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At Children=92s Mercy, we are presently accepting all calls from parents =
within 72 hours of being
seen in the ED. These are referred to the physician who saw the patient i=
f they are present, or
to the attending on duty. This has been (and still is) debated, as it cer=
tainly discouages
parents from contacting their PCP. We may go to a "next business day" sys=
tem, where we will take
calls until the PCP office is open.
 
We call all missed fractures (even if properly treated and referred), oth=
er x-rays needing
follow up, and all positive cultures needing treatment or follow up.
 
Needless to say, this consumes a fair amount of ED attending time each da=
y and is potentially a
confidentiality problem as Dr. Christopher rightly points out. I am not r=
eally sure what the
"right" answer to this issue is.
 
Regards,
Ted
Theodore M. Barnett, M.D.
Section of Emergency Medicine
Children=92s Mercy Hospital
2401 Gillham Road
Kansas City, MO  64108
[log in to unmask]
 
"Norman C. Christopher, MD" wrote:
 
> I wonder if there is any concensus as to how to handle telephone calls
> by patients/families looking for results of labs/cultures? Knowing that
> most ED's have a policy discouraging entertaining such requests, does
> any one feel "obligated" by medicolegal pressures to respond by giving
> information?
>
> For example, a patient fails to improve after discharge from the ED (to
> make it easy, say it's an infant with fever and no other source), a
> parent calls asking for  information, knowing that a culture is pending=
,
> they are told by a "staff person" that "it's against policy to share
> such information by telephone", the caller is angered, the patient does
> poorly, etc etc.
>
> How does everyone handle such situations? Do you call families or
> patients with positive cultures obtained in the ED? (for example, a
> child suspected of having a UTI at the time of discharge is placed on
> amoxicillin empirically - the culture grows amp-resistant E coli, and
> sensitivity testing suggests a change in therapy). Do you have a
> mechanism in place, or do you feel responsible, to follow up with these
> families?
>
> We are re-evaluating our current process, and would appreciate any inpu=
t
> that you may have. Thank you.
>
> Norm Christopher
> Children's Hospital/Akron
>
> 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://www.brown.edu/Administration/Emergency_Medicine/ped-em-l.html
 
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://www.brown.edu/Administration/Emergency_Medicine/ped-em-l.html