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

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***** 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 will call RLA 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'''
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*** 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 Scott, ACMO RLA, Michael Bolaris, ACMO RLA
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


    • 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
    • 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)

Bradley Chappell, VC Clin Ops HUMC; Barry Jordan, CMO RLA; Michael Bolaris, ACMO RLA; Michael Scott, ACMO RLA; Peter Balingit, Medical Director MAC