The Rules and Regulations of the medical staff were revised by the MEC and approved by the Board of Trustees on October 31, 2017, to address regulatory requirements of the NJ DOH relative to the timeliness of consultation. The following is the approved policy:
EMERGENCY DEPARTMENT OR INPATIENT CONSULTATION:
1. Emergent – requests designated as “emergent” indicate that the requesting clinical provider wishes to present a patient to the on-call physician and that the patient’s condition requires the on-call physician’s prompt response. Since patient outcome in emergent cases may be directly related to care provided by the on-call physician, that physician shall respond by telephone within 20 minutes of receiving a call from hospital clinical staff. In addition, the treating physician present in the hospital and the on-call physician shall discuss and agree upon an appropriate in-person response time for the on-call physician. The in hospital practitioner requesting the emergent consultation may be an Attending physician, resident, fellow, or advanced practice nurse or physician’s assistant.
2. If the physicians or practitioners are unable to reach an agreement as to an appropriate in-person response time for the on-call physician, then the opinion of the treating physician present in the hospital shall govern. However, with regard to patients aged 18 or under, if an in-person response is required, the in-person response time shall not be longer than 60 minutes after the initial call to the on-call physician.
3. The in hospital physician and staff shall note on the patient’s medical record the events occurring during the patient’s stay in the emergency department and the hospital. The hospital shall monitor that information and the hospital quality improvement staff shall review that information at least quarterly
4. Urgent consultation – For urgent consultation, the consulting service should be notified directly (not through EMR order alone) by telephone or secure text. Response to that communication for urgent consultation should be within 2 hours. In person consultation from the service should be performed within a time agreed upon by the consulting and consultant services, but no longer than 24 hours from the time of consultation. Documentation of consultation by the attending physician should be completed within 24 hours.
5. Routine – For routine consultations, the consultants may be notified directly by phone, or secure text , or, at the consulting services discretion, via the EMR. Consultation should be completed and signed by the consulting attending within 48 hours of initial consultation order.
6. If there is no response from the consulted service, then the appropriate Department Chief and/or Division Head will be notified of failure to response. The physician leader must arrange for immediate patient care needs.
a. The Department Chief will discuss the matter with the offending physician; informing him/her that failure to call back within the allotted time for any level of consultation violates state regulation and medical staff rules, compromises patient care, and may result in disciplinary action up to an including loss of Cooper Medical Staff privileges.
b. Repeat offenders may be referred to hospital Peer Review.
7. All consultations require an electronic summary of recommendations immediately available to the referring provider.
Thank you for your attention and providing timely care to our patients.
Eric Kupersmith, MD, SFHM
Senior Vice President