Patient Safety and Quality

  • 1.  Policy for transfer from office to hospital

    Posted 07-08-2020 16:02
    Hi -

    We're working on a policy for sending patients from the office to hospital in the setting of various acute conditions - eg severe-range blood pressure, preeclampsia w/ severe features, etc.  Hoping folks might be willing to share any guidance on when it is reasonable for a companion to drive a patient to the hospital vs. when to call an ambulance.

    Thanks in advance for any existing policies!

    -Alison

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    Alison Stuebe
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  • 2.  RE: Policy for transfer from office to hospital

    Posted 07-09-2020 13:04
    Allison -

    This is a great question for which there is virtually no published guidance.
    My practice does not have a protocol or guideline.

    This blurb appears in an undated online article in the Journal of Urgent Care Medicine (which is not indexed in pubmed):

    Mode of Transport
    The choice between EMS and a personal vehicle cannot be made lightly, and requires consideration of several factors: Is the patient alone? Do they have a reliable driver? Is there a chance the patient may deteriorate? Do the patient and family understand the severity of their illness, and will go straight to the ED?  EMS is a viable option for transport, and is the obvious choice if the patient is unstable or if you are anticipating the patient to deteriorate during transport.

    I interpret this to mean "Use common sense" - but that's hard to write into a guideline.

    EMS/NHTSA published a 50-page Guide to Interfacility Patient Transfer in 2006
    It makes no mention of medical offices anywhere.

    I will be very curious to see whether anyone else chimes in with a protocol or guideline that they use.

    Regards,
    Andy
    ______________________________
    C Andrew Combs MD, PhD
    Patient Safety & Quality Committee, SMFM
    Women's Services Safety & Quality Committee, GSH
    Program Commitee, Pacific Coast Ob Gyn Society

    Obstetrix Medical Group, an affiliate of Mednax
    900 East Hamilton Avenue, Suite 220
    Campbell, California 95008

    E-mail: andrewcombs@me.com
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