STC provider evaluates pt - PowerPoint Presentation

Slide1

STC provider evaluates

pt

in STC, makes decision to admitSTC provider discussed admission with ward fellow/attending who agree to take admissionSTC provider enters in ORCHID order “consult to UR”, entered on Infusion Center FIN

UR calls back by phone to STC provider with preadmit FINSTC provider enters a “REQUEST FOR BED” order on the preadmit FIN, identifying the H/O ward team as the care team

Ward team evaluates patient in STCWard team does not enter admit orders UNTIL bed location is identified and available (ie, room is empty, cleaned, and RN ready to accept report)--- Once bed is assigned, H/O Ward team enters admit orders on preadmit FIN

STC provider informs H/O Ward team of the preadmit FIN

Ward team enters admission orders on the preadmit FIN (which is ‘flipped’ to the inpatient FIN when the patient arrives on the floorPt is transported to assigned bedAdmission orders entered on preadmit FIN are activated

Immediately upon registration in the ER, an “ER FIN” will be generatedThe preadmit FIN and all attached orders will disappearThe Infusion Center FIN and all attached orders will disappear

STC provider calls ER physician, presents case which needs to be transferred to ER, identifies the H/O Ward team as the accepting team, and does verbal handoff of any ongoing treatment plans on the Infusion FIN

Ward team waits for the ER FIN to be generated, and then writes admit orders on the ER FINWard team signs out the pt in the ER to the cross cover team

STC provider may identify additional interventions while patient is in STC before transfer (e.g., cultures, fluids, antibiotics); these orders are entered in ORCHID on Infusion Center FIN

HOWEVER: these orders will be lost the moment the Infusion Center FIN is cancelled either by (a) the activation of the preadmit FIN (which happens at admission) or (b) transfer of the patient to the ER and generation of an ER FIN

Ward team does this:

STC team does this:

Ward Team may identify additional interventions while patient is in STC before transfer (e.g., cultures, fluids, antibiotics); these orders are entered in ORCHID on Infusion Center FIN

If a bed is not assigned by 3 pm, the patient will be transported from STC to the ER

If patient is sent to ER:

If patient is sent to floor:

Handoff check list:

Orders for blood tests, cultures, and/or imaging studies ordered in STC on

infusion Center FIN: were they done?Any critical signs/symptoms/VS which need monitoring? e.g. did the tachycardia respond to IV fluid bolus?Does the floor RN see all of the medication orders? The floor RN’s cannot see medications started in STC or prior MAR medicatons; verify critical medications (e.g., antibiotics for patients with SIRS/SEPSIS)