Medical staff knowledge of EMTALA at a large, tertiary-care hospital☆☆☆

Abstract 

The study objective was to determine what percentage of a hospital's medical staff have heard of the Emergency Medical Treatment and Active Labor Act (EMTALA) statute, and of those who have heard of it, to determine the extent of their knowledge. A questionnaire was mailed to 600 members of the active medical staff of an urban, 900-bed, private, tertiary-care hospital asking if they had ever heard of the EMTALA statute, and if so, to complete a 20-question multiple-choice quiz on specifics of EMTALA law. The main results were whether they had ever heard of EMTALA; if knowledge of EMTALA was related to specialty, age, years in practice, or frequency of ED call; and the quiz scores and any relationship they might have to those same demographic factors. Questionnaires were returned by 41.5% (n = 249). Thirty-one specialties were represented and seven had greater than 10 physicians each. Physician age and years in practice were skewed toward older ages. Approximately one-third (34.5%) took ED call at least monthly. Only 29.3% had ever heard of EMTALA. There was a significant linear correlation between on-call frequency and positive knowledge of the law, but of those who took call at least monthly, 50% had never heard of EMTALA. The average score on the 20-question quiz was 69%. Questions concerning definition of a transfer, definition of an emergency medical condition, investigations of EMTALA, on-call staff responsibilities, and the number of hospitals cited for EMTALA violations were answered correctly by <50% of the respondents. Most members of the medical staff of a large, tertiary-care hospital have never heard of EMTALA, and of those who have, the extent of their knowledge is limited. This presents challenges for the hospital to facilitate education efforts to reduce liability. (Am J Emerg Med 2003;21:8-13. Copyright 2003, Elsevier Science (USA). All rights reserved.)

Keywords:  EMTALA, COBRA