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Based on medical record review and staff interview it was determined the hospital failed to establish emergency department policy requiring documentation of the patient's requests for a specified physician and the subsequent attempts to reach that physician. This affected one of ten (Patient # 9) emergency department patient medical records reviewed. The 23-bed emergency department registered 37,072 patients in 2012.

Findings include:

Review of the medical record for Patient # 9 was completed on 01/03/13. This patient received emergency care in the hospital's emergency department on 10/06/12 for an injury to his left thumb. On or about 12/04/12 the hospital received an e-mail from the patient with a complaint regarding the care he received in the emergency department on 10/06/12. The nature of the complaint was that his request for his orthopedic physician of choice was not heard nor was his orthopedic physician of choice called.
The hospital patient advocate began the investigation and kept the patient informed that his complaint was being investigated. Per hospital policy, a letter indicating a resolution of the complaint was sent on 12/10/12 from the hospital to the patient.

An interview with the hospital emergency department director, the chief nursing officer, the director of corporate compliance and the corporate compliance officer was conducted on 01/02/13 at 2:00 PM. Through the hospital's own investigation of this patient's complaint, the opportunity for improvement was recognized. It was decided, after reviewing this patient's medical record and interviewing the staff involved, that the communication to the patient regarding his request for his physician of choice had fallen short of what the hospital expects for it's patients.

The clinical manager of the ED sent an email to all ED staff re-educating staff of the hospital policies regarding "Specialist on call" and "Private Physician Responsibility to the ED". These policies both indicate that the patient's preference is always honored, if possible. During interview, the panel of hospital staff could not ascertain that it was written into policy whether the documentation of these requests or attempts is required.

This finding substantiates Complaint Number OH00068275.