Two main questions to ask yourself:
• What can you do to mitigate or reduce the risk not only to the
facility, but also to the doctors and all staff members as well?
• And what can you do if the patient just doesn't comply with your
discharge policy?
At a minimum, have clear written policies regarding patient dis-
charge — and notify patients of these requirements. Enforcing them is
a car of a different color. Should a patient insist on taking Uber, Lyft
or a cab, you must document the patient's knowing and willful devia-
tion from the center's policies in the patient's medical record.
Here are some tips to help you avoid potential legal issues arising
from patient discharges without accompaniment:
• In pre-op. Clearly set forth a requirement in the pre-operative
paperworkfor patients to have a responsible adult driver to accompany
them home. When you bring a patient in to schedule a procedure,
advise her of this requirement and ask her to sign a document
acknowledging the requirement to have a responsible adult present
upon discharge.
• On the day of surgery. Verify that the patient has a responsible
adult present in the waiting room. If the surgery is going to take sever-
al hours, ensure the responsible person will be present upon comple-
tion of the procedure. Ask for the individual's contact information.
You could give the patient's ride home a beeper so he can run an
errand or grab a bite rather than sit in the waiting room.
• Upon discharge. If a patient doesn't have someone — a friend, a
family member or someone who is claiming responsibility for that
patient — I recommend you wait to discharge her until someone
arrives. If a patient insists on using an Uber, Lyft, cab or other trans-
portation source, note that you advised the patient of your policies
and procedures in the patient's record and have a staff member assist
Legal Update
LU
2 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • F E B R U A R Y 2 0 1 9
