16 Del. Admin. Code § 4302-15.0
Current through Register Vol. 28, No. 7, January 1, 2025
Section 4302-15.0 - General Policies15.1 There are well-defined lines of authority with a clear reporting mechanism to upper level management.15.2 Air medical personnel understand the organizational structure and the chain of command.15.3 A policy shall be in place that clearly explains the air medical service's disciplinary process for all levels of staff.15.4 Management policies encourage ongoing communications between all levels and types of air medical service personnel.15.5 There are formal, periodic staff meetings for which minutes are kept on file. There are defined methods for disseminating information between meetings.15.6 For public or private institutions and agencies that contract with an aviation firm to provide air medical services, there shall be a policy that specifies the lines of authority between the medical management team and the aviation management team.15.7 Management sets guidelines for press related issues and marketing activities. 15.7.1 Policies Relating to Patient Management 15.7.1.1 Management ensures, through policy, that all transfers of patient care occur from a lower level of care to an equal or higher level of care except for elective transfers for patient convenience or returning a patient to a referring facility.15.7.1.2 A patient record shall be maintained on all patients utilizing the services of an air medical ambulance. The record shall be used to document care given during transport, as well as all other relevant patient related factors, such as status prior to, during at the end of transport.15.7.1.3 A copy of the patient record will be left at the receiving hospital to facilitate continuity of care. A copy will be kept on file by the air medical ambulance service for a period of time to include that of the statue of limitations.15.7.1.4 The air medical ambulance services has written policies and procedures which indicate what therapies can be performed without on-line medical direction.15.7.1.5 Inter facility transports require physician referralcceptance to ensure continuity of care and establish patient care parameters during the transport. Patient transfer protocols must comply with existing Federal requirements.15.7.1.6 Management ensures an appropriate utilization review process based on: 15.7.1.6.1 Medical benefits to the patient: 15.7.1.6.1.1 Timeliness of the transport as it relates to the patient's clinical status.15.7.1.6.1.2 Transport to an appropriate receiving facility; an appropriate receiving facility may include: 15.7.1.6.1.2.1 A hospital or facility where the patient has previously undergone specialized treatment and where the patient's previous medical records are located.15.7.1.6.1.2.2 A facility at too great a distance for ground transport.15.7.1.6.1.2.3 A facility with a specialized level of care not available in the referring hospital.15.7.1.6.1.3 Specialized air medical personnel expertise available during transport that would otherwise not be available.15.7.1.6.1.4 Safety of the transport environment.15.7.2 Cost of the transport: 15.7.2.1 A structured, periodic review of flights (to determine transport appropriateness or that the mode of transport enhances medical outcome, safety or cost effectiveness over other modes of transport) performed at least semi-annually and resulting in a written report.15.7.2.2 Hospital or non-hospital based program directordministrator is oriented to FARs that are pertinent to the air medical service.15.7.3 Policies Pertaining to Safety 15.7.3.1 A Safety Committee shall meet at least quarterly with written reports sent to management and kept on file as dictated by policy. The responsibilities of the safety committee may be assumed by the QA/CQI committee.15.7.3.2 Written variances relating to "safety" issues will be addressed in Safety Committee meetings. The committee will promote communications between air medical personnel and pilots addressing safety practice, concerns, issues and questions.15.7.3.3 Recommendations for operational and safety issues will be reviewed by management.16 Del. Admin. Code § 4302-15.0