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Based on interviews, the review of medical records and the Emergency Department (ED) log, it was determined that the facility failed to maintain an ED log that reflects the accurate disposition of patients who were evaluated in the ED. This finding was noted in 4 of 5 patients whose disposition were entered as transfers in the ED log (Patient #1, #2, #3 and #4).

Findings include:

The review of five randomly selected patients from the ED log for September 2014 to January 2015 revealed the disposition of four patients was not accurately documented.

Patient #1 is a 4-year-old who was evaluated at the Emergency Department on 12/18/14 and was transported to the facility's Emergency Department at another location to rule out appendicitis. The ED log did not indicate the final disposition of the patient; instead, it notes the patient was transferred.

Patient #2, a 32-year-old female was evaluated on 1/19/15 for severe headache. The attending radiologist recommended Magnetic Resonance Imaging (MRI) following a CT scan (X-ray computed tomography is a technology that uses computer-processed X-rays to produce virtual 'slices' of specific areas of a scanned object, allowing the user to see inside the object without cutting) that showed possible pituitary apoplexy (sudden neurologic impairment, usually due to a vascular process). The patient was transported to the facility's ED at another location for MRI. The ED log did not capture the final disposition of Patient #2.

Patient #3 is a 23-year-old female, Gravida 2 (a woman in her second pregnancy), Para 1 (a woman that has had one pregnancy that achieved more than 20 weeks of gestation age), at 5 weeks gestational age who presented to the ED on 1/31/15 at 6:30 PM with complaint of abdominal cramping and vaginal bleed. The patient was evaluated by the ED physician with a diagnostic impression of "Threatened abortion". She was transported to the hospital's ED at another location for continued care. The final disposition of the patient was not entered into the ED log.

Patient #4 is a 56-year-old female who was evaluated in the ED on 8/5/24 at 5:34 PM with complaints of abdominal pain, nausea, and vomiting. The physician's diagnostic impression was "Acute Gastroenteritis". Following a CT scan of the abdomen and pelvis, she was transported to another ED of the hospital for surgical consultation. The ED log notes the patient was transferred.

The review of the ED log found that thirty-one patients were transferred in August 2014; however, upon interview with Staff #1 on 2/5/15 at 1:20 PM, she provided a document that confirmed that only one patient out of the thirty-one had been transferred to another facility, the rest were transferred to other campuses of the hospital.

At interview with Staff #2 on 2/5/15 at 1:39 PM, she stated that regardless of whether patients were transferred to another facility or to the hospital's ED at another location, their disposition is entered into the log as transfers. The staff stated she is unable to determine the final disposition of Patient #1, #2, #3, and #4.