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Lisa,
Similar pressures at my institution.  We have a large ED centrally run with a separated PedED.  

For our ED, we developed a policy that prioritizes minors over adults but acknowledges that all ED clinical space should be made available to waiting patients.  If there are no patients in the PedED waiting room (late night/early mornings), we cherry pick adult patients that are 'compatible' to the PedED.  We also keep space available for EMS transports (typically 1-2 rooms available for sudden arrivals).  We are currently staffed entirely with double boarded (EM-Ped) physicians so limitations on skill set and credentialing are not relevant.

We have this agreement in letter format that was taken to our ED operations committee.  I am happy to share the text if it helps.
Good luck.      
 
Dale
________________________________________
From: Pediatric Emergency Medicine Discussion List [[log in to unmask]] on behalf of Lisa A Drago [[log in to unmask]]
Sent: Monday, April 21, 2014 12:13 PM
To: [log in to unmask]
Subject: Adult patients in the PED

Recently our adult colleagues have been requesting the PEM docs see young adults ( under 30) when their volume becomes unbearable. Any PEM docs seeing young adults in your practice and legally how are you handling this (separate hospital privileges?)

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For more information, send mail to [log in to unmask] with the message: info PED-EM-L
The URL for the PED-EM-L Web Page is:
                 http://listserv.brown.edu/ped-em-l.html