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| Have Protocols, Will Practice |
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by Donald Correll MD - April 25, 2011
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Eleven years ago we hired our first physician assistant. He arrived with a 3-ring binder notebook with around an inch of pages that he made himself. He handed me the notebook and said, “You will need these Protocols; they are required by state law”.
“I copied them off the internet,” he then stated. This was the first time I had heard that protocols for physician assistants were a requirement, and I thanked him for his help.
Since that time, we have employed additional physician assistants for our emergency department and now have 12. I do not know how we existed without them.
The protocols that I was given were office-based with applications to what we see in the ED, such as asthma, ankle sprains, low back pain etc, each on one page with several fill-in-the-blanks for medications. Having fulfilled a state requirement, we went on our way in contentment for many years.
After several years, there occurred situations that the Protocols did not specifically address, and patients were discharged that had undesirable outcomes without any physician involvement on the case. Legal action unfortunately resulted. It is not known if consulting a physician would have prevented what occurred, but it would have been desirable to have that interaction and a co-signature.
I decided to purchase Protocols that were more comprehensive and acuity based. After searching for a book, and contacting other groups, it became apparent that such comprehensive Protocols did not exist that I could access. As medical director, I thought I would write 50 or so pages of Protocols for my department that would hopefully prevent adverse outcomes and improve patient care.
At this time the Protocols are over 750 pages. Oh well. I have retitled the book for Nurse Practitioners and decided to make it available to others who need more comprehensive protocols. Some have expressed, in those states that do not require them, the sentiment that they do not like the concept of “Protocols,” so I created a Practice Guide. The content is essentially the same with more autonomy in the Practice Guide. Either can be used for acute care in emergency departments, urgent care centers and office practices. For more information about these guides, visit www.acutecarehorizons.com.
Best regards,
Donald Correll MD
Jackson-Madison County General Hospital
Jackson TN
www.acutecarehorizons.com
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