HospitalInspections.org

Based on review of documents, medical records and staff interview it was determined the facility failed to ensure all medical staff in the Emergency Department (ED) followed hospital policy relative to availability of the on-call physician (see tag 2404), and because of not following hospital policy, caused a delay in treatment (see tag 2408).

Based on review of documents and staff interview it was determined the facility failed to ensure the Emergency Department (ED) Physicians were all trained in accordance with the hospitals policies and procedures when they are unable to make contact with the on call physician in an emergency situation. This has the potential to negatively affect all patient's by leaving them with their needs unmet.

Findings include:

1. Hospital policy titled CAMC MEDICAL STAFF CHAIN OF COMMAND, last updated 10/2011, states in part: "for call coverage issues; call the appropriate Department Chief, if care concerns not resolved, contact the Chief of Staff and/or the Chief of Staff Elect."

2. During a telephone interview on 3/18/14 at 1055 with the surgeon who was on call on 9/3/13 he stated he never received a page from the ED. He also stated if the ED physician kept calling without a response, he should have followed the chain of command.

Based on review of documents, medical records and staff interview, it was determined the facility failed to ensure the emergency department (ED ) staff followed the proper protocol in attempting to contact the on-call physician in one (1) of one (1) medical records reviewed for failure of the on-call physician to appear (#1 on identifier list). This has the potential to negatively impact patient's causing a delay in treatment.

Findings include:

1. Hospital policy titled CAMC MEDICAL STAFF CHAIN OF COMMAND, last updated 10/2011, states in part: "for call coverage issues; call the appropriate Department Chief, if care concerns not resolved, contact the Chief of Staff and/or the Chief of Staff Elect."

2. Patient #1 was transferred to the facility with a partial amputation of her left thumb and a complete amputation of the proximal tip of her left ring finger. Documentation in the medical record revealed the ED physician attempted to reach the on-call surgeon multiple times over a two (2) hour period.

3. During a telephone interview on 3/18/14 at 1055 with the surgeon who was on call on 9/3/13 he stated he never received a page from the ED. He also stated if the ED physician kept calling without a response, he should have followed the chain of command. He stated when he went to the floor on 9/4/13, he noticed a patient had been admitted to his service and couldn't figure out how that had occurred. Once he examined the patient, he took her to surgery and performed the procedures necessary to correct the patient's injuries.