Obligation to serve patients

Recognize the obligation of health care facilities to serve sexual assault patients.[1]  It is essential that all sexual assault patients who present to health care facilities be thoroughly evaluated. Treating injuries alone is not sufficient in these cases. Staff who examine these patients must be educated and clinically prepared to collect evidence and document findings while maintaining the chain of custody. They should be able to coordinate crisis intervention and support for patients, as well as provide STI evaluation and care, pregnancy assessment, and discuss treatment options, including reproductive health services. They must be aware of and follow jurisdictional reporting policies, and be able to provide court testimony if necessary.
 
The Joint Commission on Accreditation of Healthcare Organizations (JCAHO)[2] requires emergency and ambulatory care facilities to have established policies for identifying and assessing possible victims of rape and other sexual molestation. It also requires staff to be trained on these policies. As part of the assessment process, JCAHO requires these facilities to define their responsibilities related to the collection and preservation of evidentiary materials.[3] Sexual assault examiner programs are helping many health care facilities to carry out these requirements. Facilities should also familiarize themselves with the Federal Emergency Medical Treatment and Active Labor Act (EMTALA), which has provisions pertaining to the ability of hospitals to turn away patients with emergency medical conditions.[4]

[1] This and the next paragraph were drawn from L. Ledray, Evidence Collection and Care of the Sexual Assault Survivor: The SANE-SART Response, 2001, p. 1.
[2] JCAHO standards for accreditation address a health care organization's level of performance in specific areas—not just what the organization is capable of doing, but what it actually does. The standards set forth maximum achievable performance expectations for activities that affect the quality of care. These standards are developed in consultation with health care experts, providers, measurement experts, purchasers, and consumers, and usually are updated every 2 years. (See www.jointcommission.org/ for more information on JCAHO.) 
[3] Information on these requirements was drawn from www.sasafefamily.com.
[4] 42 U.S.C. § 1395dd. See http://www.emtala.com for more information about EMTALA. 


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