tx.us/emmt/

>

> ______________________________________________________________________

>

>

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Good Evening Gene....

We do note the name of the nurse/physician receiving our patients on the EMS

patient chart.

Jack

> [] Re: RE: quiet

>

>

> Jack Pitcock wrote:

> >

> > Good Evening...

> >

> > We do not require our medics to obtain a nurse or physician

> signature on the

> > patient chart. We do require that a copy of the chart be left with the

> > patient's records in the emergency department.

> >

> > Jack Pitcock, EMT-P

> > EMS Coordinator

> > Baytown Health Dept EMS

> > Baytown, Texas

>

> Jack,

>

> In the event of a legal dispute over when and to whom care of your

> patient was transferred to the hospital staff, how would you prove it?

> If the patient claimed abandonment by your employees, do you have a

> legally sufficient and admissible record showing who received the

> patient and when?

>

> Gene

>

> --

> E. Gandy, JD, EMT-P

> EMS Professions Program Director

> Tyler Junior College

> Tyler, TX

> ggan@...

>

> Check out our website at: http://www.tyler.cc.tx.us/emmt/

>

>

>

> ______________________________________________________________________

>

>

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Another way to tackle this problem may be cooperation:

If the hospital you are delivering the patient to is a dispro facility, they

are

required to participate in the RAC and to report pre hospital information to the

state. Simply stated, if they are not cooperating, they may be blind siding

themselves. They may need your information as much as you need theirs. I am sure

that the hospital administration may see the need to cooperate more than the

E.R.

staff. You may need to get them involved. We have not had the experience of

nursing

staff refusing to sign as of yet.

As far as providers leaving copies of the report with the hospital. I don't

believe it states you have to leave the final copy of the report. ( I could be

wrong

of course) We have designed a multi copy form that has the basic information

that

the hospital must have to report to the state and room for a narrative and

signature, the medic and the e.r. staff. We then take our copy back to the

station

and generate a computer report for our records. We attach the hospital copy to

the

computer report for our files. We designed the hospital report around the exact

pre

hospital data that the state needs from the hospital. We have found that this

simplifies the data entry for the hospital and minimizes the number of times

hospitals have to contact us for additional information.

I don't think sending a copy to the hospital later meets the intent of the

rule

or benifits the patient or the hospital E.R. Staff. I will certainly pull my

provider rule tomorrow and see if that is even allowed.

Henry Barber

E. Gandy wrote:

> BatCom401@... wrote:

> Ricky,

>

> I must have missed Brad's reply, so I don't know what law you're talking

> about. Generally, there is no magic way of documenting turnover, so

> long as you have one. A computer based report is a business record just

> like all others. The only difference would be that if you have a signed

> receipt for the patient, that's better evidence than your written or

> computer report, since it can be attacked for accuracy. Perhaps someday

> there will be a fingerprint sensor, or an iris sensor on your computer,

> and you can just get them to touch it to sign--or, better yet, hold it

> before their face sort of like you do a wooden stake to Dracula! ;~)

> It would record the person receiving the report.

>

> In the meantime, maybe you could have just a simple receipt form saying

> they have received this patient and your report at ___hours, _____date.

>

> As the technology improves, we'll figure out how to do this better.

>

> Gene

> E. Gandy, JD, EMT-P

> EMS Professions Program Director

> Tyler Junior College

> Tyler, TX

> ggan@...

>

> Check out our website at: http://www.tyler.cc.tx.us/emmt/

>

> > Hey Brad,

> >

> > Thanks for the response. I am not familiar with this law so Gene, it's your

> > turn. I posed this question initially because we conducting our patient

> > reports via computer. Pen based is not up to scale yet, therefore,

paramedics

> > were having to complete a written report, have the nurse sign it and return

to

> > quarters to duplicate the report by entering it into the computer. The long

> > range goal is to implement pen based computerization. But today, and hence

> > the question, I would like to have the medics take the patient in, provide a

> > verbal followup from their phone patch, assist if needed, clear the

hospital,

> > return to quarters, complete the report and send the " FULL DETAILED " report

to

> > the hospital via fax/modum. As always, I want to entertain your thoughts on

> > this because someone will always have a better idea or may shed some legal

> > issues on this idea. Look forward to hearing from each of you.

> >

> > Ricky Black, Battalion Commander

> > Southlake Fire Services

> >

> > ______________________________________________________________________

> >

> >

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<html><div>Since I have been integrally involved in the Houston Fire

Department's transition to the pen-based computers, I guess I respond to

thes posts. & nbsp; Basically, the system is supposed to work as you

note. & nbsp; However, as with all new technology, there are glitches and

lack of compliance problems.</div>

<br>

<div>Actually the system should work better than you note - When we send

the records via the cell phone, the fax should be at the fax machine in

the hospital ER within 5 minutes. & nbsp; However, there are several

possible delays in the system:</div>

<div>1) & nbsp; User compliance - Though the paramedics using this system

are getting better, there are still compliance problems with two areas;

completing the records in a timely fashion and completing the records

within the parameters of the computer program.</div>

<div>2) & nbsp; Network problems - Currently, the network that runs the

system is monitored by our current records clerks. & nbsp; These folks are

not used to the system yet and do not have enough training with the

system, IMHO. & nbsp; Our previous records system worked on a COBOL based

computer and the clerks don't all have experience with Windows based

computers.</div>

<div>3) & nbsp; Hospital problems - We notified all of the hospitals over a

year and a half ago that we woiuld be converting to this system and

asking them for their ER fax numbers. & nbsp; Let me say that compliance

was NOT universal. & nbsp; & nbsp; In fact, one medical center hospital that

will remain nameless gave us the number of a fax machine that either 1)

they only turn on when they know they are getting a fax or 2) is always

broken. & nbsp; The other hospital problem is the paperwork shuffle. & nbsp;

If there is not someone who follows up and makes sure this information is

on the chart (i.e. gets transfered from the fax to the chart), then that

is beyond HFD's control.</div>

<br>

<div>In the six months that I was doing training for the laptop system,

we did not have one complaint from the hospitals about missing run

records that I am aware of personally.</div>

<br>

<div>As with any new technology, there is always a period of transition

that can cause problems. & nbsp; The software we use is also not without

faults (it is new software, not Westech or other widely available

software), but it works well when all the pieces fall together.</div>

<br>

<div>As for the printer, we tested another system that did have a printer

attachment and it was more trouble than it was worth.</div>

<br>

<div>If anyone has questions about our system, email me privately at

MMMeyer1@..., or call Jay Barkdull, the system coordinator, at

.</div>

<br>

<div>The above views are mine only and not those of my employer.</div>

<BR>

<font face= " Times New Roman, Times " >Marc M. Meyer, RN, MS, EMT-P,

EMS-I/E<br>

Firefighter/Paramedic, Houston Fire Department<br>

EMS District Training Officer, Cy-Fair Volunteer Fire Department</font>

</html>

______________________________________________________________________

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