Documenting a Frequent Flyer

[NPO]

Do you think it is ever acceptable to document (professionally) that a patient is a frequent flyer?

Or "high volume user" if you prefer that term.

 

[cprted]

Is it clinically relevant? If the patient has called 5 times in the last seven days with the same complaint and has be discharged each time, that can be relevant. Or I might document, "patient's COPD is poorly controlled resulting in multiple ED visits over the previous 6 months."

If you start your narrative with, "patient is a well-known high frequency EHS user," you're basically saying, "this patient's complaint should not be taken seriously nor properly investigated please read no further." We all have them, but remember, frequent fliers have legit medical emergencies too sometimes.

 

[CentralCalEMT]

Document the response as you would any response. Generally you should document it as if it is the first time you have seen that patient. It depends on if it has anything to do with patient care. As the previous poster said, you do not want to minimize your patient's complaint. It also could be useful in responses that can turn into social services issues. For example, if you document "patient fell to the ground, denied any injury, and was assisted up by EMS. Patient has suffered multiple falls over the past several weeks resulting in multiple EMS calls to the residence." Documentation like that can be helpful. However, any documentation meant to minimize or demean the patient has no place in your PCR.

We all have frequent flyers. Because I always fully assess them, I have caught a STEMI as well as got one to admit to me they took a whole bottle of Lithium.

 

[NPO]

It was not my intent to belittle the patient's complaints. I am fully aware that everyone has a legit medical issue, sometimes an emergency, even the frequent flies eventually.

I more meant along the lines of for the hospital staff, and/or social services to use as documentation or evidence. I dont really know how social services works, so if someone is homeless for example, and in poor health, cant see/doesnt have a doctor etc...

 

[Ewok Jerky]

If they are well known to you they are probly well known to hospital staff as well. You can always mention in your verbal report that they need to see a social worker.

 

[NomadicMedic]

I document FIRST PERSON observations, such as, "I have seen this patient three times within the past 48 hours, and each time have evaluated and transported this patient to the emergency department, presenting with the same initial
complaint of xxxxx."

Don't judge or speculate, but state what you personally have seen and done. If one of the EMTs says, "oh, it's just Betty, we take her all the time" that has no relevance to my charting.

 

[SandpitMedic]

When a patient tells me they've been to the ER 2, 3, 19 times for this and they told them they couldn't do anything, or that they have a doctors appointment but it's too far out to wait... I put that in my subjective.

 

[Tigger]

If the patient tells me that they have been in the ambulance/ED x times in y time-frame I will certainly put that in my subjective, along with why the patient has done so. If I have run on the patient x times in y time-frame, I will also add that, along with why the patient called/chief complaint. But if someone else mentions that they were out there too, I leave that out.

 

[Dfib23]

Treat them as if this is the first time you have seen them. If they have been to the ER for a similar complaint make note of it and pass it on the staff of the ER. I am sure they will know who they are.

 

[titmouse]

Yes. I document FF the same way as I do with new patients.