Harbor:Urgent Outpatient IR

CURRENTLY ON HOLD DUE TO NOT ENOUGH IR CAPACITY - JUST ADMIT IF PROCEDURE IS NEEDED URGENTLY

• For emergent procedures, place "consult to IR" order and contact IR at p5423 or x64747

• For stable patients who can get outpatient IR procedures - items such as stenosed/thrombosed dialysis catheter, etc
  • For DHS/MHLA patients who require an urgent IR procedure, and have no other indication to be admitted, then the patient will be accommodated in the IR schedule to get their procedure done within 2-4 days as outpatient.
    • Patient will need CBC, chem 7, POC INR, and COVID test
    • ED provider does NOT need to discuss with IR resident
    • Starting on 3/15/22 no more Grey Form for ED patients
    • Send a message to the “Har-IR request” message pool using the “==HarIRrequest==" dotphrase (replaces the paper Grey form - pilot for ED only)
      • Use “autotext copy utility” button on the FirstNet toolbar to copy it from Ross F. if using it for the first time.
      • CC the message to the empaneled PCP so they are aware of the plan
      • Click the "save Message to Chart" box
      • Change title of the message. Fill in the clinical info, use F3 to jump to next field.
    • Order the procedure needed
      • IR Central Venous Catheter Tunneled (for both placements and exchanges)
      • IR Renal Catheter Perc Placement (Left or Right)
      • IR Exchange of Nephrostomy Catheter
      • IR loopogram (for clotted HD access)
    • The request will be processed at the beginning of the following business day.
    • If patient needs the procedure to be done sooner, then page the IR resident on call to discuss.
    • Patient will be contacted by the IR schedulers for exact appointment time and be told to go to OR second floor surgery registration area to get check in to be registered therefore do not need to come back to ED on the day of procedure.
    • For OOP patients:
      • ED providers can call UM to see if patient can be transferred to in-network hospital, or an urgent appointment with patient's PCP or specialist can be made. If patient's care cannot be safely transferred to in-network, then we can request for an authorization to admit the patient, given that procedure will be done the next day.