Harbor:Receiving phone calls

Abnormal Lab Callbacks

1. Try to locate patient, check if patient is still in the ED (or even in MSE), admitted
2. If admitted, tell the tech/rads that they need to call the admitting doctor by calling up to the floor
3. Check out what was done for the patients -- EDM -- if not yet in EDM, to find out WHO SAW THE PATIENT and the pt's DISCHARGE DIAGNOSIS--- on regular Affinity, go to the Results scroll down for "chemistry" vs "comprehensive" select "ED Log", a new window pops up that should give you the resident who saw them and their diagnosis
4. If pt was sent home and you feel they need to be recontacted look up pt contact info - I do so by using the "affinity clinic work station" as this has a separate "Administrative data" scroll down button with phone number and address. There is supposed to be a Demographics button on the regular affinity too - Call patient or send them a telegram if they are hard to reach

ED Discrepancy Folder (Over Reads)

1. You are responsible for taking a look at this folder every shift, and clearing 2-3 over-reads
2. Open synapse and go to -->Conferences--->ED discrepancy
3. If the patient is admitted, then just write that the pt is admitted in the note section
4. if not, then it's the same process for pt with abnl labs, depending on the situation you may have to track down the patient and call them/send a telegram
5. Again, ask an attdg if you have questions

Outside clinics, MLK, Hubert-Humphrey transfers

1. We generally don't refuse any transfers
2. However, if the pt is unstable, they should call 911 and go to the nearest hospital
3. Inform the charge nurse that there is someone coming and if they need to be monitored d) You generally cannot triage MLK/HH transfers back out to triage...but if we are severely overcrowded (as above) it's acceptable if the attdg is ok with it

Harbor Clinic patients

1. Again, generally cannot refuse patients
2. if they do not need to be monitored bed, they can go to Urgent Care instead
3. if they are being admitted, and are otherwise stable (do not need monitor) then they should bypass the ED and go through pt flow coordinator
4. When Urgent care closes, pt get sent to the ED
5. Again FYI the charge nurse about all incoming patients

MAC transfer requests

1. Often for "higher level of care"
2. Make sure you run the patient by the specialist and admitting team, e.g. multi-trauma pt who needs NSG intervention needs to be accepted by neurosurgery AND trauma
3. Good trick: tell MAC to call consultant directly, can then bypass the ED if they have a bed.