Harbor:ED follow-up options: Difference between revisions
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*[[:File:PED followup flowchart 8-23-21.pdf]] '''''</big>
*[[:File:PED followup flowchart 8-23-21.pdf]] '''''</big>
*Outpatient Follow up is based on patient’s insurance network
*Outpatient Follow up is based on patient’s insurance network
*Out of Plan (OOP), means the patient has Non-DHS insurance network, Private insurance, Other Medi-Cal HMOs, or could be out of County/Country.  
*'''Out of Plan (OOP)''', means the patient has Non-DHS insurance network, Private insurance, Other Medi-Cal HMOs, or could be out of County/Country.  
* DHS means LA County Department of Health Services network eligible
* '''DHS''' means LA County Department of Health Services network eligible
* MHLA, MyHealthLA, are > 18yo, “uninsurable,” community clinic PCP that can e-consult to get subspecialty & inpatient care through DHS
* '''MHLA''', MyHealthLA, are > 18yo, “uninsurable,” community clinic PCP that can e-consult to get subspecialty & inpatient care through DHS


===[[Same/Next Day Specialty Clinic Follow up]]===
===[[Same/Next Day Specialty Clinic Follow up]]===

Revision as of 20:53, 15 October 2021

FOLLOW-UP

REFER TO

  • File:AED followup flowchart 8-23-21.pdf
  • File:PED followup flowchart 8-23-21.pdf
  • Outpatient Follow up is based on patient’s insurance network
  • Out of Plan (OOP), means the patient has Non-DHS insurance network, Private insurance, Other Medi-Cal HMOs, or could be out of County/Country.
  • DHS means LA County Department of Health Services network eligible
  • MHLA, MyHealthLA, are > 18yo, “uninsurable,” community clinic PCP that can e-consult to get subspecialty & inpatient care through DHS

Same/Next Day Specialty Clinic Follow up

RESULTS/SYMPTOM FOLLOW-UP

OOP

  • If no emergent need for same day/next day follow up with specialist [insert link], then follow up in home county / country for referral or have patient call 2-1-1 or One Degree (1degree.org)
  • For routine primary care needs (PCP) then send patient back to health plan to arrange follow up. Check insurance card for PCP/health plan details, call for follow up. For anyone (even OOP) can use this flyer to call 2-1-1 File:Looking for a Doctor English & Spanish.pdf
  • If recently moved to LA County and wants to change to DHS, then need to change address of record: bring proof or LAC residence (mail, DMV record) to Registration Rm PCDC 108, 1st floor main hospital, ext 64150
  • For urgent specialist follow up w/in 2 weeks,
  • OOP: refer patient back to their health plan / PCP for referral
    • Exception: complication within 30 days of an emergent operation / procedure done at Harbor – follow steps on previous slide
    • Exception: pediatric orthopedic follow-up for a patient that was seen by orthopedics and reduced / splinted or casted (link for ped ortho f/u instructions)
    • Potential exception: CCS-eligible pediatric patient (link for CCS instructions)

Instructions for clerk requesting/booking an appointment

  • Under Follow-Up Date in the Depart process [create link for instructions for clerk requesting/booking an appointment]
    • Choose Free-text Follow Up
    • Type in the appropriate clinic and click Add
    • Enter the date and time the specialist wishes to see the patient
    • Under Edit Comments, enter the OK-ing doctor & reason for urgent f/u
    • Click OK
    • Click the pencil by Schedule Follow Up Appointment
    • Makes a star appear on the track
    • Clerk then knows to make an appt

DHS eligible patients

  • Primary Care
    • Only arrange PCP referrals if discharging from ED
    • Needs a PCP
      • DHS eligible PCP follow up options.png
      • Urgent PCP need, refer to Continuity Care Clinic (CCC) [insert link]
  1. Instruct the patient to follow up with their empaneled provider
  2. Use the 'communicate' tool to send a message to the empaneled provider listed in the banner bar
  3. Write a brief message explaining why and when the patient needs follow up
  4. Their empaneled provider can initiate e-consults if applicable
  5. Empaneled providers are automatically notified of ED visits but you can still message them with any specific concerns

Urgent <2 Week Specialty Follow-up for DHS or MHLA Patients

  • Certain clinics can be direct booked without talking to the subspecialist [insert link]
  • Speak to consultant, discuss need for follow up and agree on timeline, and whether consultant will take responsibility to book or have ED clerk request appt
  • Write the following items in the follow up field for clerk to book:
  1. Name of approving doctor
  2. Time frame (I.e., 2 days, 1 week, etc.)
  3. Reason for urgent follow up

Direct book without consultant discussion

  • Certain ortho injuries (adult and ped lists)
    • Pediatric Cardiology
    • Pediatric Adolescent Medicine
    • Gyn Urgent Care
    • Adult Nephrology for non-dialysis patients
    • Anticoagulation clinic
    • Ophthalmology next-day for:
      • Orbital wall fx w/o concern for orbit injury
      • OK per Dr. Prasad

NERF

  • New Empanelment Referral Form (NERF) time frame can vary depending on where the patient is in obtaining Medi-Cal. Where they are in the process will determine how quickly the patient can be NERF’d
  • Before NERF’ing, ensure that the patient wants a PCP within DHS and has given their preferred phone number.
  • A NERF is not needed for a patient who already has MHLA or has non-DHS Medi-Cal managed care.
    • If the patient no longer wants to get their care from their current MHLA or Medi-Cal managed care provider and the patient confirms that they would prefer to come to DHS, then a NERF may be submitted.
    • Please use the Comment Box to indicate that the patient would like to switch their care to a DHS provider. This will help the Patient Relations Team know that the NERF was not submitted in error.
  • Patient Relations Rm 1-B-1, x64400 during business hours is great resource for patients to get PCP and navigate insurance (Out of Plan or Out of County, wants to switch to DHS)
  • Medi-Cal continuum is complex, check the ‘Additional Patient Info’ on ED Summary or Demographics to find out what patient’s insurance plan is
    • Hospital presumptive eligibility (HPE) 402 need to go to Financial Services in 3S to complete their application for Medi-Cal, must do so before the end of the following month. Only good ONCE in 12 months.
    • Fee For Service (FFS) 405 window when application getting processed. Will get packet for them to PICK plan, or will get auto-assigned. Might start out DHS but then turned into OOP later.
    • Restricted 406 for patients that don't qualify for a plan due to residency challenges, or self pay --> CAN GET NERF'd quickly
  • Ask Registration if you have any questions on shift
  • Patient Access Center/Appointment Center x66500 for patients that want to schedule clinic follow up or enquire about their NERF status.
  • Continuity Care Clinic (CCC) [insert link] is a good resource with adult patient getting discharged with chronic medical condition that cannot get NERF'd quickly (HPE and FFS).
  • You don't need to know this, but if you're curious: The following are generally eligible for empanelment, although for most of these insurance codes, empanelment is dependent on the Medi-Cal application being completed and processed.
    • Medicare Fee-for-Service (Insurance Code: 301)
    • Medi-Cal Fee-for-Service (Insurance Code: 405)
    • Restricted Medi-Cal (Insurance Code: 406)
    • Hospital Presumptive Eligibility Medi-Cal (Insurance Code: 402)
    • Pending Medi-Cal (Insurance Code: 423 or 407)
    • Ability to Pay (Insurance Code: 350 or 351)
    • Self-Pay patient (Insurance Code: 000 or 469).
    • For a full list of eligible empanelment by insurance codes, please see the Office of Patient Access – Insurance Codes and Financial Clearance Guidelines.

Patient wants to switch to Harbor

  • If they want to switch to Harbor UCLA or have problems with their health plan, they can call their own insurance plan. For MHLA patients, they can also contact MHLA directly and request the change if eligible.
    • Patient Relations in Rm 1B1 x66201 open during business hours can help switch patients to DHS if eligible (2 ED vistis in 6 months, 1 primary care visit in 18 mo, or 2 specialty visits in 12 months)
  • If they are Out of Country/County, and now reside in LA County, they can go to Registration PCDC Rm 108, 1st floor main hospital, ext 64150 to change their address by bringing any mail or DMV record.
  • If patient is frustrated with their medical home, please tell them to call the CA Department of Managed Care Office https://www.dmhc.ca.gov/?referral=hmohelp.ca.gov or to submit an online complaint

Pediatrics CCS Follow up

  • California Children Services (CCS) conditions can be approved for follow up and admission here after discussion with specialist and UR, even if OOP.
  • Up to age 21 yo
  • New acute illness requiring a subspecialist (new DM, new malignancy/tumor, new seizure d/o, etc.)
  • Call the subspecialist and ask them if patient has a CCS eligible diagnosis, if yes then tell UR and they should be able to be admitted at Harbor or obtain outpatient follow up here at Harbor.

CCC

  • CCC will work to be primary care until empaneled (place NERF)
  • Need at least one chronic medical condition
    • Chronic conditions which appropriate outpt care prevents inpt admission and/or complications.
    • Asthma, CHF, Cancer, CVA, ESRD, CF, DM, HIV/AIDS, IBD, Heart Dz, HTN, HL, Neuromuscular dz, Psych d/o, CKD, RA, Sz d/o, Substance abuse d/o, Specified debilitating conditions
      • Please refer all DHS patients with substance use disorder (SUD) started on medication assisted treatment (MAT) to CCC for enrollment in Dr. Brown's addiction clinic


MAT/BUP/Opiate Withdrawal

  • Please refer all DHS patients with substance use disorder (SUD) started on medication assisted treatment (MAT) to PVCC/CCC – Har for enrollment in Dr. Brown's addiction clinic
    • In the "For referral, specify need" box: "MAT for opiate/alcohol dependency"

Qualifying patients

  • Active withdrawal or post-overdose: start buprenorphine in ED via buprenorphine protocol
  • Not in active withdrawal but with opioid use disorder: rx for home start using home initiation protocol
  • Patients with chronic pain and opioid dependence with PMD at Harbor: message PMD AND Christopher Brown AND Gloria Sanchez to link patient to Harbor SUD clinics
  • For pregnant patients - once the primary complaint is addressed (or if primary complaint is pregnant and opiate use disorder/withdrawal), if patient has confirmed IUP please send to OB triage for initiation of Suboxone during pregnancy

Patient MAT/Buprenorphine Follow Up Options

Insurance Clinic Hours
DHS Empaneled and DHS Eligible (not Harbor Family Medicine) Primary Care & Diagnostic Center (PCDC) - Basement Clinic C

1000 W. Carson St
Torrance, CA 90502
(424) 306-4546

Schedule as "HAR PC MAT New" or

Walk-In: Monday AM or Thursday AM
For questions, please message Chris O. Brown, MD via ORCHID/Outlook

DHS Empaneled and DHS Eligible Lomita Clinic

1430 W Lomita Blvd, 2nd Fl
Harbor City, CA 90710
(310) 602-2600
(424) 306-4193 - SUD Counselor

Walk-In: Tuesday AM or Friday AM

For questions, please message Gloria Sanchez, MD via ORCHID/Outlook

DHS Empaneled, DHS Eligible, MyHealthLA, Uninsured (No OOP) LAC+USC Urgent Care

2051 Marengo St, 2nd Floor
Los Angeles, CA 90033
(323) 409-1000

Walk-In:

Tuesday-Thursday & Saturday
8am-7pm

All Patients Tarzana Treatment Center

5190 Atlantic Blvd
Long Beach, CA 90805
(818) 654-3933

Walk-In:

24/7

All patients can call the Substance Abuse Service Hotline 24/7 for more help (844) 804-7500


Follow up In Other Clinics

For DHS eligible patients only: Clerk will book into appointment slot, or if unable, will place a request into the scheduling queue for Patient Access Center/Call Center to take over. Patients can also call PAC to schedule appointments (Rather than calling the clinic directly)

Anticoagulation (Coumadin) Clinic

  • Book without consultant approval
  • Book at 7d post initiation of anticoagulation
  • M-F 8am-4pm Ext. 5159, M-F after hours 4-9pm pager 9995, S- Sun 8am-8pm Pager 9995

Breast Diagnostic Center (Radiology)

Breast Surgery Clinic

CARDIOLOGY

  • Daytime: Talk to CORE during the day, Afterhours: Talk to C-team Night fellow (listed on MedHub)
  • Book: with consultant approval - write name of approving doctor, time frame, and reason for follow up. (Cards will message Mariedel Morales and Sheila Walters IC, the Cardiology clerks, to book).
  • For ZioPatch (holter monitor) - message empaneled PCP or CCC for cardiology
Stress Testing
  • OOP - refer back to in-network PCP for cardio workup
  • DHS empaneled - message PCP for further cardio workup or schedule for stress test
    • 1 - Ensure patient is ambulatory (walk 2 blocks); if not able to complete a treadmill stress test, consult cardiology to determine best option
    • 2 - Send COVID test via "AMB Coronavirus Covid-19" order
      • Select "nasopharyngeal" then modify order
        • Change order for future visit to "no"
        • Change collection priority to "STAT"
      • If the stress test appointment is more than a week in advance, DHS patients can be tested at N26 (the COVID test has to be resulted within 3-7 business days of the procedure)
        • Modify to: "future order"; "RN collect"; "anterior nares"
        • Call x67786 (N-26) with any questions about the COVID testing procedure
    • 3 - Place order for "CV Treadmill Stress Test"
      • Reason for procedure "Chest Pain"
      • Special Instructions "Schedule in 3-4 business days"
    • 4 - In DEPART section, click "Schedule Follow-up Appointment" so clerk makes appointment prior to patient DC
      • If the COVID test is positive, the Cardiology fellow/attending at the Heart Station will call the patient to discuss
        • 1 - COVID symptoms
          • If asymptomatic for >10 days (or >20 days if severe COVID disease or immunocompromised), the appointment will stand
          • If symptomatic, the appointment will be canceled and the Cardiology fellow/attending at the Heart Station will message the empaneled PCP to ensure close follow-up
        • 2 - Cardiac Symptoms
          • The Cardiology fellow/attending at the Heart Station will call the patient to further risk stratify
            • If deemed high risk, Cardiology will schedule an alternate non-AGP stress test
            • If deemed low-risk, stress testing will be deferred to the PCP for follow up
  • DHS Eligible without assigned PCP
    • 1 - Ensure patient is ambulatory(walk 2 blocks); if not able to complete a treadmill stress test, consult cardiology to determine best option
    • 2 - Send COVID test via "AMB Pre-surgical/Procedure Coronavirus COVID-19 Screening" order
      • Select "nasopharyngeal" then modify order
        • Change order for future visit to "no"
        • Change collection priority to "STAT"
    • 3 - Place order for "CV Treadmill Stress Test"
      • Reason for procedure "Chest Pain"
      • Special Instructions "Schedule in 3-4 business days"
    • 4 - In DEPART section
      • ***CCC for NERF*** (get a PCP assigned)
      • Click "Schedule Follow-up Appointment" so clerk makes appointment prior to patient DC
    • If the COVID test is positive, the Cardiology fellow/attending at the Heart Station will call the patient to discuss
      • 1 - COVID symptoms
        • If asymptomatic for >10 days (or >20 days if severe COVID disease or immunocompromised), the appointment will stand
        • If symptomatic, the appointment will be canceled and the Cardiology fellow/attending at the Heart Station will message the empaneled PCP to ensure close follow-up
      • 2 - Cardiac Symptoms
        • The Cardiology fellow/attending at the Heart Station will call the patient to further risk stratify
          • If deemed high risk, Cardiology will schedule an alternate non-AGP stress test
          • If deemed low-risk, stress testing will be deferred to CCC for follow up

Drs. Chappell, Shah, & Pillutla 8/19/2020

DERM

  • Book: with consultant approval - write name of approving doctor, time frame, and reason for follow up

ENT

  • Book: with consultant approval - write name of approving doctor, time frame, and reason for follow up

Expedited Work-up Clinic (EWC)

  • The Expedited Workup Clinic (EWC) is an option for patients who are stable but require close outpatient follow-up for further diagnostic evaluation (ex. uncharacterized mass, anemia, etc). These are patients that would have been admitted otherwise, but are clinically stable. The EWC is for patients who do not have a primary care provider and must have reliable contact information.
  • Clerk books WITHOUT consultant approval
  • HAR CCC Rm 4, every Monday afternoons.
  • Must have reliable contact info, confirm phone number and address
  • Ideal candidates are those patients that would be admitted in the absence of EWC, and do not have a primary care provider. Patients must have reliable contact information to attend this clinic.
  • If no slots available, send a message to CCC to book the patient.
  • Clinical criteria:
  1. New onset ascites: New diagnosis and first presentation of ascites. Requires paracentesis performed in ED to rule out infection, SAAG >1.1, transaminases < 3x normal, rapid HIV, CBC, lipase, CMP. No referral for therapeutic paracentesis alone, No evidence of pancreatitis or biliary obstruction.
  2. Anemia (Hgb< 8g/dL on initial presentation): Requires CBC, peripheral smear, CMP, rapid HIV, ECG, CXR, type and screen No evidence of pancytopenia, HIV, leukemia, active GI/GU bleeding, or evidence of hemolysis. Patients with suspected gynecologic etiology should be referred to the GYN service. Post transfusion CBC required.
  3. Weight loss, unexplained >10% within 1 month or >15% in 6 months: Requires CBC, CMP, ECG, CXR, rapid HIV. Patients with prior imaging must have actual images or be instructed to retrieve images prior to clinic appointment.
  4. Undiagnosed mass (excluding primary breast, brain, renal, head and neck masses): Requires results or radiographic imaging to confirm presence of mass. Patients with prior imaging must have actual images or be instructed to retrieve imaging prior to clinic appointment. Send CBC, CMP, PT/INR, HIV on all patients.
  5. New onset pleural effusion: Requires thoracentesis, CMP, CBC, serum amylase, LDH, and pleural fluid analysis (predominant lymphocytic effusion or high suspicion for Tuberculosis must be admitted). Chest CT only if immediately clinically indicated (ie. suspicion for pulmonary embolism).
  • Patient is stable (T< 38.3c, HR<100, RR <24, BP >110/50, BP <180/110, pulse ox >92% on room air, oriented x 4)
  • Able to be seen in 2-10 business days without significant risk
  • No ACTIVE co-morbidities (ie infection, CAD, CHF, stroke, metastatic cancer, renal failure, dyspnea).

GYN

  • Book: with consultant approval - write name of approving doctor, time frame, and reason for follow up

Gyn UCC

  • Book without consultant approval
  • 3-4d f/up for ALL DHS PID patients (cervical motion tenderness or adnexal tenderness, empirically treated)

Interventional Radiology

  1. REDIRECT [[1]]

Nephrology Clinic

  • For non-dialysis patients only: Don’t need Nephrology fellow approval per Sharon Adler, MD, Chief, Division of Nephrology and Hypertension, 7/28/17)
    • 3 slots a week specifically earmarked for ED use for Thursday morning Nephrology clinic (GN, diabetes, other CKD)
    • 2 “Discharge” slots for the Friday afternoon Hypertension (complex/resistant HTN, HTN with CKD, stones, PCKD, SLE)

Neurosurgery

  • Book: with consultant approval - write name of approving doctor, time frame, and reason for follow up

Limb Salvage

  • Book: with consultant approval - write name of approving doctor, time frame, and reason for follow up
  • Clerk books directly into HAR Surg VASC -> Podiatry New

OB

  • For new pregnancy: discharge patient with OB clinic intake phone number (424-306-7200) so they can schedule appointment
  • For patients considering pregnancy termination or interested in discussing options: discharge patient with general Gyn clinic phone number (424-306-4061), they can request appointment with ROC (reproductive options clinic)

ONCOLOGY

  • Book: with consultant approval - write name of approving doctor, time frame, and reason for follow up.
  • Newly diagnosed, metastatic cancer - discuss with oncology fellow p7862

OPHTHO

  • Book without consultant approval for next day follow up for orbital wall fractures w/o orbital injury concerns, ok per Dr. Prasad, Division Chief
  • All other cases: Book: with consultant approval - write name of approving doctor, time frame, and reason for follow up

ORTHO

  • Book: with consultant approval - write name of approving doctor, time frame, and reason for follow up
  • Orthopedic conditions that can be managed in the ED with Orthopedic follow-up (must be neurovascular intact; ED clerk can book into orthopedic fracture clinic):
    • ADULT:
      • Clavicle: <5mm mid-shaft; sling, ortho in 2 weeks
      • Shoulder dislocation: after reduction, place in shoulder immobilizer, ortho 1 week
      • Humerus:
        • Proximal: non-displaced; sling, ortho in 1 week
        • Shaft: non-displaced; sugar tong/sling, ortho 1 week
      • Radius:
        • Non-displaced distal or shaft; volar splint, ortho 2 weeks
        • Non-displaced head with good ROM: sling, ortho in 2 weeks
      • Ulna: non-displaced; volar splint, ortho 2 weeks
      • Occult Scaphoid: thumb spica splint, ortho in 3 weeks
      • Metacarpal: non-displaced shaft and neck
        • MCP 4&5: Ulnar gutter splint, ortho 3 weeks
        • MCP 2&3: Radial gutter splint, ortho 3 weeks
      • PIP/DIP dislocations: simple, no fracture; buddy tape with padding between digits/splint, ortho 1 week
      • Hand: Distal Phalanx - buddy tape/alumiform splint, ortho in 3 weeks
      • Metatarsal 2/3/4 with <2mm displacement and no rotational deformity: post op shoe, ortho in 2 weeks
      • Foot: non-displaced phalanx fracture - buddy tape, ortho in 2 weeks
      • Chronic or non-healing fracture: CCC for e-consult (call ortho if needs closer follow-up)
    • PEDIATRIC
      • Radius, ulna, fibula, clavicle, tibia fractures
        • < 5mm displaced and < 15 degrees angulation
        • Pain controlled by oral meds
        • Normal neurovascular status
        • 5 years and older
      • Proximal humerus fractures with minimal displacement – place in sling
      • Elbow trauma with elevated posterior fat pad, no visible fracture
      • Foreign bodies not in bone or joint space
      • Salter Harris 1 fractures that are not displaced
      • Distal phalanx fractures not involving joint space
      • Tuft fractures


  • Call Orthopedics for the following fractures
    • Displaced radius, humerus, ulna, tibia, fibula fractures
      • >5mm displaced or >15 degrees of angulation all ages
    • All elbow and femur fractures (unless only posterior fat pad)
    • Open fractures or concern for
    • Fractures entering a joint space or concern for
    • Suspected septic joint
    • Fractures with suspected neurologic or vascular injury or pain not controlled by oral pain meds
    • Excessive swelling or ecchymosis suggesting risk for compartment syndrome
    • Scaphoid fractures
    • All fractures in children less than 5 years
    • Any fracture > or = to 10 days that may need reduction
    • Anytime unsure of what to do or if fracture not included on any of this protocol


  • Peds Specifics
    • OK to Splint; DHS Eligible
      • Call ortho and ask for approval to book in clinic the next Tuesday for Pediatric fracture clinic.
      • Ortho does not have to see the patient or write a consultation
    • OK to splint; OOP (these will not qualify for CCS)
      • D/c patient with copies of films
      • Specific instructions to family to call and get ortho referral
      • Hand-out available with options for families (PMD, Shriner’s, Orthopedic institute)
    • Patients Seen at OH splinted and referred to Harbor; Call ortho if:
      • DHS eligible or empaneled
      • Believe urgent/emergent intervention needed
      • Needs a reduction
      • Patient having difficulty getting into empaneled orthopedist (can give hand-out of other options).
        • Ortho attempts to get CCS and if not able helps get care
          • Ortho and CCS (California Children’s Services)
            • Ortho has hired Anna Contreras ( Daisy) to help get CCS for many of the OOP ortho patients
            • If patient is OOP and ortho requests to see them after they splint or cast send a communication to Anna Contreras through Cerner and she gets back to families within 1 business day.
            • Instructions on each computer in PED doc box
            • If the patient doesn’t qualify for CCS, they will help the family get into their orthopedist

PEDIATRICS

  • Book: with consultant approval - write name of approving doctor, time frame, and reason for follow up

Pediatric Adolescent Clinic

  • Book: with consultant approval - write name of approving doctor, time frame, and reason for follow up

Pediatric Cardiology

  • Book: with consultant approval - write name of approving doctor, time frame, and reason for follow up

PLASTIC SURGERY

  • Book: with consultant approval - write name of approving doctor, time frame, and reason for follow up

PULMONARY

  • Book: with consultant approval - write name of approving doctor, time frame, and reason for follow up


PROCEDURE CLINIC

  • For patient needing recurrent paracentesis
  • From Dr. Anshu Abhat:
  • only available for patients who are empaneled to Harbor-UCLA Internal Medicine or Geriatrics clinic.
  • If an ED provider thinks a patient could benefit from procedure clinic, they should include this in the ER note/documentation (ideal) or message the empaneled provider. Referrals to procedure clinic should only come from PCP's (not from ER providers).

RHEUM

  • Book: with consultant approval - write name of approving doctor, time frame, and reason for follow up

SURGERY

  • Book: with consultant approval - write name of approving doctor, time frame, and reason for follow up

UROLOGY

  • Book: with consultant approval - write name of approving doctor, time frame, and reason for follow up

72 HRS STRESS TEST

Place order in ORCHID for "CV Treadmill Stress Test"

  • If test is abnormal, cardiology follow up automatically generated by HEART station.
  • If test is normal, no notification occurs, other than typical follow up. If you want someone to follow up on the result, consider messaging empaneled PCP or refer to CCC.
  • Outpatient P-MIBI Nuclear stress has to be arranged by CORE

FOLLOW-UP FOR OUT-OF-COUNTY/OUT-OF-COUNTRY (OOC) PATIENTS

Per DHS Policy 516.1, Out of County/Country Patients who need an urgent follow-up for an emergency medical condition may be provided such follow-up at Harbor

  1. Emergent Conditions:
    1. Places health in serious jeopardy
    2. Threatens serious impairment to bodily functions
    3. Threatens serious dysfunction to any organ or body part
  2. If they are from a county close by - consider referring them to their home county. Call 2-1-1 social services hotline.
  3. Do not arrange follow-up for NON-EMERGENT/URGENT issues
  • If patient is no longer Out of Country/County, they can go to Registration Rm 108, 1st floor main hospital), ext 8101 to change their address.

Dir AED, Dir OPS, DHS Policy 516.1 9/25/17

See Also

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