Internal Affairs

As part of my new role, I also wear the hat of Risk Management.  This means that all complaints and reports of medical errors come through my office.  It also means that I get all the “He said, she said” crap that comes with EMS not being accepted as part of the patient care team.

Surprisingly I have received more than one report of a crew “not giving notification via radio” from a hospital.  This often happens when the person who answered the radio was unhappy with the report, lost the triage slip and is in trouble or that the crew simply didn’t make the call.  It happens.  Sometimes we’re busy with a little thing called patient care and our partners driving should not be distracted by talking on the radio while driving if we’re that busy.

 

Now for the best part: The investigation.

 

I go over to the computer and pull up the crew, date and time, review the chart and get a feel for what was going on during the call.  Most importantly I look through the timeline of interventions to see if there was time to make a call, and then I script what my report would have sounded like.

Then I go over to the fax machine and pull out a Request for Radio Traffic Form and pull the tape.

Much like politicians, I think some people forget that everything is recorded these days and simply saying “No they didn’t” can be proven wrong in as little as 24 hours.

When that CD arrives and I listen to a pretty good radio report matching the patient I just read about, then hear a voice aknowlege it I feel great.  My guys did the right thing and I get to play that sound clip to the hospital.

Of course it’s also a drag when I get an email from radio that states “No traffic exists for specified date/time, please check.”  Then I can’t confirm what really happened and have to be the bad guy.

When your CQI calls you on the phone or into the office, it’s not because of some sadistic desire to torture you (despite how much that seems to be the purpose), but because we can no longer find evidence to support your version of events.  I have already been able to deal with most of the complaints that come in by reviewing your documentation, your previous documentation to ensure it wasn’t a fluke, and everything else available to defend your care and demeanor.

Sometimes you just plain screwed up.

Make it easy for me:

Do what’s right, write down what you did, tell the right person when you get there.

 

They’ll still complain, but at least I’ll have the ammo to defend you.

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10 thoughts on “Internal Affairs”

  1. Seems to me as though though ER needs to find better things to do w/ their time. Really, a write up for not calling the hospital? Unless the crew/medic is consistently doing this, it should be chalked up to, “sometimes shit happens”…

    Just my $0.02.

  2. Couldn’t even tell you how many times I get attitude for calling in.

    No, I didn’t miss a “not” there.  I’ve been yelled at by a trauma center nurse for making a required pre-hospital notification call.  Unless it’s a code or horrendous trauma, they don’t generally to hear about it. 

  3. I almost always call in. On the rare occasions I don’t, the ED nurses know me well enough to know there was good reason for not calling in.

    For those that insist on bitching about it, I gently remind them that pre-arrival notification in our system is a courtesy, not a requirement, and the more they show their asses, the less courteous I feel.

    That usually works.

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  5. Reminds me of the time my QI guy pages me to call him “911”. He says the triage nurse at ED X says I never assessed the pt that had a broken hip I did not report. I asked him if he had read the PCR. “No, I just got the complaint from the RN.” I told him to read the PCR then get back to me. First sentence in the narrative,” Pt refused physical exam, VS or assistance of any sort from EMS crew.” Hey paged me back, “Sorry, my bad.”

  6. I especially enjoy the “copy, we’ll see you in 5 minutes” acknowledgement, then the same nurse assumes care of your patient & acts like they had no clue you were on the way. Transporting all of our patients to the same community hospital, it’s easy to know who was taking report on the radio.

  7. Your guys have to call in every patient? Wow, just wow. It’s an ED, they’re supposed to expect the unexpected. Unless it’s a trauma room candidate or someone who needs the cath lab, we just don’t call in before hand.

    1. Our notifications were started in an effort to allow the facility to triage and have a room/bed awaiting our arrival.  Now they demand it and that WE take the triage vitals.  If it’s used to speed up the transfer, great, if not, then why are we doing it?

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