Staff Roles and Responsibilities
You must first assign staff roles and responsibilities. Cardiology Medical Group uses all of their staff effectively and has a proactive team approach. The approach reinforces the important role that each staff member plays in emergency preparedness, and it stresses that appropriate preparation can potentially improve a patient’s outcome.
Use the size of the practice and the staff members’ skills and training to shape specific roles and responsibilities. Each individual must be well-versed in the office’s emergency response plan, understand his or her duties, and know the appropriate steps to follow during a medical emergency.
Examples of roles include:
•Who will notify the physician of the medical emergency and direct him or her to where the patient is located (if the physician is not with the patient when the emergency occurs).
•Who will take the lead in providing emergency care to the patient.
•Who will assist the team leader in bringing the emergency supplies and helping administer care.
•Who will call 911 (or another emergency service).
•Who will meet the emergency responders when they arrive and direct them to the patient.
•Who will document the course of events.
•Who will direct the flow of patients while other staff members are responding to the emergency.
Specific responsibilities during a medical emergency are delegated based on job positions, rather than to specific individuals. This helps prevent gaps in responsibility if a staff member is out of the office. The individual who is covering the position needs to be notified of the duties that they will be expected to perform. If they do not have the appropriate training or skills, the responsibilities should be reassigned to an appropriate staff member.
Additionally, emergency response accountabilities are included in written job descriptions for relevant positions. Each position’s assignments are reviewed at least annually to ensure that the office’s emergency response plan is thorough and complete. Competencies for each staff position include skills that will likely be required for responding to emergency situations.
Staff Training
All Cardiology Medical Group staff should obtain certification in basic life support (BLS).
Depending on the nature of the practice and the patient population, the office may provide training in advanced cardiac life support (ACLS) and/or pediatric advanced life support (PALS). Any training or certification related to BLS, ACLS, or PALS is documented in staff members’ personnel files.
Staff training also involves conducting routine emergency drills. These drills verify knowledge of emergency techniques, protocols, and usage of emergency response equipment and supplies. Drills should also be used to evaluate the team’s ability to effectively provide emergency care at a moment’s notice.
Continuing education (CE) also offers opportunities to learn more about emergency medicine and response. CE courses may be available through medical and dental schools, local hospitals, medical and dental societies, and other organizations (such as the American Heart Association (AHA) and the American Red Cross.
Emergency Supplies and Equipment
Medical and dental professional organizations and emergency preparedness literature generally recommend that office practices maintain at least basic emergency supplies and equipment. Beyond that, the breadth and contents of each office’s emergency kit largely depends on:
•The type of practice.
•The patient population.
•The procedures/therapies performed.
•Anticipated emergencies or level of risk.
•Geographic location.
•Physician and staff training and skills.
•State requirements.
The most important consideration when purchasing or assembling an emergency kit is ensuring that office physicians and staff members have the knowledge and training to administer the emergency medications and use the emergency equipment. For medical and legal reasons, no office should stock equipment that cannot be used safely by office staff.
Emergency supplies and equipment are stored in a designated location that is cool, dry, and accessible at all times. Emergency kits are labeled and easy to transport. This allows staff to quickly transfer equipment and supplies to the person requiring assistance.
An assigned staff member routinely inventories all emergency medications, checks expiration dates, and restocks medications as appropriate. The staff member uses a checklist to facilitate thorough documentation of the results of these inspections.
Likewise, emergency equipment should be routinely inventoried and tested to verify that it is functioning properly. You should test critical equipment, such as lifesaving and emergency equipment, at least twice a year. The practice also should maintain equipment logs to document all inspections, testing, preventive maintenance, and repairs for emergency equipment (as well as other types of equipment).
Communication within the Office and with Emergency Services
While the medical response is occurring, various communication activities take place, including calling for emergency help, directing staff, obtaining information from family members or caregivers and providing them with updates (if applicable), calling the hospital emergency department to alert them of the situation, and documenting the sequence of events as it takes place.
The first step in managing a medical crisis in the office is a prompt call for emergency medical services. In addition to 911, other phone numbers, such as the local hospital’s number, should be posted in a visible location to help facilitate the response process. If the caller has to dial a prefix to activate an outside line, that information also should be noted. The list of emergency numbers should be checked periodically for accuracy.
When calling for emergency help, the caller provides certain essential information, such as:
•The patient’s age and gender.
•A preliminary diagnosis, such as a possible stroke.
•Symptoms and vital signs, such as whether the patient is conscious and his or her blood pressure reading.
•Details about any emergency treatment the patient is receiving, such as BLS, oxygen, and/or medication.
•The practice’s phone number and address, including important identifying information about the office location, such as names of crossroads, proximity to landmarks, specific locations within a building, etc.
Assign a staff member to meet emergency responders as they arrive and direct them to the patient’s location.