Hospital & Report Procedures

Section 2 - EMERGENCY OPERATIONS

PURPOSE:

To establish procedures for delivery of the patient to the hospital staff, completion of the Electronic Patient Care Report, when EMS reports are to be completed, and minimizing out of service time after arriving at the hospital.

PROCEDURE:

It is the responsibility of crew members to complete a draft of the Maitland Fire Rescue TripTix patient care report and leave a copy at the hospital for each patient. All crew members are required to report the transport mileage to the nearest tenth of a mile in order to meet new Medicare guidelines effective January 1, 2011. They must also obtain a copy of the hospital face sheet for billing purposes. Therefore, the Maitland Fire Rescue Department will utilize the following procedure:

• Once the patient has been turned over to the hospital staff and reports have been given, the attending crew member will complete a draft of the Maitland Fire Rescue TripTix patient care report, leaving a copy at the hospital for the patient’s records.
• When the patient is able to do so, obtain patient’s signature on the electronic Patient Signature Form and in the Patient Signature Box within TripTix. (Refer to SOG 220.05) Also have the hospital representative sign the “Transfer of Care Signature Form.”
• Contact the Emergency Department admitting staff to obtain a copy of the patient’s hospital face sheet, which lists insurance information for the patient.
• If a face sheet is not yet available, obtain an MRI number (medical records number) from hospital staff and make a note of it.
• If the face sheet was not ready, leave a completed copy of the Maitland Fire Rescue Department Request for Patient MRI / Face Sheet with the Emergency Department admitting staff and ask them to fax the information to us when available. Also, check with the Emergency Department admitting staff if the crew returns to the hospital on other calls during the shift.
• If the face sheet is not available and all options have been exhausted to obtain one, complete the billing section of the TripTix Patient Care Report.
  

Obtaining a face sheet on each patient will eliminate the need to complete the billing section on the TripTix electronic patient care report.

• Hospital Delays - Obvious Delay - Upon arrival at an ED with an obvious delay (i.e. multiple rescues/ambulances waiting) call the on-duty Battalion Chief immediately. Not an Obvious Delay - Upon a delay in offload make the first call at the 30 minute mark to the on-duty Battalion Chief. Ensure to have the name and contact information of the charge nurse. Battalion Chiefs are to contact the charge nurse to determine an offload timeframe. If offload is determined to be imminent (within 5 mins) the Battalion Chief will advise the crew and follow-up to confirm offload. If the offload is determined to be longer than 5 mins the Battalion Chief will contact the Nurse Manager or Assistant Nurse Manager to apprise them of the situation. Once the 45 minute mark is achieved the Battalion Chief shall contact the Deputy Fire Chief. The Deputy Chief will contact the Director of Nursing. At the 60 minute mark the Deputy Chief shall contact the Fire Chief for further notifications. The patient may be placed on a green cot if they meet the requirements detailed in Practice Parameter 1.16. The decision to use a green cot shall only be made by a Battalion Chief, Assistant Chief, Deputy Chief or the Fire Chief.
• Transport mileage on the patient care report must be calculated to tenth of a mile. The transport mileage may be based on start/stop odometer readings noted during transport or may be gained from entering the starting address and ending address in MapQuest.
• A TripTix Patient Care Report is to be generated on all EMS calls in the City of Maitland or Town of Eatonville; this includes but is not limited to – patient assists, auto accidents, dry runs (EMS nature), transports, refusals, no patient found, assist PD (EMS nature), etc…. Furthermore, a report must also be generated during calls for service with other agencies if care is rendered by MFRD personnel. When care is not rendered, the NFIRS report must indicate “No EMS report needed.”
• Upon completion of the call, the attending crew member will complete the following:
  1. Computer generated TripTix Patient Care Report;
  2. Attach a TripTix/ADPI barcode to any patient related paperwork that was generated but not captured within TripTix. Place an individual barcode on each type of different types of paperwork. This includes EKG tracings, hospital face sheets, patient signature forms, stroke alert forms, cardiac alert forms, etc. Then enter each of these barcodes numbers in the appropriate fields within the TripTix Patient Care Report.
  3. Every sheet of paper (i.e. ECG, face sheet, signature form) should include, at a minimum, a bar code and patient’s name.
  4. All paperwork pertaining to the same patient shall be paper clipped together and place in an interoffice transport envelope.
  5. Interoffice Envelope: At the end of each shift, complete an interoffice transport envelope that includes all bar-coded documents generated for that shift.
  6. TripTix Patient Care Reports are to be completed prior to the end of shift. Exceptions to this are to be made on a case by case basis and approved by the on-duty Battalion Chief.
• At the end of each shift, the OIC shall complete the following:
  1. Collect any envelopes for the shift.
  2. Verify that all reports have been entered into TripTix.
  3. Verify that required paperwork has a barcode and patient’s name attached to each related sheet, is paper clipped by patient, and is present in the envelope.
  4. The OIC or his/her designee shall log into Intermedix “Supervisor Review” to review and submit to the QA process any completed EMS reports by 2000hrs. EMS reports completed after 2000hrs shall be reviewed by the end of the shift. All reports should have requested corrections made within 72 hours and submitted to Intermedix. At no time should a report be under Supervisor Review for more than 9 days.