INTRA and INTERhospital Transfers: Difference between revisions
From Guide to YKHC Medical Practices
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*Receives report from OP Clinic RN | *Receives report from OP Clinic RN | ||
*Cares for patient as any other ED patient | *Cares for patient as any other ED patient | ||
==Transfer from ED to LTC== | |||
'''ED Provider''' | |||
*Assesses/evaluates the patient and transfer back to LTC is appropriate Contacts LTC Provider (or LTC RN after hours) to discuss transfer | |||
*Communicates with ED RN | |||
*Documents the rationale for transfer | |||
*Completes the Discharge Medication Reconciliation | |||
'''ED RN''' | |||
*Communicates with LTC RN that the patient will be transferred | |||
*Calls report to LTC RN In conjunction with ED clerk, arranges transport of the patient to the LTC | |||
LTC Provider: Evaluates patient upon return to LTC | |||
*Updates orders as needed | |||
'''LTC RN''' | |||
*Receives report from ED RN | |||
*Reviews new orders if indicated | |||
*Cares for patient as any other LTC patient |
Revision as of 09:32, 30 October 2020
Admit from ED to NW (Inpatient)
ED Provider
- After assessment and work-up, deems admission is warranted
- Contacts the NW provider to discuss admission
- Communicates with ED nursing staff that patient will be admitted
- Places the order Decision to Admit
- Completes the Admission Medication Reconciliation
ED Nursing Staff
- Communicates with NW Charge nurse that the patient will be admitted
- Verifies bed status with NW Charge nurse
- Requests Pre-Admit FIN to be entered by ED clerk
- NOTE: the Pre-Admit FIN can be accessed in First Net and Power Chart by changing the location in the blue banner bar
- Calls report to NW RN
NW Provider
- Accesses the patient’s chart, finding the newly created Pre-Admit FIN (NOTE: orders must be entered from the correct FIN)
- Places admitting diagnosis on the encounter
- Enters the admission Power Plan: MED Adult Admission, PED Pediatric Admission, or MED Adult Admission Holding Orders
- NOTE: the ED Provider may, at times, enter the MED Adult Admission Holding Orders
- Selects “Plan for Later” when signing the Power Plan
- Completes the Admission Medication Reconciliation AFTER the transfer is complete
- Informs NW RN the orders are entered
NW RN
- Receives report from ED RN
- Requests NW clerk contact Registration to change the Pre-Admit FIN to Inpatient FIN (communicating the patient’s room number)
- Initiates Admission orders
- Notifies NW Provider when patient arrives
Admit from Outpatient (Ambulatory) to NW
Outpatient Provider
- Assesses/evaluates the patient and deems admission is warranted
- Contacts NW Provider to discuss admission
- Communicates with OP Clinic/Charge RN
- Completes the Outpatient Medication Reconciliation
OP Clinic/Charge RN
- Communicates with NW Charge nurse that the patient will be admitted
- Verifies bed status with NW Charge nurse
- Requests Pre-Admit FIN to be entered by Outpatient clerk
- Calls report to NW RN
NW Provider
- Accesses the patient’s chart, finding the newly created Pre-Admit FIN (NOTE: orders must be entered from the correct FIN)
- Places admitting diagnosis on the encounter
- Enters the admission Power Plan: MED Adult Admission, PED Pediatric Admission, or MED Adult Admission Holding Orders
- Selects “Plan for Later” when signing the Power Plan
- Informs NW RN the orders are entered
- Completes the Admission Medication Reconciliation AFTER the transfer is complete
NW RN
- Receives report from Outpatient RN
- Requests NW clerk contact Registration to change the Pre-Admit FIN to Inpatient FIN (communicating the patient’s room number)
- Initiates Admission orders
- Notifies NW Provider when patient arrives
Admit from OB Triage to OB Inpatient
OB Provider
- Places admitting diagnosis on encounter (NOTE: uses the same FIN as in OB Triage)
- Enters Admission Power Plan: OB Labor and Delivery Admit and OB Postpartum
- Selects “Plan for Later” when signing the Power Plan
- Informs OB RN the orders are entered
- Completes the Admission Medication Reconciliation AFTER the transfer is complete
OB RN
- Requests NW clerk contact Registration to communicate the admission and the patient’s room number
- Initiates Admission orders
Direct Admit to NW
NOTE: Patients may be directly admitted from ANMC, the village, or another health care facility
NW Provider
- Has been in contact with a provider regarding the admission
- Accepts the admission directly
- Accesses the patient’s chart, finding the newly created Pre-Admit FIN (NOTE: orders must be entered from the correct FIN)
- Places admitting diagnosis on the encounter
- Enters the admission Power Plan: MED Adult Admission, PED Pediatric Admission, or MED Adult Admission Holding Orders
- Selects “Plan for Later” when signing the Power Plan
- Informs NW RN the orders are entered
- Completes the Admission Medication Reconciliation AFTER the transfer is complete
NW RN
- Receives report from RN at transferring facility
- Requests NW clerk contact Registration to create a Pre-Admit FIN
- After the patient arrives, requests NW clerk contact Registration to change the Pre-Admit FIN to Inpatient FIN (communicating the patient’s room number)
- Initiates Admission orders
- Notifies NW Provider when patient arrives
Transfer from LTC to ED
LTC Provider
- Assesses/evaluates the patient and deems emergent evaluation is warranted
- Or, receives report from LTC RN that the patient needs emergent evaluation
- Contacts ED Provider to discuss transfer
- Communicates with LTC Charge RN
- Documents the rationale for transfer
- Completes the (INSERT WHICH ONE) Medication Reconciliation
LTC RN
- Communicates with ED RN that the patient will be transferred
- Calls EMS for transport
- Calls report to ED RN
ED Provider
- Evaluates patient to determine a disposition (admission or transfer back to LTC)
- Communicates with NW or LTC provider
ED RN
- Receives report from LTC RN
- Cares for patient as any other ED patient
Transfer from Ambulatory to ED
Outpatient Provider
- Assesses/evaluates the patient and deems emergent evaluation is warranted
- Contacts ED Provider to discuss transfer
- Communicates with OP Clinic/Charge RN
- Documents the rationale for transfer
- Completes the Outpatient Medication Reconciliation
OP Clinic RN
- Communicates with ED RN that the patient will be transferred
- Calls report to ED RN
- Transports patient to the ED, providing a warm hand-off
ED Provider
- Evaluates patient to determine a disposition (admission or discharge)
ED RN
- Receives report from OP Clinic RN
- Cares for patient as any other ED patient
Transfer from ED to LTC
ED Provider
- Assesses/evaluates the patient and transfer back to LTC is appropriate Contacts LTC Provider (or LTC RN after hours) to discuss transfer
- Communicates with ED RN
- Documents the rationale for transfer
- Completes the Discharge Medication Reconciliation
ED RN
- Communicates with LTC RN that the patient will be transferred
- Calls report to LTC RN In conjunction with ED clerk, arranges transport of the patient to the LTC
LTC Provider: Evaluates patient upon return to LTC
- Updates orders as needed
LTC RN
- Receives report from ED RN
- Reviews new orders if indicated
- Cares for patient as any other LTC patient