Harbor:CORE: Difference between revisions
 
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===Who to call===
===Who to call===
* 7a-8a - hold for CORE NP at 8a
* 7a-8a - hold for CORE NP at 8a
* 8a-4:30p - CORE NP - Orchid autopage (p1687)
* 8a-8p (M-R; 4:30p Friday) - CORE NP - Orchid autopage (p1687)
* 4:30-5:30 - CORE Fellow - p0135
* 4:30-5:30 - CORE Fellow - p0135
* Signout time ~5:30p-6p - signout from CORE to ED Hospitalist
* Signout time ~5:30p-6p - signout from CORE to ED Hospitalist
* Night 6p - 7a:  ED Hospitalist; p204-9753 ... CORE attending available for questions 24/7
* Night 6p - 7a:  ED Hospitalist; p204-9753 ... CORE attending available for questions 24/7


Kaji/Bui, 4/15/2021
Kaji/Bui, 4/15/2021


===Background===
===Background===
*Any OOP patients needing observation or CORE services should be transferred to an in-network hospital if they are stable - Peterson 5/2016
*Any OOP patients needing observation or CORE services should be transferred to an in-network hospital if they are stable  
*Only patients with internal medicine (or family medicine) covered illness can be placed on obs.  All other services require admission (or transfer) - Lewis 5/2016
*Admit CORE patients to Cardiology during day time hours, or the covering ED hospitalist after hours.  
*If the hospitalist is capped (cap is 20 if single overnight hospitalist coverage, which includes Obs and CORE leftover from dayshift, new Obs or CORE, and new admissions), and you have a patient you’d like to place in Observation, CORE, or an admission:
**Do not place the order for obs placement, CORE, or the ‘request for admit’ order. This becomes confusing for nursing who is actually managing the patient. Only place this order when you have discussed the patient and the care officially transfers to the inpatient/obs/CORE physician.
**Continue to manage the patient until the next hospitalist shift starts (typically 7:30am) or the next medicine slot is available.
**Do put in an Attending Admit Note at the time of the actual admit decision but document in your notes that patient is being held in the ED due to lack of hospitalist/Medicine capacity.


* Core idiosyncrasies
* COREidiosyncrasies
** Admit for non-CHF edema, anasarca (abdominal or scrotal edema), or requiring significant diuresis (>10kg)
** Admit for non-CHF edema, anasarca (abdominal or scrotal edema), or requiring significant diuresis (>10kg)
** Psych can consult in CORE, or patient can be discharged from CORE to psych ED on patients requiring cardiac clearance
** Psych can consult in CORE, or patient can be discharged from CORE to psych ED on patients requiring cardiac clearance


{{Harbor CHF disposition}}
{{Harbor CHF disposition}}

Latest revision as of 20:42, 2 July 2023

Who to call

  • 7a-8a - hold for CORE NP at 8a
  • 8a-8p (M-R; 4:30p Friday) - CORE NP - Orchid autopage (p1687)
  • 4:30-5:30 - CORE Fellow - p0135
  • Signout time ~5:30p-6p - signout from CORE to ED Hospitalist
  • Night 6p - 7a: ED Hospitalist; p204-9753 ... CORE attending available for questions 24/7

Kaji/Bui, 4/15/2021

Background

  • Any OOP patients needing observation or CORE services should be transferred to an in-network hospital if they are stable
  • Admit CORE patients to Cardiology during day time hours, or the covering ED hospitalist after hours.
  • COREidiosyncrasies
    • Admit for non-CHF edema, anasarca (abdominal or scrotal edema), or requiring significant diuresis (>10kg)
    • Psych can consult in CORE, or patient can be discharged from CORE to psych ED on patients requiring cardiac clearance


See Also

References

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