How ERs can improve their relationship with police

Emergency departments deal frequently with high-risk patients and victims of violence, and as a result they often face heightened security concerns. Therefore, it's imperative that they strive to cooperate with the police without compromising patient privacy, according to a recent paper published in the Canadian Journal of Emergency Medicine.

In the piece, Brodie Nolan, M.D., and Alun Ackery, M.D., both ED physicians at St. Michael's Hospital in Toronto, describe two common interactions between police and ED staffers to showcase each party's differing needs and perspective, and how to find common ground.

In the first, an ED treats a trauma patient, in this case a 23-year-old stabbing victim accompanied by emergency medical services staff and police. The ED physicians may need to reassure the patient that they won't share information with police in order to obtain an accurate history, Nolan and Ackery write, but the police need cooperation from medical personnel in order to build an effective criminal case.

As a possible compromise, they suggest that physicians either ask for the patient's consent to share certain information with police, or if that isn't possible, they should provide limited information to assist in the investigation but avoid unnecessarily infringing on the patient's privacy.

In the second case, an emotionally disturbed, combative 29-year-old man, who was yelling at pedestrians and walking through traffic, is accompanied to the ED by two police officers. For these type of patients, who often face long ED wait times, police officers can provide important information to help caregivers assess whether a person is a candidate for involuntary admission. Physicians, on the other hand, may be busy with more critical patients and may not receive support if their hospitals don't employ crisis intervention services.

One solution, the authors write, is to implement protocols to streamline the ED admission process for patients brought in by police. One example is the use of an "emotionally disturbed person information form," which allows police to document their observations in situations where they have to leave the ED before a physician can assess a patient.

To cut down on ED overuse and overcrowding, some initiatives in the U.S. also employ first responders to handle and divert non-life-threatening cases, FierceHealthcare has reported.

To learn more:
- read the paper