Emergency Medical Services ACUTE CARE HOSPITAL EMERGENCY AMBULANCE RECEIVING FACILITY ASSESSMENT DOCUMENT. January 2004

Transcription

1 Emergency Medical Services ACUTE CARE HOSPITAL EMERGENCY AMBULANCE RECEIVING FACILITY ASSESSMENT DOCUMENT January 2004 Basis for Conducting Facility Assessments Division 2.5, California Health and Safety Code, Sect ions , and , allows the State EMS Authority to establish guidelines for the utilization of hospital facilities according to critical care capabilities and requires local EMS agencies to utilize planning and implementation guidelines developed by the State EMS Authority in the assessment of hospitals and critical care centers. This document is a summary report of the self-assessment updates performed by acute care hospitals in County between October 2003 and January The intent of this document is to serve as a resource directory for emergency medical and other health professionals in the county. Information contained in this document has been obtained from the individual hospitals.

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5 DEMOGRAPHIC INFORMATION (Listed for each hospital in alphabetic order) Hospital Name: Mailing Address and Phone Number: Physical Address (if different): Chief Executive Officer: Chief Operating Officer: Contact Person for this survey - Telephone and FAX Numbers: Regional Medical Center & Health Centers 2500 Alhambra Avenue Martinez, CA (925) (same) Jeff Smith, MD Kathryn Grazzini Marcelle Indelicato (925) , fax (925) Date of Survey: November 25, 2003 Designation for Tax Purposes (public, private no-for-profit, private forprofit): Public Total Number of Licensed Acute Care Beds (all types): 164 Licensed Intensive Care Beds (all types except neonatal): 8 Emergency Department Treatment Spaces: 19 Total Number of Out-Patient Treatment Areas if integrated or attached out-patient facility: When did the Joint Commission for Accreditation of Health Organizations (JCAHO) last review your facility? 4 areas: Family Practice Clinic 21 spaces, Specialty Clinic North 10 spaces, Specialty Clinic South 9 spaces, Infusion Room 6 spaces May, 2001 Health Services Emergency Medical Services 1 Acute Care Facility Self Assessment Resource Document November 2003

6 DEMOGRAPHIC INFORMATION (Listed for each hospital in alphabetic order) Hospital Name: Mailing Address and Phone Number: Physical Address (if different): Chief Executive Officer: Chief Operating Officer: Medical Center Pablo Campus 2000 Vale Road Pablo, CA (510) (same) Von Crockett Todd Hoff Contact Person for this survey - Telephone and FAX Numbers: Date of Survey: 2/03/04 Julie Kline, Chief Nursing Officer (510) , fax (510) Designation for Tax Purposes (public, private no-for-profit, private for-profit): Private-for-profit Total Number of Licensed Acute Care Beds (all types): 232 Licensed Intensive Care Beds (all types except neonatal): 29 Emergency Department Treatment Spaces: 24 Total Number of Out-Patient Treatment Areas if integrated or attached out-patient facility: When did the Joint Commission for Accreditation of Health Organizations (JCAHO) last review your facility? 4 areas: Same-day Surgery 9 spaces; Outpatient burn 2 spaces; Outpatient chemotherapy 7 spaces; Hyperbaric Outpatient 2 spaces August 2003 Health Services Emergency Medical Services 2 Acute Care Facility Self Assessment Resource Document November 2003

7 DEMOGRAPHIC INFORMATION (Listed for each hospital in alphabetic order) Hospital name: Mailing Address and Phone Number: Physical Address (if different): Chief Executive Officer: John Muir/Mt. Diablo Health System Chief Administrating Officer JMMC: Contact Person for this survey - Telephone and FAX Numbers: 1601 Ygnacio Valley Road Walnut Creek, CA ((925) (same) J. Kendall Anderson Kenneth L. Meehan John Muir Medical Center Julie Crouse (925) , fax (925) Date of Survey: 1/20/04 Designation for Tax Purposes (public, private no-for-profit, private for-profit): Private not-for-profit Total Number of Licensed Acute Care Beds (all types): 321 Licensed Intensive Care Beds (all types except neonatal): 35 Emergency Department Treatment Spaces: Total Number of Out-Patient Treatment Areas if integrated or attached out-patient facility: When did the Joint Commission for Accreditation of Health Organizations (JCAHO) last review your facility? 15; 22 11am to 11 pm 4 areas; Endoscopy, Eye lab, Infusion Center, Out-pt Surgi-Center January 2001 Health Services Emergency Medical Services 3 Acute Care Facility Self Assessment Resource Document November 2003

8 DEMOGRAPHIC INFORMATION (Listed for each hospital in alphabetic order) Hospital Name: Mailing Address and Phone Number: Physical Address (if different): Chief Executive Officer: Chief Operating Officer: Contact Person for this survey - Telephone and FAX Numbers: Permanente Medical Center 901 Nevin Avenue, CA (510) (same) Bettie L. Coles Sue Muscarella Mark J. Tinsley (510) , fax (510) Date of Survey: 12/18/03 Designation for Tax Purposes (public, private no-for-profit, private for-profit): Private not-for-profit Total Number of Licensed Acute Care Beds (all types): 50 Licensed Intensive Care Beds (all types except neonatal): 8 Emergency Department Treatment Spaces: 15 Total Number of Out-Patient Treatment Areas if integrated or attached out-patient facility: When did the Joint Commission for Accreditation of Health Organizations (JCAHO) last review your facility? 3 areas: Special procedures; Urgent care 24hr. medical services; Clinic departments November 2001 Health Services Emergency Medical Services 4 Acute Care Facility Self Assessment Resource Document November 2003

9 DEMOGRAPHIC INFORMATION (Listed for each hospital in alphabetic order) Hospital Name: Mailing Address and Phone Number: Physical Address (if different): Chief Executive Officer: Chief Operating Officer: Contact Person for this survey - Telephone and FAX Numbers: Foundation Hospital Walnut Creek 1425 South Main Street Walnut Creek, CA (925) (same) dra H. Small Christine Robisch Kevin Langkiet (925) ; FAX (925) Date of Survey: 11/21/03 Designation for Tax Purposes (public, private no-for-profit, private for-profit): Private not-for-profit Total Number of Licensed Acute Care Beds (all types): 229 Licensed Intensive Care Beds (all types except neonatal): 24 Emergency Department Treatment Spaces: 52 Total Number of Out-Patient Treatment Areas if integrated or attached out-patient facility: When did the Joint Commission for Accreditation of Health Organizations (JCAHO) last review your facility? 5 areas: 2 ambulatory surgery centers, 1minor injury center, 1 endoscopy suite October 2001 Health Services Emergency Medical Services 5 Acute Care Facility Self Assessment Resource Document November 2003

10 DEMOGRAPHIC INFORMATION (Listed for each hospital in alphabetic order) Hospital Name: Mt. Diablo Medical Center Mailing Address and Phone Number: P.O. Box 4110 Concord, CA (925) Physical Address (if different): 2540 East Street, Concord, CA Chief Executive Officer: Chief Operating Officer: Contact Person for this survey - Telephone and FAX Numbers: CAO: Thomas Harlan Executive Vice Presidents: Donna Brackley Donna Brackley, Sr. VP Patient Care Services (925) , fax (925) Date of Survey: 11/21/03 Designation for Tax Purposes (public, private no-for-profit, private for-profit): Private not-for-profit Total Number of Licensed Acute Care Beds (all types): 254 Licensed Intensive Care Beds (all types except neonatal): 25 Emergency Department Treatment Spaces: 22 Total Number of Out-Patient Treatment Areas if integrated or attached out-patient facility: When did the Joint Commission for Accreditation of Health Organizations (JCAHO) last review your facility? 4 areas: Short stay 22 spaces, GI lab, 4 endo suites, Cancer Center, Cardiac Rehab. January 2001 Health Services Emergency Medical Services 6 Acute Care Facility Self Assessment Resource Document November 2003

11 DEMOGRAPHIC INFORMATION (Listed for each hospital in alphabetic order) Hospital Name: Mailing Address and Phone Number: Physical Address (if different): Chief Executive Officer: Chief Operating Officer: Contact Person for this survey - Telephone and FAX Numbers: Regional Medical Center 6001 Norris Canyon Road, CA (925) (same) Gary Sloan Sue Micheletti Kathy Kelley-Conley, Director, Emergency Services (925) , fax (925) Date of Survey: 1/21/04 Designation for Tax Purposes (public, private no-for-profit, private for-profit): Private-for-profit Total Number of Licensed Acute Care Beds (all types): 123 Licensed Intensive Care Beds (all types except neonatal): 12 Emergency Department Treatment Spaces: 9 Total Number of Out-Patient Treatment Areas if integrated or attached out-patient facility: When did the Joint Commission for Accreditation of Health Organizations (JCAHO) last review your facility? Health Services Emergency Medical Services 7 Acute Care Facility Self Assessment Resource Document November 2003

12 DEMOGRAPHIC INFORMATION (Listed for each hospital in alphabetic order) Hospital Name: Mailing Address and Phone Number: Physical Address (if different): Chief Executive Officer: Chief Operating Officer: Contact Person for this survey - Telephone and FAX Numbers: 3901 Lone Tree Way Antioch, CA (925) (same) Linda Horn, MHA Susan Bumatay, RN, MSN Medical Center Kenneth Harman, MHA (925) , fax (925) Date of Survey: 2/7/02 Designation for Tax Purposes (public, private no-for-profit, private for-profit): Private not-for-profit Total Number of Licensed Acute Care Beds (all types): 111 Licensed Intensive Care Beds (all types except neonatal): 12 Emergency Department Treatment Spaces: 16 Total Number of Out-Patient Treatment Areas if integrated or attached out-patient facility: When did the Joint Commission for Accreditation of Health Organizations (JCAHO) last review your facility? October 2001 Health Services Emergency Medical Services 8 Acute Care Facility Self Assessment Resource Document November 2003

13 SPECIAL PERMIT SERVICES Please indicate which of the following Special Permit Services are provided in your facility under a current permit to provide these services from the State Department of Health Services, meeting all provisions of the appropriate section of Title 22 Article 6. SERVICE Pablo John Muir Walnut Cr. Mt. Diablo Cardiovascular surgery service No Yes Yes No No Yes Yes No Comprehensive emergency medical service No No No No No No No No Basic emergency medical service Yes Yes Yes Yes Yes Yes Yes Yes Standby emergency medical service No No No No No No No No Burn center No Yes No No No No No No Renal transplant center No No No No No No No No Chronic dialysis unit No No No No No No No No If your facility provides any of these services in a limited fashion with no current permit, please describe here, or on a separate page the limitations of the service, or the current status of permit applications. n/a n/a n/a n/a n/a n/a n/a n/a Health Services Emergency Medical Services 9 Acute Care Facility Self Assessment Resource Document November 2003

14 SUPPLEMENTAL SERVICES Please indicate which of the following Supplemental Services are provided within your facility with current State Department of Health Services approval, meeting all provisions of the appropriate section of Title 22 Article 6. SERVICE Pablo John Muir Walnut Cr. Mt. Diablo Coronary Care Service No Yes Yes Yes Yes Yes Yes Yes Dental/Oral Surgery Service Yes Yes Yes No No Yes No Yes Intensive Care Service Yes Yes Yes Yes Yes Yes Yes Yes Nuclear Medicine Service Yes Yes Yes No Yes Yes Yes Yes Occupational Therapy Service Yes Yes Yes Yes No Yes Yes Yes Pediatric Service Yes No Yes Yes Yes Yes No No Prenatal Unit Yes Yes Yes No Yes Yes No Yes Physical Therapy Service Yes Yes Yes Yes Yes Yes Yes Yes Rehabilitation Center No No Yes No No No No Yes Respiratory Care Service Yes Yes Yes Yes Yes Yes Yes Yes Social Service Yes Yes Yes Yes Yes Yes Yes Yes Speech Pathology and/or Audiology Yes Yes Yes No Yes Yes Yes Yes If any of these supplemental services are provided in a limited fashion or without current State Department of Health Services approval, please describe the limitations of the service and the current status State approval application. n/a n/a n/a n/a n/a n/a n/a n/a Health Services Emergency Medical Services 10 Acute Care Facility Self Assessment Resource Document November 2003

15 HOSPITAL SPECIALTY SERVICES Please indicate if any of the following services are provided (as described) in your facility: SERVICE SP John Muir WC Mt. Diablo Inpatient acute hemodialysis services staffed by trained technicians in-house/on-call 24/7. Inpatient acute hemodialysis services provided though not available 24 hrs/day, 7 days/wk. No Yes Yes Yes Yes Yes Yes No No n/a n/a n/a n/a n/a n/a No Pharmacist in-house 24 hrs/day. No No Yes No Yes No No No Radiation Emergency Medical Team available on 24-hour call, including radiation medicine physician, health physicist and radiation technician. Hand surgery service with hand surgeon with experience in macro and micro vascular surgery oncall and promptly available 24 hrs/day. Physical medicine/hand rehabilitation service including physiatry services on call, occupational therapy, physical therapy, hydrotherapy, social services, and pain clinic. No Yes Yes No No No Yes No No No No No No Yes (no reimplantation) Yes No Yes No No Yes-2 on staff, but not 24/7 coverage Trauma Services (EMS designated Trauma Center). No No Yes No No No No No If Trauma Center, special pediatric trauma capabilities? Trauma rehabilitation services provided by dedicated rehabilitation staff under direction of physician and supported by physical therapy, social services, psychologist, and occupational therapy. Burn Service (organized burn service components including physician director, training for personnel, burn care protocols, routine burn care evaluation). n/a n/a No n/a n/a n/a n/a n/a No No Yes No No No No No No Yes No No No No No No No No No Yes Health Services Emergency Medical Services 11 Acute Care Facility Self Assessment Resource Document November 2003

16 TRANSFER AGREEMENTS Do you have transfer agreements with other hospitals to facilitate the transfer of any of the following type of patients from your facility? (This information is intended as an inventory of formal transfer agreements; it is not listed to limit hospital staff in choosing a facility for patient transfer). TYPE OF TRANSFER Pablo John Muir WC Mt. Diablo Traumatic injuries JMMC JMMC,AL.CO. JMMC JMMC JMMC Spinal cord injuries JMMC, K- Redwood City JMMC JMMC Burn emergencies DMC-SP DMC-SP St. Francis, SF DMC-SP Pediatric emergencies Cardiac emergencies Other types of transfers (please specify) CHO & JMMC CHO CHO JMMC OB Lvl III & Nursery Lvl III. Alta Bates MC CCRMC/Neuro Psych - Mt. Diablo Pavillion & Herrick, Alta Bates-OB/GYN; K. Oak & CHO Pedi surgery; Psych dependent on need CHO, K-Oak, A Bates K-SF, K-Oak, Summit JMMC- Neurosurgery; Alta Bates- OB/GYN; K. Oak & CHO Pedi surgery; Psych dependent on need; Ortho; K Oak Stable Neurosurgery; K Redwood City Unstable Neurosurgery CHO CHO CHO MDMC Level III ICN _- JMMC, CHO,, Psych CCRMC, Mt. Diablo Medical Pavilion; OB JMMC, ; PEDS JMMC, CHO Stnfrd/ heart trnsplnt JMMC Neurosurgery; Alta Bates OB/GYN; K. Oak & CHO Pedi surgery; Psych dependent on need, Ortho; K Oak Stable Neurosurgery; K Redwood City Unstable Neurosurgery MDMC SRRH (rehab) MDMC Nuerosurg- JMMC, Eden Health Services Emergency Medical Services 12 Acute Care Facility Self Assessment Resource Document November 2003

17 EMERGENCY SERVICES Please indicate which of the following Special Permit Services are provided in your facility under a current permit to provide these services from the State Department of Health Services, meeting all provisions of the appropriate section of Title 22 Article 6. EMERGENCY DEPARTMENT (ED) CAPACITY AND RESOURCES Pablo John Muir WC Mt. Diablo FY 2002 patient volume: 48,684 38, ,328 65,000 43,739 47,285 How many total pt treatment spaces (not beds) are available in the ED? Number of ED resuscitation spaces sufficient to accommodate a portable x- ray machine and 3 staff at the bedside of each patient simultaneously: Other monitored spaces in the ED: portable How many pts can be monitored at the nurse s station simultaneously? Non-critical treatment spaces: Does your facility have an FAA and CALTRANS approved helipad? If no approved helipad, does your facility have an identified EMS landing site? Is your facility an EMS designated base hospital? No Yes Yes No No No No No Yes n/a n/a Yes Yes Yes Buchanan Field No No Yes No No No No No No Yes data Health Services Emergency Medical Services 13 Acute Care Facility Self Assessment Resource Document November 2003

18 RADIATION / HAZARDOUS MATERIAL EXPOSURE PREPARATION Does your ED maintain or have ready access to the following equipment for radiation or hazardous material exposure management? RADIATION/HAZMAT CAPABILITIES: Fixed decontamination area with buffer zone, control points, fixed shower, sink Area in or near the emergency department designated in advance as a potential decontamination area Radiation detection equipment including portable equipment, survey meter, film badges or dosimeters Portable decontamination shower with collection tanks or barrels. Appropriate protection equipment available for staff. # of hospital personnel trained in first responder operations training Pablo John Muir Walnut Cr. Mt. Diablo No Yes Yes Yes Yes Yes No No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Some Yes Yes Yes Yes Yes Yes Permanent Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes 4 >25 8 >6 Decontamination supplies Yes In progress Yes Yes Yes Yes Some Yes Brand of decontamination supplies Does your ED maintain or have ready access to written or telephone information for radiation or hazardous material exposure management? Has the federal govt designated or contracted with your facility as a directed support facility for radiation/hazardous material injuries? various Yes Yes Yes Yes Yes Yes Yes Yes No No No No No No No No Health Services Emergency Medical Services 14 Acute Care Facility Self Assessment Resource Document November 2003

19 DISASTER EMERGENCY PREPAREDNESS DISASTER PREPAREDNESS/CAPACITY Pablo John Muir Walnut Cr. Mt. Diablo Has your facility adopted/integrated Hospital Emergency Incident Command System (HEICS)? Phone and Fax # s for designated Incident Command Center. Contact Name/Phone number for Emergency Preparedness. Is a written hospital evacuation plan for your facility on file with the EMS Agency? Do critical resources in your facility meet State mandated 2008 seismic standards: Yes Yes Yes Yes Yes Yes Yes Yes fax Larry Carlson fax: Nursing Sup Anne Lum Kevin Langkeit fax Dan Zoellner Lawrence Mouglia Yes No Yes Yes Yes Yes Yes Yes Yes Yes Bldg safe but needs sprinkler system fix. Emergency department Yes not known Yes Yes Yes Yes Yes Yes Surgical suites Yes not known Yes Yes Yes Yes Yes Yes # of suites meeting standards 7 not known all Laboratory facilities Yes not known Yes Yes Yes Yes Yes Yes Radiology facilities Yes not known Yes Yes Yes Yes Yes Yes Intensive Care Unit(s) Yes not known Yes Yes Yes Yes Yes Yes # of beds meeting standard 8 ICU, 10 Intermediate not known all General inpatient units Yes not known Partially Yes Yes 83% yes 17% no # of beds meeting standard 146 not known National Defense Medical Systems (NDMS) agreement with the Federal Govt. Yes Yes 8 CCU, 12 tele Yes 25 M/S, 14 postpartum No Yes Yes No No Yes No No Health Services Emergency Medical Services 15 Acute Care Facility Self Assessment Resource Document November 2003

20 INTENSIVE CARE UNITS INTENSIVE CARE CAPACITY Pablo John Muir Walnut Cr. Mt. Diablo Total # of licensed intensive care beds (includes all categories except neonatal): If you have a California Children s Services (CCS) designated Pediatric ICU, # of beds: # of intensive care beds with pediatric equipment and specially trained nurses: If you have a separate CCU, # of beds (included in total ICU bed count): If you have a separate Neurosurgical ICU, # of beds: If other designated intensive care specialty beds, please specify # and type: n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a 9 11 n/a n/a 10 n/a n/a n/a n/a 12 n/a n/a n/a n/a n/a n/a 6 Burn 0 n/a 25 Neonatal 0 0 n/a OTHER MONITORED INPATIENT BED CAPACITY Pablo John Muir Walnut Cr. Mt. Diablo # of monitored step-down or tele beds: Beds in addition to licensed intensive care beds? How many patients can be monitored from a central nurses' station simultaneously? If other monitored inpatient beds, please specify # and type: Yes Yes Yes Yes Yes Yes Yes Yes n/a 7 Recovery n/a n/a 0 n/a n/a n/a Health Services Emergency Medical Services 16 Acute Care Facility Self Assessment Resource Document November 2003

21 SURGICAL SERVICES SURGICAL SERVICE CAPACITY/STAFFING Pablo John Muir Walnut Cr. Mt. Diablo # of surgical suites: In-house surgical staffing 24 hours a day: No No Yes No Yes 2 No No No On-call surgical staffing available 24 hours a day by written policy: Yes Yes Yes Yes Yes 3 Yes Yes Yes Backup on-call surgical team available within 1hr Yes Yes Yes Yes Yes Yes Yes No POST ANESTHESIA RECOVERY CAPACITY/STAFFING Pablo John Muir Walnut Cr. Mt. Diablo Does your facility have a separate postanesthesia recovery unit? Yes Yes Yes Yes Yes Yes Yes Yes # of dedicated post-anesthesia recovery beds: If no separate post-anesthesia recovery unit, do you use ICU for recovery? RN s in hospital 24 hrs/day and who are specially trained in post-anesthesia recovery? RN s/essential personnel available 24 hrs/day by written policy? n/a n/a n/a n/a n/a n/a Yes No No No No No Yes 2 No Yes 4 No Yes Yes Yes Yes Yes Yes Yes Yes 1 Plus 1 cysto room 2 M-Fweekends/holidays day shift only 3 weekends & holidays 4 ED and ICU trained to cover during night shift. Health Services Emergency Medical Services 17 Acute Care Facility Self Assessment Resource Document November 2003

22 CRITICAL ANCILLARY SERVICES LABORATORY SERVICES / STAFFING Pablo John Muir Richmon d Walnut Cr. Mt. Diablo Does your facility have in-house laboratory staffing 24 hours a day? On-call or back-up lab staff available 24 hours a day by written policy? Yes Yes Yes Yes Yes Yes Yes Yes No Yes n/a Yes Yes n/a Yes No Please indicate which of the following laboratory services are available at your facility 24 hours per day. Chemistry Yes Yes Yes Yes Yes Yes Yes Yes Hematology Yes Yes Yes Yes Yes Yes Yes Yes Coagulation Yes Yes Yes Yes Yes Yes Yes Yes Toxicology Yes Yes Yes No No Yes Yes Yes Microchemistry Yes Yes Yes Yes No Yes Yes No1 Blood bank Yes Yes Yes Yes Yes Yes Yes Yes What is your source of blood products? American Red Cross American Red Cross American Red Cross American Red Cross Blood Center of the Pacific American Red Cross American Red Cross American Red Cross Health Services Emergency Medical Services 18 Acute Care Facility Self Assessment Resource Document November 2003

23 CRITICAL ANCILLARY SERVICES RADIOLOGY & SPECIAL PROCEDURES / STAFFING Pablo John Muir Walnut Cr. Mt. Diablo Does your facility have in-house radiology staffing 24 hours a day? On-call or back-up radiology staff available 24 hours a day by written policy? Do you have the following special capabilities inhouse or available within one hour by written policy? Yes Yes Yes Yes Yes Yes No Yes Yes 1 Yes n/a Yes Yes Yes Yes No Angiography, coronary artery No Yes Yes No No Yes Yes Yes, limited Angiography, all other types Yes Yes Yes No Yes Yes Yes Yes, limited Computer tomography--head Yes Yes Yes Yes Yes Yes Yes Yes Computer tomography - body Yes Yes Yes Yes Yes Yes Yes Yes Magnetic resonance imaging No No Yes No Yes Yes No Yes Ultra sound (sonography) Yes Yes Yes Yes Yes Yes Yes Yes Nuclear scanning Yes Yes Yes Yes Yes Yes Yes Yes Echocardiography Yes Yes Yes Yes Yes Yes Yes Yes Cardiovascular stress testing within 24 hours Yes Yes Yes Yes Yes Yes Yes Yes Myelography Yes Yes Yes Yes No Yes Yes Yes Ventilation perfusion lung scan capabilities Yes Yes Yes Yes Yes Yes Yes Yes Thallium scanning capabilities within 24 hrs Yes 2 Yes Yes Yes Yes Yes Yes Yes 1 CT & special procedures only. 2 Week days only Health Services Emergency Medical Services 19 Acute Care Facility Self Assessment Resource Document November 2003

24 PHYSICIAN SPECIALTY AVAILABILITY: PHYSICIAN SPECIALTY AVAILABILITY Specialty and sub-specialty practice physician availability for each facility are indicated by category, as defined below. The physician availability information obtained from each facility is specific to physicians who are on the medical staff of the facility. IN-HOUSE: In-house In-hospital 24 hours a day, 7 days a week. This requirement may be fulfilled by residents or other in-house (non-emergency department) physicians with special competence in the care of emergencies relevant to that specialty as judged by the chief of the respective service with qualified attending staff specialists on-call and promptly available for consultations and on-site supervision. Note: General surgery residents must have completed at least 3rd year of residency to fulfill this requirement. NORMALLY PROMPTLY AVAILABLE: Normally On-call 24 hours a day, 7 days a week and listed on the Emergency Department call list with a minimum of 3 specialists in each category on-staff and routinely participating in the call schedule. OCCASIONALLY AVAILABLE: Occasional Staff physicians on-call only intermittently, not always available, available during certain hours only, or fewer than 3 specialists in each category on staff and participating in the call schedule. NOT AVAILABLE: Not Specialty or sub-specialty practice physician is not available. Health Services Emergency Medical Services 20 Acute Care Facility Self Assessment Resource Document November 2003

25 PHYSICIAN SPECIALTY AVAILABILITY: The physician availability information obtained from each facility is specific to physicians who are on the facility s medical staff. Does not include specialty physicians available for consultation by telephone only, but who are not on staff at your facility. SPECIALIST Pablo John Muir Walnut Cr. Mt. Diablo Anesthesiology In-house Normally In-house Normally In-house Normally Normally Normally Cardiac Surgery Not Normally Normally Not Not Normally Normally Not Cardiology Normally Normally Normally Normally Normally Normally Normally Normally Dentistry/Oral Medicine Normally Occasional Normally Not Not Not Not Occasional Emergency Medicine In-house In-house In-house In-house In-house In-house In-house In-house Family Practice Normally Normally Normally Not Normally Normally Normally Normally General Surgery Normally Normally In-house Normally In-house Normally Normally Normally Internal Medicine Normally Normally Normally Normally In-house Normally Normally Normally Neurology Normally Occasional Normally Normally Normally Normally Normally Occasional Neurologic Surgery Normally Occasional Normally Not Not Normally Normally Not OB/GYN Surgery In-house Normally In-house Normally In-house Normally Normally Normally Ophthalmic Surgery Normally Normally Normally Normally Normally Occasional Normally Occasional Orthopedic Surgery Normally Normally Normally Normally Normally Normally Normally Normally Otorhinolaryngologic Surgery Normally Occasional Normally Normally Normally Normally Normally Occasional Pediatrics In-house Occasional In-house Normally In-house Normally In-house Normally Psychiatry Normally Occasional Normally Normally Normally Occasional Occasional Occasional Thoracic/Vascular Surgery Normally Occasional Normally Not Normally Normally Not Occasional Radiology Normally Normally In-house Normally Normally 2 Normally Normally Normally Urologic Surgery Normally Normally Normally Not Normally Normally Normally Occasional Health Services Emergency Medical Services 21 Acute Care Facility Self Assessment Resource Document November 2003

26 PHYSICIAN SPECIALTY AVAILABILITY: The physician availability information obtained from each facility is specific to physicians who are on the medical staff of the facility. Does not include specialty physicians available for consultation by telephone, but who are not on staff at your facility. NOTE: For the following specialists, the definition of Normally Promptly Available is revised to on-call 24 hrs/day, 7 days/wk with 2 specialists minimum. SPECIALIST Pablo John Muir Walnut Cr. Mt. Diablo Allergy Occasional Occasional Normally Occasional Not Not Normally Occasional Clinical Toxicologist Occasional Not Not Not Not Not Normally Not Endocrinology Not Occasional Normally Not Not Normally Normally Not Gastroenterology Normally Normally Normally Occasional Normally Normally Normally Normally Gerontology Occasional Occasional Occasional Not Not Not Normally Not Hand Surgery Normally Normally Normally Not Occasional Occasional Occasional Occasional Hematology Normally Occasional Normally Not Not Normally Not Occasional Immunology/ Rheumatology Occasional Occasional Normally M-F Not Occasional Not Occasional Infectious Diseases Normally Normally Normally Occasional Occasional Normally Not Occasional Microsurgery Not Not Occasional Not Not Occasional Not Not Nephrology Normally Normally Normally Normally Occasional Normally Normally Occasional Neonatology Normally Normally In-house Not Normally Normally Normally Occasional Neuroradiology Not Not In-house Not Not Normally Not Not Pathology Normally Normally Normally Occ. (M-F) Occasional Normally Occasional Normally Pediatric Radiology Not Not Occasional Not Not Normally Not Not Pediatric Surgery Not Not Occasional Not Not Normally Not Not Plastic & Maxillofacial Surgery Normally Occasional Normally Not Not Occasional Normally Occasional Pulmonary Diseases Normally Normally Normally Normally Normally Normally Normally Occasional Urologic Surgery Normally Normally Normally Normally Not Normally Normally Occasional Health Services Emergency Medical Services 22 Acute Care Facility Self Assessment Resource Document November 2003

27 SPECIAL SERVICES NEONATAL & OBSTETRICAL EMERGENCIES Pablo John Muir Richmon d Walnut Cr. Mt. Diablo Please indicate if your facility has any of the following services or capabilities: Labor and Delivery Unit within the hospital Yes Yes Yes No Yes No Yes Yes Newborn Nursery Yes Yes Yes No Yes No Yes Yes Cesarean Section Suite, staffing promptly available in-house or on-call within 30 minutes, 24 hrs/day by written policy). Does your facility have a California Children's Services approved Tertiary Neonatal Intensive Care Unit? Yes Yes Yes No Yes Yes Yes Yes No No No No No No No No Does your facility have a California Children's Services approved Intermediate (Community) Neonatal Intensive Care Unit? No No Yes No No No No No PEDIATRIC EMERGENCIES Pablo John Muir Richmon d Walnut Cr. Mt. Diablo Does your facility offer inpatient pediatric services? Yes No Yes No Yes Some Some 1 If yes, number of pediatric inpatient beds: 8 n/a 15 n/a 12 n/a None n/a 1 YES, but transfer by policy Health Services Emergency Medical Services 23 Acute Care Facility Self Assessment Resource Document November 2003

28 SPECIAL SERVICES PSYCHIATRIC EMERGENCIES Pablo John Muir Walnut Cr. Mt. Diablo Does your facility offer inpatient psychiatric services? If yes, indicate total number of inpatient beds Do you have pediatric psychiatric inpatient services? If yes, indicate total number of inpatient beds Yes No No No No No No No 51 n/a n/a n/a n/a n/a n/a n/a No No No No N/a No No No N/a n/a n/a n/a n/a n/a n/a n/a Which of the following services are offered through your psychiatric unit of facility: Physically separate psychiatric unit meeting requirements of sections Psychiatric rehabilitation provided by a dedicated rehabilitation staff under the direction of a Psychiatrist supported by occupational therapists, social services and others, or these services provided by contract Yes No n/a No No n/a n/a n/a Yes No n/a No No n/a n/a n/a Locked psychiatric ward Yes No n/a No No n/a n/a n/a Health Services Emergency Medical Services 24 Acute Care Facility Self Assessment Resource Document November 2003

29 ADDITIONAL SPECIAL SERVICES List and briefly describe below any special services offered in your facility and not covered in the self-assessment thus far: (example--hyperbaric medicine service with walk-in chamber and hyperbaric team on-call and available within 20 minutes by written policy, also available for telephone consultation). : Pablo: John Muir: : Walnut Cr: Mt. Diablo: : : OB; Oncology; Psychiatric Emergency Hyperbaric medicine w/ 3 chambers, Cardiac Rehab, Chemical Dependency Services, Wound Center Hyperbaric; Wound Care Center; Oncology; Infusion Center; High risk perinatology; Orthopedics; Lactation Center; High risk infant follow-up; Cardiac Rehab; Pulmonary Rehab; Breast center; Stem Cell transplant; Home Health; Diabetes Center; Sleep Studies n/a n/a Oncology; Breast Center; Cardiac Rehab; Pulmonary Rehab; Diabetes Center Cardiac rehab n/a Health Services Emergency Medical Services 25 Acute Care Facility Self Assessment Resource Document November 2003