Policy on provision of informal emergency medical telephone advice to other health professionals

P181 V2

This is a policy of the Australasian College for Emergency Medicine (ACEM; the College). The policy relates to the provision of informal emergency medical advice over the telephone to external health professionals who telephone a hospital Emergency Department (ED). Informal advice would apply to impromptu calls received outside of an agreed system of care. 

This policy is applicable to emergency departments in Australia and Aotearoa New Zealand.

ACEM recognises that external health professionals such as community general practitioners, nurses or rural health practitioners may telephone the emergency department (ED) to seek emergency physician advice regarding their patients.

ACEM advises that any advice provided from the ED to external health professionals is conducted through formal systems and partnerships between services. This supports mutual understanding between external health professionals and the ED, including the limitations of providing medical advice by phone. For example, the recipient of the phone call is limited by the information provided by the health practitioner and does not have the visual cues that would normally help determine the severity of a patient's condition.

ACEM acknowledges the rapidly evolving area of telehealth in medical practice, medical education and supervision and has developed an (S843) Interim Position Statement on Telehealth in Emergency Medicine for the use of telehealth in emergency medicine. Medical advice over the telephone does not a substitute for a formal telehealth assessment through a registered telehealth emergency care provider. ACEM strongly believes that any emergency medical education or supervision sought from health professionals external to the ED must be through formal tele-education/supervision channels.

Informal telephone advice does not constitute a full medical assessment, and ED staff should exercise caution in providing an opinion to other health professionals. Any telephone advice provided only serves to assist external health professionals to make their own decisions to best care for their patients. Any telephone advice provided does not constitute a formal delegation, referral or handover of care.

Emergency physicians should advise external health professionals calling for advice that they are responsible for following or not following any advice provided by phone, and responsible for any record keeping of advice provided from the ED.

Should an ED and other health services determine that advice to external health professionals is feasible and appropriate to be provided by the ED, a clear, agreed approach, policy and structure should be implemented for provision of medical advice.

Emergency physicians key priority is to provide emergency care to patients in the ED and this must be considered when engaging with external health professionals and the time required to address their queries. 

Emergency departments should ensure that all ED staff are aware of this policy and internal policies on the provision of telephone advice to health professionals.

The following are available within through the ACEM Standards Library:

• S843 Interim Statement on Telehealth in Emergency Medicine
• P44 Provision of Emergency Medical Telephone Advice to the General Public