INTRA and INTERhospital Transfers: Difference between revisions

From Guide to YKHC Medical Practices

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==Admit from Outpatient (Ambulatory) to NW==
==Admit from Outpatient (Ambulatory) to NW==
===Outpatient Provider===
'''Outpatient Provider'''
*Assesses/evaluates the patient and deems admission is warranted
*Assesses/evaluates the patient and deems admission is warranted
*Contacts NW Provider to discuss admission
*Contacts NW Provider to discuss admission
*Communicates with OP Clinic/Charge RN
*Communicates with OP Clinic/Charge RN
*Completes the Outpatient Medication Reconciliation
*Completes the Outpatient Medication Reconciliation
===OP Clinic/Charge RN===
 
'''OP Clinic/Charge RN'''
*Communicates with NW Charge nurse that the patient will be admitted
*Communicates with NW Charge nurse that the patient will be admitted
*Verifies bed status with NW Charge nurse
*Verifies bed status with NW Charge nurse
*Requests Pre-Admit FIN to be entered by Outpatient clerk
*Requests Pre-Admit FIN to be entered by Outpatient clerk
*Calls report to NW RN
*Calls report to NW RN
===NW Provider===
 
'''NW Provider'''
*Accesses the patient’s chart, finding the newly created Pre-Admit FIN (NOTE: orders must be entered from the correct FIN)
*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
*Places admitting diagnosis on the encounter
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*Informs NW RN the orders are entered
*Informs NW RN the orders are entered
*Completes the Admission Medication Reconciliation AFTER the transfer is complete
*Completes the Admission Medication Reconciliation AFTER the transfer is complete
===NW RN===
 
'''NW RN'''
*Receives report from Outpatient 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)
*Requests NW clerk contact Registration to change the Pre-Admit FIN to Inpatient FIN (communicating the patient’s room number)

Revision as of 09:39, 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

Decision to Admit.png

  • 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

Banner bar location.png

  • 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

Admission Orders.png

  • 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

Admission Orders.png

  • 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

OB Admission Orders.png

  • 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

Admission Orders.png

  • 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

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

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