Purpose

To provide access to a medical screening exam for all patients presenting to the hospital for emergency care.

Policy

1. Any person who presents to the Emergency Department, or anywhere on hospital property, requesting evaluation of a medical condition will be escorted to the Emergency Department, triaged by an RN and receive a screening exam by the emergency physician to determine whether the patient has an emergency medical condition. Additionally, the patient shall be registered provided the registration shall not unreasonably delay the patient’s screening exam.
2. The medical screening exam will include, but is not limited to:
   1. Vital signs
   2. Medical history
   3. Physical exam
3. The medical screening exam is generally conducted in the Emergency Department, but may occur at other sites. Regardless of location, patients will be screened in a respectful fashion, considerate of their privacy and confidentiality rights and consistent with their clinical presentation, the attendant circumstances and available Hospital resources.
4. In the event of concern for staff or patient safety, the nursing staff or Emergency Department physician may at their discretion request the presence of an Hancock Regional Hospital Security Officer or other assistive personnel. Any associate present in the area where the medical screening exam is conducted shall have signed the “Information Security Agreement” and shall have received instruction regarding Patient Rights and Confidentiality, HIPPA and Corporate Compliance.
5. After receiving a screening exam and any indicated stabilizing treatment, patients who do not have a family physician and who need outpatient follow-up care will be:
   1. Referred to a physician, either primary care or specialty, as felt most appropriate by the Emergency physician.
   2. If the patient requires close or urgent follow-up care, the Emergency physician will notify the receiving physician to discuss the care and ensure proper follow-up.
6. If the patient is determined to have an emergency medical condition and the patient requires services not available at this facility, the physician will arrange for a transfer to an appropriate tertiary facility and explain risks and benefits to the patient being transferred. (Refer to Nursing Manual Policy #CC 300). Informed consent will be obtained.
7. If the hospital becomes aware that an individual intends to leave prior to receiving the medical screening examination, the following steps should be taken:
   1. Offer the individual further medical examination and treatment within the staff and facilities available at the hospital as may be required to identify and stabilize an emergency medical condition;
   2. Inform the individual of the benefits of such examination and treatment and of the risks of withdrawal prior to receiving such examination and treatment; and
8. In the event the individual refuses a medical screening exam, a “Refusal of Medical Screening Form” will be completed and the patient requested to sign. If the patient refuses to sign, staff will document this on the form that will be a part of the patient’s permanent medical record.
9. The medical record will be processed in the same manner as all Emergency Department records.