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August 2, 2004
(Updated: February 23, 2006)
The Florida College of Emergency Physicians believes that
the public is best served through universal access to high
quality emergency care. Quality emergency care requires
immediate access to a hospital and its medical staff. An
off-site facility, such as a free-standing emergency department,
should only be considered when a hospital-based facility is not
available within a large geographic area. Urgent and
non-emergent patients can be adequately served in urgent care
centers, walk-in medical centers and clinics. The perception that
a true emergency can be appropriately treated in any
free-standing facility should be discouraged. Any policy
recommendation should be considered in light of how it improves
emergency and trauma care in Florida. A recommendation to
approve the creation of free standing emergency departments
should be based on the following criteria: Need
Is there a public need?
Some of the important factors that can play into this
assessment include:
A distance of 30 miles or greater to the nearest emergency
department
Time of travel of greater than 30 minutes via EMS in normal
traffic.
Physical obstacles, such as bridges, lakes, inlets which make
the local emergency department difficult to access Staffing
Are on-call specialists schedules
established and monitored?
Staffing capability of a free standing emergency
department should be no less or equivalent to current
requirements for a hospital based emergency department. EMS
Support
Does the free standing emergency department have a written
agreement
with local EMS agencies?
Free standing emergency departments should be
required to have a local EMS sub-station present on
premises, as well as transport guidelines established. The
policy permitting off-site emergency departments should not
conflict with Chapter 401, F.S., applicable rules and any county
ordinances or a Certificate of Public Convenience and Necessity
(COPCN). Lab Availability
Does the free standing emergency department have all
necessary lab
availability 24 hours a day?
These should include x-rays with technician and C-T Scan
capabilities and Ultrasound, as well as a fully staffed CLIA
sanctioned laboratory. Minimum AHCA ED Standards
Does the free standing emergency department meet all
other minimum requirements set by AHCA for a hospital based
emergency department? |
