EMTALA Keep it Short and Simple (KISS) Principles

For the hospital staff and emergency physicians inquiries:

• Do you want to see a doctor?

• I’ll take you to the ED.

ED:

• Log ALL patients.

• Medical screening exam for all patients by physician.

— If not, document why

— Left without treatment

— Refused

• Treat all patients to a reasonable disposition in the ED.

Transfers:

• Obtain acceptance from the receiving facility and complete a transfer form on ALL patients not otherwise being routinely discharged.

• Accept ALL transfers if the hospital has the capacity (bed available and ever done it before) to treat the presenting problem. If not, document why.

Reporting:

• Set up a system for reporting suspicious transfers.

• Report ALL suspicious transfers to you and ALL suspicious refusal to accept outgoing transfers.

• Document ALL incoming and outgoing transfers.


For the medical staff physician

If you are called — you are chosen if on-call for the ED:

• Respond appropriately: No excuses, no complaints.

• The emergency physician dictates appropriateness unless or until you assume care of the patient.

Transfers:

• Accept ALL transfers if the hospital has the capacity (bed available and ever done it before) to treat the presenting problem. If not, document why.

• Obtain acceptance from the receiving facility, and complete a transfer form on ALL patients not otherwise being routinely discharged.

ED Patient Follow-Up:

• Do what you agreed to do later or come to the ED.

• Do not demand payment up front or refer back to the ED if unable to pay or a non-contracted health plan.

Reporting:

• Set up a system for reporting suspicious transfers.

• Report ALL suspicious transfers coming to you and ALL suspicious refusals to accept outgoing transfers.

• Document ALL incoming and outgoing transfers.

How can I help you with this patient?

Source: Todd Taylor, MD, FACEP, Good Samaritan Regional Medical Center, Phoenix.