Category:Consults

From Guide to YKHC Medical Practices

Introduction

YK has a number of on-site (internal) consultants and a network of outside Bethel (external) consultants. Within the hospital, we have pediatricians; high risk OB physicians (either an OB/GYN specialist or family medicine physician with extra OB training); emergency room physicians; dentists; optometrists; TB officers (providers who have received extra training in TB),as well as lactation, HIV and wound care consultants. YKHC consultants can be accessed through Tiger Connect by their assigned roles.

Consultants outside YKHC can be accessed through a network of native and private providers and hospitals. Alaska Native Medical Center (ANMC) is our Native referral hospital located in Anchorage. ANMC has multiple adult specialists and some pediatric specialists that can be accessed through their system using phone or Tiger Connect. For non-beneficiary (or non-native) patients and any specialists not available through ANMC, we contact Providence or use specialty phone lists posted in departments of the hospital. Occasionally, we are required to call specialists outside Alaska such as pediatric rheumatology or pediatric neurosurgery. These specialists can be reached at Seattle Children's Hospital or through a second opinion hotline (MEDCON).

Before you contact a consultant, take the time to organize your patient presentation and develop a clear and concise request of the specialist. Use SBAR communication including letting consultants know who you are and where you are calling from. A consult call should take no longer than 5-10 minutes. See Consultations YKHC Clinical Guideline -be quick and concise with both your YK as well as external consults.

Internal (Bethel) Consult Services

Breast Feeding

We have one lactation consultant in clinic (Dr. Roll), one in OB, and a WIC Peer Lactation Educator.

Dental

There is a dentist on call and available 24/7 for consultation and help managing a complex or concerning dental patients. They can be contacted through TigerConnect by messaging the "Dental On Call" Role. The ER also has a list of dentists and their cell numbers.

Emergency Department Bethel

If an emergency occurs in the Bethel Regional Hospital outside of the Emergency Department, call a Rapid Response or Code Blue as appropriate. If neither is appropriate, you can call the ED and talk to the MD on-call. Have your charge nurse talk to their charge nurse for any transfers.

High Risk OB (HROB):

There is a physician ‘on call’ and available 24/7 for high-risk obstetric consultation. The HROB provider is available to help manage a difficult patient or to assume care of a patient needing a C-section. TigerText the “OB High Risk On Call HROB” role not the physician’s personal TigerText as on call schedules can occasionally change.

If you have an emergency issue, put that in the text page. Make sure there is a contact number for the provider to call back. The on call physician should call back to confirm they received the page. If you do not hear back within 3-5 minutes about an emergency page or in 15 to 20 minutes about a routine consult page, please page again or call the on call physician’s cell number that is listed on the medical staff contact list.

HIV

Contact our Community Case Manager to report and coordinate care of any newly diagnosed cases. The case manager can also assist with mandatory reporting to Public Health 543-2110.

Dr. Roll is one of our local HIV experts. Contact her with any questions about HIV. If she is not available, you can contact Alaska State Epidemiology Section on HIV, Tel: 907-269-8000 Fax: 907-563-0453.

Internal Medicine

You can Contact ANMC and ask to speak to the IM consulting physician if you are in need of this service.

Optometry

There is an optometrist available 24/7 for consultation and help managing a complex or concerning eye patient. They can be reached through TigerConnect by messaging the "Optometry On Call" Role. The ER also has a list of optometrists and their cell numbers for emergency eye concerns after hours, weekends, or holidays.

Pediatrics

For non-urgent pediatric consults, please utilize the pediatrician that is scheduled in your hallway to discuss management or address questions. For urgent pediatric consults that require a higher level of care, or if the outpatient pediatrician is unavailable, there is a pediatrician ‘on call’ and available 24/7. TigerText "Peds Wards On Duty" to contact the on call pediatrician.

If you have an emergency issue, please put that in the text page. Make sure there is a contact number for the provider to call back. The on call physician should call back to confirm they received the page, even if they are on the way. If you do not hear back within 3-5 minutes about an emergency page or in 15 to 20 minutes about a routine page, please page again OR call the on call physician’s cell number that is listed on the medical staff contact list or one of the "Peds cell" numbers listed on the Peds Reference Phone Numbers List saved in the Peds folder.

For any toxic-appearing or critically ill children, activate a Rapid Response or call a Code Blue as appropriate. Please discuss with the Emergency Room doctor for urgent transfer from clinic to the ER and notify the on call pediatrician. Do not wait for the on call pediatrician to return your text.

TB

There are many TB cases in the Delta. For any TB questions, and for assistance with any active TB cases, contact one of our TB officers (Elizabeth Roll, Robert Tyree, Kim Fisher).

Upper lobe infiltrates should prompt contacting a TB expert.

Negative pressure rooms are available in Chum, Sockeye, King, Pike, and Silver hallways for any suspected active TB cases. Please refer to LTBI and Active TB Guidelines for assistance.

If none of these local providers are available you can contact Dr. Michael Cooper, MD, MS Section of Epidemiology Tel: 907-269-8000 Fax: 907-563-7868 Email: michael.cooper@alaska.gov

Wound Care

Currently, physical therapy manages Wound Care at YKHC. Basic abscesses etc., can be sent to Nurse Only Specialty Clinic for repacking, but any concerning wounds need to involve physical therapy. PT should be contacted and pictures (with tape measure) should be uploaded to Multi- Media Manager in Power Chart if possible. Marking the area of a wound also advised and very helpful for ongoing monitoring.

External Consult Services

ANMC Specialty Services

  • ANMC Specialty Clinic Services
  • (*97) 800 478-6661.
  • Adults - IM, Surgery, ER, GI, Infectious Disease, Urology, Neurology, Heme-Onc, Pulmonology/Intensive Care, Cardiology, Rheumatology, Renal Nurse Practitioner for chronic renal failure, Podiatry, Endocrinology
  • Adults and Peds - Ortho, ENT, Allergy&Immunology
  • Peds - Peds Surgery, Peds Urology, Peds Endocrinology

Providence Specialists

  • Allergy Asthma & Immunology Center of Alaska: website

HIV

UCSF HIV Consultation on line Website with helpful information on HIV and contact information for more assistance.

Warm Line (800) 933-3413 M-F 9 a.m.– 8 p.m. EST. Phone number for providers to call to get a consultation on a HIV-related issue. This can be done for post-exposure prophylaxis or for patient related questions if the ANMC infectious disease physician isn't available.

MEDCON Seattle

MEDCON is a 24/7, toll-free phone line to UW Medicine experts in oncology, cardiology, OB/GYN, infectious disease, neurology and other specialties. 800 326-5300

Pathology

Call ANMC (*97) 800 478-6661 and ask for Pathology Department

Palliative Care

Call ANMC (*97) 800 478-6661 and ask for Dr Piromalli Telemedicine/AFCHAN

Poison Control

(*98) 800-222-1222

Seattle Children’s Hospital

206 987-7777 (ask for doctors consult line)

Tele-Radiologists YKHC

There is a published calendar of who is on call posted in all the units. The radiologists live in Ohio, which is 4 hours ahead. Only call them after hours if it is urgent to avoid burning them out. Speed dials are: Warren (*54) Voss (*94) Vanderburgh (*95)

TB

Francis Curry National TB Center Warm Line (877) 390-6682

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