Harbor:ED to Rancho Los Amigos (RLA): Difference between revisions
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* ED to RLA (2/ | * ED to RLA (2/10/2026) | ||
** Stable vs Unstable | ** Stable vs Unstable | ||
*** If unstable for transfer, admit! | *** If unstable for transfer, admit! | ||
*** | *** No ICU admissions from ED to RLA (HUMC ICU can consider lateral transfers) | ||
** '''DHS Empaneled or DHS Eligible only''' | |||
*** If OOP, goal is to transfer to in-plan hospital | |||
*** Only OOP Exception - Kaiser: '''during Kaiser strike ONLY''', place IQ request; once given authorization to admit after doc-to-doc conversation, place the "Consult to Transfer Center" order | |||
*** | |||
** <big><big>ED to RLA Admission Process</big></big> | |||
*** Patients 18 y/o and older | |||
***'''MONDAY - FRIDAY, 8am to 10pm (must place the "Consult to Transfer Center" during these times)''' | |||
** '''To initiate transfer''' | ** '''To initiate transfer''' | ||
*** Place Orchid order for "Consult to Transfer Center" | *** Place Orchid order for "Consult to Transfer Center" | ||
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***** Provider name/Call Back Number | ***** Provider name/Call Back Number | ||
***** Is the patient receiving chemotherapy (should be "no") | ***** Is the patient receiving chemotherapy (should be "no") | ||
**** MAC does their own financial clearance process and will inform us if there is no capacity for this level of care at RLA | **** MAC/RLA PAC does their own financial clearance process and will inform us if there is no capacity for this level of care at RLA | ||
**** RLA MOD/HOD (doctor on duty daytime/hospitalist on duty after-hours) will call back within 15 minutes for doc-to-doc/review and exclusion criteria | **** RLA MOD/HOD (doctor on duty daytime/hospitalist on duty after-hours) will call back within ~15 minutes for doc-to-doc/review and exclusion criteria | ||
**** If the patient is accepted: | **** If the patient is accepted: | ||
***** Need signed EMTALA | ***** Need signed EMTALA | ||
***** ED clerk will schedule BLS or ALS transport via Round Trip | ***** ED clerk will schedule BLS or ALS transport via Round Trip | ||
***** HUMC RN | ***** MAC will connect HUMC RN with RLA RN once bed is assigned | ||
**** '''If the patient is declined by the RLA MOD, contact UR for admission clearance at HUMC if not already MET''' | **** '''If the patient is declined by the RLA MOD, contact UR for admission clearance at HUMC if not already MET''' | ||
** General Exclusions for RLA | ** '''General Exclusions for RLA''' | ||
*** Acute Gastroenterology/Hepatology services need (acute GI bleeds) | *** 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 | *** Any cardiac issues deemed by cardiology team as likely needing invasive procedures such as Cath, CTS, or electrophysiology consult | ||
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*** Likely Oncology or urgent hematology needs | *** Likely Oncology or urgent hematology needs | ||
*** Patients being admitted solely for placements (can be placed if primarily admitted for medical need) | *** Patients being admitted solely for placements (can be placed if primarily admitted for medical need) | ||
Bradley Chappell, VC Clin Ops HUMC; Barry Jordan, CMO RLA; Michael Bolaris, ACMO RLA; Michael Scott, ACMO RLA; Peter Balingit, Medical Director MAC | |||
Latest revision as of 01:33, 11 February 2026
- ED to RLA (2/10/2026)
- Stable vs Unstable
- If unstable for transfer, admit!
- No ICU admissions from ED to RLA (HUMC ICU can consider lateral transfers)
- DHS Empaneled or DHS Eligible only
- If OOP, goal is to transfer to in-plan hospital
- Only OOP Exception - Kaiser: during Kaiser strike ONLY, place IQ request; once given authorization to admit after doc-to-doc conversation, place the "Consult to Transfer Center" order
- Stable vs Unstable
- ED to RLA Admission Process
- Patients 18 y/o and older
- MONDAY - FRIDAY, 8am to 10pm (must place the "Consult to Transfer Center" during these times)
- 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/RLA PAC does their own financial clearance process and will inform us if there is no capacity for this level of care at RLA
- RLA MOD/HOD (doctor on duty daytime/hospitalist on duty after-hours) 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 or ALS transport via Round Trip
- MAC will connect HUMC RN with RLA RN once bed is assigned
- If the patient is declined by the RLA MOD, contact UR for admission clearance at HUMC if not already MET
- Enter the following info:
- Place Orchid order for "Consult to Transfer Center"
- 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)
- ED to RLA Admission Process
Bradley Chappell, VC Clin Ops HUMC; Barry Jordan, CMO RLA; Michael Bolaris, ACMO RLA; Michael Scott, ACMO RLA; Peter Balingit, Medical Director MAC