How Scheduling Software Supports Your Hospital’s On-Call Policy
The Emergency Medical Treatment and Labor Act (EMTALA) is a federal law enacted in 1986 to combat the practice of “patient dumping.” Patient dumping occurred when private hospitals transferred uninsured patients or those with Medicaid coverage to public hospitals without first examining the patient to ensure that they were stable enough to be safely transferred.
The two keys to establishing patient stability are a medical screening evaluation and necessary treatment. This means that, for most hospitals, a cornerstone of EMTALA compliance is maintaining a roster of on-call physician specialists who can treat unstable patients following initial evaluation by emergency department personnel.
The On-Call Policy
A hospital’s on-call policy is the foundational document for compliance with EMTALA and associated state laws. Its purpose is to establish guidelines that enable the hospital and its personnel to understand what physician resources are available to stabilize emergent patients for transport. The heart of the policy is twofold:
- Maintaining a roster of on-call specialty and sub-specialty physicians who have privileges at the hospital; and
- Educating those physicians about their legal obligations in treating emergent patients.
The on-call policy should outline the procedures the hospital takes to ensure EMTALA compliance. Those drafting such on-call policies should consider including provisions relating to:
Creating an On-Call Schedule. Typically, an on-call policy requires that schedules include the names and personal contact information for each on-call physician, and places the responsibility for providing accurate contact information on the physician.
Records Retention. A hospital most often requires that every version of every on-call schedule be retained for a certain period of time, typically ten years.
Maintaining a Physician List. The on-call policy outlines the factors to be considered in creating the on-call list. For example, factors may include how many physicians hold privileges in which specialties and historical data on the demand of on-call physicians in emergent cases.
Back-Up Plans. Ideally, a hospital’s on-call policy addresses a plan for back-up coverage and the need for transfer agreements should a specialist not be available at the facility.
Responsibilities of Physicians. Typically, an on-call policy enumerates the physician’s responsibility in responding to calls, such as the acceptable timeframe for response and how the specialty care must be delivered. The policy may also outline the protocols to be followed if a physician doesn’t respond within the specified timeframe.
Limits of Physician Directives. An on-call policy is usually clear on the limitations of physician directives. For example, the policy may outline the physician’s lack of authority to decline a transfer request and instead place that responsibility with a hospital administrator.
Roles of APPs. The on-call policy typically includes a provision that covers the role that advanced practice practitioners may play in assessing and stabilizing patients, while outlining the responsibilities of the designated on-call physician in consulting and delivering care.
Delivering Other Care. A hospital’s on-call policy usually addresses whether or not an on-call physician is allowed to deliver patient care or perform elective surgery. If the policy allows the physician to deliver other care, it typically outlines the arrangements that must be made to ensure that the specialty or sub-specialty care is available to emergent patients.
The Role of On-Call Scheduling Software
On-call scheduling software helps ensure that a hospital’s on-call policy is implemented. Creating cloud-based on-call schedules results in up-to-the-minute schedules that can be accessed online or via a mobile app. In contrast to pen-and-paper or spreadsheet schedules, records retention via scheduling software is a breeze, since all schedule versions are automatically stored. Further, maintaining a physician list is straightforward, as physicians can update their contact information in real time and call centers can more easily reach the proper on-call physician.
A robust on-call policy is critical to meeting a hospital’s EMTALA obligations. When on-call scheduling software is the centerpiece of your hospital’s on-call policy, EMTALA compliance becomes more straightforward and everyone across the facility has access to a single source of truth.
MDsyncNET’s cloud-based physician scheduling software delivers four advantages: low set-up fees, simple to learn, an exceptional adoption rate, and painless scheduling swaps. Call 888-506-5061 to see how MDsyncNET can help you integrate physician scheduling software into your hospital’s on-call policy