Adding to the DCFEMS “Patient Bill of Rights”

DC FEMS Abulance from Daquela manera on flickrJust saw this on Facebook and I'm sure the blogosphere will jump all over this in the coming weeks but I wanted to do some editing of my own first.  My additions are in BOLD.

This was downloaded from the DCFEMS website and is in the public domain.  And like most "Bill of Rights" they clearly come from a long history of trouble situations.

 

As our patient, you have the right to expect competent and compassionate service from us. This is kind of a given, isn't it?  That the people I call for help will know what they're doing and care?  But, I guess we do need to start on a high note, so good job there.

If you have any questions, comments, compliments, or complaints about our service you are encouraged
to call the Office of the Fire & EMS Chief at 202-673-3320, or email us at director.fems@dc.gov.  Nice

You may expect: You may also expect the clerk at the store to know how to use the cash register I'd prefer somethign along the lines of "We will do our best :"

1. To receive timely and appropriate medical services without regard to age, race, religion, gender, sexual orientation, national origin, disability, or any other protected class. No brainer

2. To be transported in a clean and properly maintained ambulance to an appropriate medical facility. We may not be able to take you to the hospital of your choice. GOLD! Get that out there now! Well Done!

3. That we will never refuse to transport you and we will never use any method to discourage you from receiving medical treatment or transportation. You forgot "when appropriate."  Is #4 to add taxi strips to the vans?

4. To have your vital signs checked and documented whether or not you are transported to a hospital. No brainer

5. To have your past medical history, medications and your current complaint of illness or injury, along with the assessment, interventions and treatment performed by our emergency personnel, thoroughly and truthfully documented on your patient care report. No brainer

6. That your patient care report and protected health information will be securely retained and stored, remain confidential and be available for your review, as required by law. This is already on the HIPAA form we're required to have them sign, right?

7. That you can refuse drugs, treatment, procedures or transportation offered to the extent permitted by law, and to be informed of the potential consequences of the refusal of any drugs, treatment, procedures or transportation. OK, but this reads as if they can order MONA ala cart, then blame us later.

8. That all of our personnel who come to help you will be clean, neat, dressed in the appropriate uniforms, and looking professional. Now I have to comb my hair and chew gum at 3AM?  This is more of a Department rule, rather than a patient "right."

9. That our personnel will explain to you or your family what is being done to assist you, and we will answer any questions you may have about your treatment. If you speak another language, assistance will be provided so you can make informed health care decisions.  No brainer

10. That all of our personnel will be polite, compassionate, considerate, empathetic, respectful and wellmannered.
Any employee will furnish their unit number and Fire/EMS Department ID number upon request. I like this one actually.

11. That your privacy, modesty and comfort will be our concern.  No brainer

12. To receive, upon request, a reasonable explanation of any charges for emergency medical care provided by us.  WHOA! Hang on there a minute! Are we going to carry billing sheets with different charges?  Perhaps in menu form?  "I'd like a BLS transport with bandaging…but…Ooooh! Is that a special on splinting?!?!"

You have the responsibility:
1. To cooperate with our personnel so we can provide the best and correct type of care for you.  That's it? Really?  This is the end of the document, so I guess the patient responsibilities need to be filled in by me.

 

Continued as ammended by yours truly:

2. To not lie, coerse, misinform or make false claims to the persons caring for you.

3. To make every effort to have non-emergent conditions addressed during normal business hours and within 24 hours of the onset of symptoms.

4.  To, when appropriate, make child care arrangements prior to transport rather than suddenly realizing our rescuers have no car seats.

5.  To remove all weapons, elicit medications and evidence of crimes before calling for a non-related issue.

6.  To understand you are responsible for payment for services rendered, regardless of insurance status or government program status.

7.  That those who respond to help you are not your employees, nor are they required to follow your every request, especially those involving moving furniture, shopping for groceries or picking up friends enroute to the hospital.

8.  To remain at the destination facility until evaluated by a physician.

9.  To act on the recommendations of said physician so as to not endanger your clearly fragile health condition and demanding transport 12 hours from now.

10.  To stop smoking.

11. To exercise more.

12.  To eat healthier.

I think that about covers it.  More in depth analysis of the pros and cons no doubt to come online today, but I am, more or less, in favor of what it says, but like mandatory seatbelt policies, it should not be necessary.

 

Agree? Disagree? Have something to add? Why not leave a comment or subscribe to the RSS feed to have future articles delivered to your feed reader?

18 thoughts on “Adding to the DCFEMS “Patient Bill of Rights””

  1. How about, “You have the right to an alternative to DCFEMS?”

    The whole system is rotten to the core. When rot is pervasive and endemic, you don’t tweak the system. You scrap the whole necrotic mess and rebuild from the ground up. They have a problem providing professional and prompt emergency medical care.

    So rather than focus on improving their weakness, what do they do? They expand their mission and become an “all hazards” agency. Apparently, stupidity is an airborne illness in D.C.

    They’d do better to scrap their entrenched administrative leadership and start over, beginning with hiring a medical director with the power to actually make changes, not just be an impotent figurehead subject to the whims of the chief and the intransigence of the union leadership. The landscape of D.C. is littered with the professional corpses of stellar physicians who excelled in other EMS systems and thought they could turn DCFEMS around.

    Every one of them failed.

    Rather than window dressing like a “Patient’s Bill of Rights,” Mayor Gray might do better to figure out why that is so.

  2. How about, “You have the right to an alternative to DCFEMS?”

    The whole system is rotten to the core. When rot is pervasive and endemic, you don’t tweak the system. You scrap the whole necrotic mess and rebuild from the ground up. They have a problem providing professional and prompt emergency medical care.

    So rather than focus on improving their weakness, what do they do? They expand their mission and become an “all hazards” agency. Apparently, stupidity is an airborne illness in D.C.

    They’d do better to scrap their entrenched administrative leadership and start over, beginning with hiring a medical director with the power to actually make changes, not just be an impotent figurehead subject to the whims of the chief and the intransigence of the union leadership. The landscape of D.C. is littered with the professional corpses of stellar physicians who excelled in other EMS systems and thought they could turn DCFEMS around.

    Every one of them failed.

    Rather than window dressing like a “Patient’s Bill of Rights,” Mayor Gray might do better to figure out why that is so.

  3. While I agree that the vast majority of these should be a given, remember, this is DCFEMS we’re talking about. It’s like if FDNY put something about expecting their employees to give a damn when in uniform and on a break. Sure, it should be given, but there’s a history there.

    For 12, sounds like a good idea. How many services do you accept where you won’t know the price until after the service is rendered without even an estimate? Would you choose an insurance company who wouldn’t tell you upfront what your deductible and copay is? Would you get your car repaired at someplace that doesn’t provide at least an estimate?

    Similarly, for the patient responsibilities, I disagree with their 1 bullet point. “Cooperation” is all too often defined as submitting to the treatments that the provider believe are indicated. I have every right to be non-cooperative with interventions and procedures that I believe are unnecessary, contraindicated, or simply not indicated. As an individual, I have the sole authority to authorize any treatment provided I have capacity. If I don’t want to have oxygen placed on me, I have every right to be “uncooperative” to the limit of preventing application. Yes, the providers have a right not to be abused, physically, verbally, or any other abuse, but there’s a difference between that and carte blanche cooperation.

    3: Who defines the emergency? What about urgent situations? If I break my leg causing significant pain, my life is not in danger, but wouldn’t a more appropriate transport decision be via a service that can provide pain management with a rolling bed instead of trying to get into and out of a car? What if I don’t have transport readily available? Opps, sorry, but since you don’t have anyone to drive you to the hospital and you can survive for the next 10 hours until normal business hours, don’t call us?

    Does 5 mean that people who are legally carrying firearms concealed or openly should not call 911 until they can secure their firearm? Is someone who is armed a de facto danger? If you’re inside, say, a movie theater when armored transport arrives to provide the theater with their change order and remove yesterday’s revenue, do you back out until they leave?

    Shouldn’t 10, 11, and 12 apply to the responders as well? Isn’t the biggest hazard to fire fighters cardiac disease?

  4. While I agree that the vast majority of these should be a given, remember, this is DCFEMS we’re talking about. It’s like if FDNY put something about expecting their employees to give a damn when in uniform and on a break. Sure, it should be given, but there’s a history there.

    For 12, sounds like a good idea. How many services do you accept where you won’t know the price until after the service is rendered without even an estimate? Would you choose an insurance company who wouldn’t tell you upfront what your deductible and copay is? Would you get your car repaired at someplace that doesn’t provide at least an estimate?

    Similarly, for the patient responsibilities, I disagree with their 1 bullet point. “Cooperation” is all too often defined as submitting to the treatments that the provider believe are indicated. I have every right to be non-cooperative with interventions and procedures that I believe are unnecessary, contraindicated, or simply not indicated. As an individual, I have the sole authority to authorize any treatment provided I have capacity. If I don’t want to have oxygen placed on me, I have every right to be “uncooperative” to the limit of preventing application. Yes, the providers have a right not to be abused, physically, verbally, or any other abuse, but there’s a difference between that and carte blanche cooperation.

    3: Who defines the emergency? What about urgent situations? If I break my leg causing significant pain, my life is not in danger, but wouldn’t a more appropriate transport decision be via a service that can provide pain management with a rolling bed instead of trying to get into and out of a car? What if I don’t have transport readily available? Opps, sorry, but since you don’t have anyone to drive you to the hospital and you can survive for the next 10 hours until normal business hours, don’t call us?

    Does 5 mean that people who are legally carrying firearms concealed or openly should not call 911 until they can secure their firearm? Is someone who is armed a de facto danger? If you’re inside, say, a movie theater when armored transport arrives to provide the theater with their change order and remove yesterday’s revenue, do you back out until they leave?

    Shouldn’t 10, 11, and 12 apply to the responders as well? Isn’t the biggest hazard to fire fighters cardiac disease?

  5. I’m thinking of a # 13 – Pt should make an attempt to bathe before picking up the phone to call 911.
    Or was I an ER nurse too long?

  6. I’m thinking of a # 13 – Pt should make an attempt to bathe before picking up the phone to call 911.
    Or was I an ER nurse too long?

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