The immediate care of patients during an emergency has become a hot topic in the OPT accreditation space, and we want to provide you with information that will clarify the requirements of this standard. This standard is not new, nor is it an updated Condition of Participation (CoP). Furthermore, the CoP interpretive guidelines have remained the same since July 24, 2014.
QUAD A Standard 15-D-14 requires that the rehabilitation agency must establish procedures to be followed by personnel in an emergency, which cover immediate care of the patient, persons to be notified, and reports to be prepared.
The standard's purpose is to confirm that the OPT has policies and procedures in place that instruct staff on the necessary steps to take during a patient emergency (including administering immediate care to the patient, notifying the patient’s doctor, and preparing reports). The agency should also have instructions in place documenting all emergency actions in the clinical record.
When a patient is in cardiac or pulmonary arrest, CPR needs to be performed immediately for the best possible outcome. While calling “911” is a necessary step in the process, it should not be the only step. Unfortunately, our surveyors have recently discovered many facilities whose only recourse in the event of a patient emergency is to call emergency services and await their arrival. The OPT must outline provisions in their policies and procedures to address urgent patient care. This includes explaining how staff competence will be demonstrated and indicating which staff are required to complete training. Although not specifically required, our team often suggests staff certification in Basic Life Support (BLS), which is considered an industry standard for immediate care to patients.
For example, sudden cardiac arrest, burns, drowning, slips, trips, falls, and lacerations from falls are risks that require some level of immediate care following the initiated “911” call and before Emergency Medical Services (EMS) arrive. The OPT’s must make a sound decision based on the risks and likely events for the patient population served that supports an effective response and delivers immediate care to a patient until emergency services reach the location.
It is our hope that this will help you understand the importance of managing and providing immediate patient care during an emergency in an OPT setting. For additional information please review the State Operations Manual Appendix E – Guidance to Surveyors: Outpatient Physical Therapy of Speech Pathology Services, beginning on page 16.
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Since 1980, QUAD A (a non-profit, physician-founded and led global accreditation organization) has worked with thousands of healthcare facilities to standardize and improve the quality of healthcare they provide – believing that patient safety should always come first.