HospitalInspections.org

Based on interview with key staff and review of Emergency Department policy "Provision of Care", on April 26, 2010, it was determined that the hospital failed to follow its own policy on the transferring of patients.

The findings are as follows:

1. The "Provision of Care" policy that pertains to the "Management of Patients Presenting with Potential Emergency Medical Conditions, specifies

"In the event that the patient has an emergency medical condition that has not been stabilized, clinical staff will not transfer the patient unless the transfer meets all of the following requirements:

b. MGMC clinical staff have contacted the receiving facility and ascertained and documented that the receiving facility:

b.(ii) Has agreed to accept transfer of the patient and to provide appropriate medical treatment."

2. Documentation by the Emergency Department (ED) Physician stated that on April 21, 2010, a critically burned patient was brought to the ED ambulance area. The ED physician came out to medically evaluate the patient and determined that the patient would best be cared for at a burn center. The emergency crew was directed to leave the hospital and go to the airport to connect with Life Flight without having a destination or an accepting hospital for the patient. This information was confirmed on April 23, 2010 during an interview with the ED Physician.

Based on interview of the Nurse Manager of the Emergency Department and review of Emergency Department actual nurse staffing on April 26, 2010, it was determined that the hospital failed to have adequate nursing personnel to meet the anticipated needs of the facility.

The findings are as follows:

1. Emergency Nurse staffing was reviewed for April 4, 2010 to April 24, 2010. There was documentation that nurse staffing did not meet the hospital's core staffing plan criteria for nine (9) of twenty-one (21) days for all shifts (April 4, 7,9,10,14,17,18,19, 24).

2. This was verified in an interview with the Nursing Manager of the Emergency Department and the ED Scheduler on April 26, 2010.