You did your part and got your patient through surgery with flying colors. But, uh-oh, the ride your patient was expecting to get home is a no-show. What should your ASC do?
Well, according to the Centers for Medicare and Medicaid Services, your ASC has a legal obligation to only discharge patients to a responsible adult when they have been under the influence of sedation.
Unfortunately, now that Uber and Lyft are such convenient options for transportation, many patients think they can simply hop in a rideshare vehicle and that’s the same thing as being discharged to a caring family member or friend.
However, the law in many states is still unclear on whether a rideshare driver counts as a “responsible adult” who is actually taking responsibility for the patient’s care just by stepping into the vehicle. In fact, in a recent Outpatient Surgery Magazine poll, 69 percent of surgical facilities said they never discharge an unaccompanied patient to take an Uber, Lyft or taxi home.
Protecting your ASC
To avoid the possibility of any legal issues surrounding your discharge procedures, here are some steps your ASC can take when your patient doesn’t have a ride available:
1. Reschedule the Procedure
If you discover during pre-op conversation that your patient will not have a responsible adult to take them home after their procedure, you should always reschedule the procedure until the patient can make proper arrangements to have a friend or family member present following their surgery.
2. Document, Document, Document
If you discover that your patient doesn’t have a responsible adult to take them home until after the procedure is complete and they’re dressed and insisting to go home on their own, your best option is to document as much as possible. Insist that the patient sign an AMA (against medical advice) form. Then write up the details of the patient’s non-compliance in an incident report in their medical record. Also, let their surgeon know.
While documenting your patient’s non-compliance can help mitigate any risk for your ASC, unfortunately, it is not an automatic defense in the event that a lawsuit is filed against your facility. It’s always best to be prepared in advance and work with your legal team to create policies and procedures in advance to handle discharge non-compliance.
Communicating with your patients before surgery and having them sign a form stating they understand they must have a responsible adult present to take them home after the procedure will go a long way toward boosting patient compliance of this important aspect of their post-op care.
For more ideas on how your ASC can avoid legal complications surrounding your discharge procedures, check out Outpatient Surgery Magazine’s article Legal Update: The Ride Home: Uber Complicated or Easy Lyft?