The American Hospital Association last week issued a "quality advisory" following the death of a 15-year-old boy. Emergency personnel at a Chicago hospital had refused to leave the facility to treat him.
Common sense was a big part of the three-page advisory on emergency room procedures the AHA released to the media last week. The advisory had been sent to AHA members May 21, less than a week after the incident at 301-bed Ravenswood Hospital Medical Center, a not-for-profit facility.
Emergency workers at Ravenswood said a hospital policy prevented them from going outside to help the boy, who had been shot and brought by friends to within yards of the ER. The hospital has since rescinded that policy.
The AHA suggested that hospitals review their ER policies to make sure they are flexible enough for healthcare workers to exercise their best judgment in similar instances.
The advisory said hospitals often have policies about personnel leaving the ER to protect the safety of emergency workers and to make sure staffers are available to care for patients already in the facility.
But George Maroney, administrator of 132-bed Memorial Hospital of Carbondale, Ill., said it's a sad commentary when hospitals have to turn to the AHA for advice on what to do when someone lays dying outside an ER.
"We're becoming paralyzed in some cases by the fear of lawsuits, by the fear of making some action that somebody is going to come back to us on," Maroney said.
He said his hospital doesn't have a policy prohibiting emergency personnel from going outside the hospital.
"You just do it," he said.
Because of the incident, Ravens-wood faces possible revocation of its Medicare eligibility by HCFA and downgrading of its accreditation status by the Joint Commission on Accreditation of Healthcare Organizations. Both decisions are expected to be rendered later this month.
Ravenswood is affiliated with Advocate Health Care, an eight-hospital system based in Oak Brook, Ill.
Medicare accounts for $48 million, or 47%, of the hospital's total net patient revenues, said Advocate spokesman Dan Parker.