Direct Admissions
· Physician requesting admission calls Transfer Center- 859-7173 **
o “I’d like to arrange a direct admission to the Pediatric Hospitalist Service at Oishei”
o Transfer Center gathers “intake” information
**Subspecialists refer to Private MD list (below) to determine if the admission is for PHS. If not, start by calling the Private MD’s group to make plans. Then move forward with Transfer Center to admit to the Private MD group once you have the accepting doc’s name.
· Transfer Center connects to PHS attending on call for 3-way call
o If this is a TRANSFER from outside facility (floor-to-floor transfer), also connects to STAT team for 4-way call
o If this is a direct admission from Community PMD or local subspecialist (to hospitalist service), patient will come by private vehicle. If not stable to come by private vehicle, must go to ED.
o PHS attending accepts patient for direct admission, or gives direction for alternate plan.
· Transfer center assigns bed placement
o PHS attending updates floor resident with sign-out
o PHS attending updates RN manager for assigned floor
§ If the floor is yet unknown (eg: for a planned/future admit), PHS attending notifies J10 & J11 RN managers and waits to notify resident team until floor is known. Sign out to PHS colleagues if patient is coming once this attending is no longer on Day-call.
Considerations for appropriate direct admission from outpatient setting:
· Must be hemodynamically stable
· Diagnoses may include: Constipation (failed outpt treatment), Cellulitis (failed outpt treatment), FTT, jaundice (with same-day bili already resulted)
· “Respiratory” Admissions must go through the ED
Private MD List (Do NOT admit to PHS- they admit their own patients!)
Holiday Pediatrics (Dejneka) [PHS will cover if his office states he’s on vacation]
Jericho Road Family Practice (Edwards, Glick, Harding, Henke, Krolikowski, Lauria, Milazzo, Robinson, Stoltzfus)
UBMD Med-Peds (Aronica, Abeles, Zambron, Blymire, Gosine, McIntosh, Padgett)
Maple Med-Peds admits to University Med Peds: (Aquino, Hartrich, Hrab, Heyden, Thierman, Riedy, Boice)
Updated 01/2023
High Pointe to OCH direct admit
Process for Calling On-Call Physician:
1. Look in Point Click Care for any Clinical Notes that pertain to the problem at hand. (defer if too urgent)
2. Look up on-call Physician:
a. Go to Kaleidascope home page
b. In the left-hand column on the main screen, click on “On Call Search”
c. Choose Facility: Oishei Children’s Hospital; Group: HighPointe- Pediatric Unit
i. Choose “all on call” rather than “only within 30 mins from now” if you’re looking ahead of time to mark down the night on-call MD
d. FYI: The on-call physician will be the in-house doc during the day (6am-8pm M-Th; 6am-4pm Fri).
3. Read the “QUICK REFERENCE- CLINICAL SUMMARY” first to orient the on-call physician to the child’s pertinent underlying problems. It is on the “Doctor’s Book”.
HighPointe to OCH Transfer Steps: **Does not apply to clinic/OR appointments **
1. HP RN calls MD on Call with Stated Problem- MD decides that patient needs to go to OCH ED. RN PRINT OUT 2 COPIES OF ORDERS- ONE TO GO WITH CHILD & ONE FOR DOCTOR’S BOOK
· It is a Super-Emergency (code)- Call 911 [AMS: 882-8400]
RN to call 911 for immediate transport (regardless of airway status) (RN should gather med list, etc as time permits; may call MD after 911)
MD call TRANSFER CENTER (859-7173), request to speak to ED MD regarding a HP patient on the way.
RN call ED RN (323-2105), request to speak to charge nurse to give report.
· Child has a trach and/or vent
RN to prepare patient for transfer- gather back up trachs, med list, etc.
MD call Transfer Center requesting STAT team for transport of the child. MD will be connected to ED or PICU MD to give sign-out, and they will send out the STAT team.
? If vent w/resp concern, try to direct admit to PICU; others go to ED.
? If STAT team is not available, MD decides if EMS transport is acceptable vs waiting for STAT.
Child does not have a trach
RN to call for EMS transport, and to gather med list, etc in preparation for transport
MD call Transfer Center and request to speak to ED MD to give sign-out.
Special Case: If a child becomes ill at school, there is no way to get them anywhere at all without them calling EMS/911. It is the only option.
When HighPointe RN receives the call from school, please immediately call MD on call.
MD to call ED MD (through transfer center) with “expect”
Updated 9/10/21
Direct Admission Pathway (or planned post-op admit) from Surgical Service to Hospitalist Service
1. Refer to Private MD list (below) to determine if the admission is for PHS (Pediatric Hospitalist Service).
a. If for Private MD, call their office to discuss before proceeding to step 2
b. If you want to discuss with PHS physician first (for example, with a case that is not straight-forward), then call the “Pediatric Hospitalist Service” physician on call first. (as listed in Open Tempo)
2. Physician requesting admission (surgeon) calls Transfer Center- 859-7173
o Transfer Center gathers “intake” information
o Transfer Center connects to PHS attending on call for 3-way call
§ PHS attending accepts patient for direct or post-op admission, or gives direction for alternate plan.
3. Transfer center assigns bed placement
a. PHS attending updates floor resident with sign-out
b. PHS attending updates RN manager for assigned floor
i. If the floor is yet unknown (eg: for a planned/future admit), PHS attending notifies J10 & J11 RN managers and waits to notify resident team until floor is known.
Pathway for Surgical Consultation of Medical Service (including any need from PACU)
· Call the consult to the J11 Senior Resident ASCOM (323-3132)
o If the patient is on a different floor, and/or covered by a different Ped Resident team, the J11 resident will instruct you on which resident to call the consult to.
· Senior Resident will see, evaluate, and discuss with the appropriate attending and will provide written and verbal recs to the consulting team.
o If part of the question was regarding transfer onto medical service, this answer will be provided once the consult is complete.
Special Considerations for PACU patients needing medical bed:
o Start with consult (as above)
o If the medical attending accepts the patient onto their service, then the surgeon of record needs to call Transfer Center (859-7173) to request a bed, with the name of the accepting attending physician.
· PACU may not request a medical bed without an accepting attending MD
· Transfer center assigns bed placement
o Originally consulting resident signs out to assigned floor resident (if not same [J11] team)
o PACU nurse manager notifies floor RN manager
Private MD List (Do NOT admit to PHS- they admit their own patients!) **This is why consults must always start with the residents, not attendings**
Jericho Road Family Practice (Edwards, Glick, Harding, Henke, Krolikowski, Lauria, Milazzo, Robinson, Stoltzfus)
UBMD Med-Peds (Aronica, Abeles, Zambron, Blymire, Gosine, McCorkle, Padgett)
· Maple Med-Peds admits to UBMD Med Peds: (Aquino, Hartrich, Hrab, Heyden, Thierman, Riedy, Boice)
Updated 2/15/2023