Harbor:ED to Rancho Los Amigos (RLA): Difference between revisions

Revision as of 16:35, 3 February 2026

ED to RLA (2/4/2026)
- Stable vs Unstable
  - If unstable for transfer, admit!
  - For now, no ICU admissions from ED to RLA (HUMC ICU can consider lateral transfers)
- DHS vs OOP
  - If OOP, transfer to in-plan hospital
  - If DHS or approved for admission, proceed to next step
- To initiate transfer
  - Place Orchid order for "Consult to Transfer Center"
    - Enter the following info:
      - Requested level of Care
      - HUMC attending
      - Reason for transfer: "Acute medicine (Rancho Los Amigos)"
      - Patient Consented for Transfer (yes/no) - I would verbally consent, then do written EMTALA if patient accepted
      - Provider name/Call Back Number
      - Is the patient receiving chemotherapy (should be "no")
    - MAC will inform us if there is no capacity for this level of care at RLA
    - RLA MOD/HOD will call back within 15 minutes for doc-to-doc/review and exclusion criteria
    - If the patient is accepted:
      - Need signed EMTALA
      - ED clerk will schedule BLS transport via Round Trip
      - MAC will arrange for ALS transport
      - HUMC RN will call RLA RN
- General Exclusions for RLA
  - Acute Gastroenterology/Hepatology services need (acute GI bleeds)
  - Any cardiac issues deemed by cardiology team as likely needing invasive procedures such as Cath, CTS, or electrophysiology consult
  - Neurosurgical needs
  - Acute general surgery or ortho surgery needs (they have full podiatry services for DFI, etc.)
  - Acute Vascular surgery needs
  - Likely Oncology or urgent hematology needs
  - Patients being admitted solely for placements (can be placed if primarily admitted for medical need)

Authors:

Bradley Chappell

@@ Line 1: / Line 1: @@
-* ED to RLA
+* ED to RLA (2/4/2026)
 ** Stable vs Unstable
-*** DHS vs OOP (if approved for admissison, proceed to next step)
+*** If unstable for transfer, admit!
+*** For now, no ICU admissions from ED to RLA (HUMC ICU can consider lateral transfers)
+** DHS vs OOP
+*** If OOP, transfer to in-plan hospital
+*** If DHS or approved for admission, proceed to next step
+** '''To initiate transfer'''
+*** Place Orchid order for "Consult to Transfer Center"
+**** Enter the following info:
+***** Requested level of Care
+***** HUMC attending
+***** Reason for transfer:  "Acute medicine (Rancho Los Amigos)"
+***** Patient Consented for Transfer (yes/no) - I would verbally consent, then do written EMTALA if patient accepted
+***** Provider name/Call Back Number
+***** Is the patient receiving chemotherapy (should be "no")
+**** MAC will inform us if there is no capacity for this level of care at RLA
+**** RLA MOD/HOD will call back within 15 minutes for doc-to-doc/review and exclusion criteria
+**** If the patient is accepted:
+***** Need signed EMTALA
+***** ED clerk will schedule BLS transport via Round Trip
+***** MAC will arrange for ALS transport
+***** HUMC RN will call RLA RN
+** General Exclusions for RLA
+*** Acute Gastroenterology/Hepatology services need (acute GI bleeds)
+*** Any cardiac issues deemed by cardiology team as likely needing invasive procedures such as Cath, CTS, or electrophysiology consult
+*** Neurosurgical needs
+*** Acute general surgery or ortho surgery needs (they have full podiatry services for DFI, etc.)
+*** Acute Vascular surgery needs
+*** Likely Oncology or urgent hematology needs
+*** Patients being admitted solely for placements (can be placed if primarily admitted for medical need)