Harbor:Psych patients: Difference between revisions
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**** Providers: try to complete the physician documentation so the Exodus staff can see what was medically addressed and view your MDM | **** Providers: try to complete the physician documentation so the Exodus staff can see what was medically addressed and view your MDM | ||
** Exodus staff (RN + security) will transport the patient back to Exodus. | ** Exodus staff (RN + security) will transport the patient back to Exodus. | ||
** '''If there is any safety or elopement concern, or there is no longer space at Exodus, the patient will be transferred to the Psych ED.''' | |||
** If there is any safety or elopement concern, or there is no longer space at Exodus, the patient will be transferred to the Psych ED. | *** At their discretion, Psych may initiate a Sheriff-accompanied transfer to Exodus. | ||
** At their discretion, Psych may initiate a Sheriff-accompanied transfer to Exodus. | ** '''Any patients INITIALLY presenting to the Adult ED needing psychiatric evaluation should be sent to the Psych ED where they may then be triaged to Exodus.''' | ||
** Any patients INITIALLY presenting to the Adult ED needing psychiatric evaluation should be sent to the Psych ED where they may then be triaged to Exodus. | |||
Revision as of 20:08, 12 September 2022
- Exodus Psychiatric Urgent Care
- Acute side is open 24/7
- Outpt side (for med refills, etc) is generally open 8a-4p (dependent upon provider availability)
- Initiating the transfer from Exodus to the AED or PED for medical clearance:
- Exodus Charge RN calls the ED to initiate transfer (call both ED physician and ED nurse).
- Adult Attending x66902 (or x66906 as backup) or PED attending x66910 (or PED Sr. Resident x66911 as backup)
- Attending places a pre-arrival note (include the reason for medical evaluation, presence of 5150, and any safety concerns).
- RME Charge for adults x66950 or PED Charge for pediatric patients x66960 (Overall Charge x66930 as backup for all patients)
- Notify RN if the patient is on a hold so a sitter can be identified.
- Note any patients that are safety risks (high flight likelihood or history of aggressive/violent behavior) so Golden Hand can be placed.
- Adult Attending x66902 (or x66906 as backup) or PED attending x66910 (or PED Sr. Resident x66911 as backup)
- Exodus Charge RN calls the ED to initiate transfer (call both ED physician and ED nurse).
- Exodus will transfer the patient to the ambulance entrance of the ED via wheelchair or van with both a nurse and security officer
- Exodus staff will then take the patient directly to triage (to the adult ED for 21 and older and to the Pediatric ED for 20 and under).
- In the AED, the reassessment RN will be the designated receiving triage RN, but the patient can be seen by any triage team that is available.
- If applicable, the original hold (5150 or 5585) documentation will accompany the patient.
- After handoff to the triage RN, Exodus staff will be released.
- Exodus will transfer the patient to the ambulance entrance of the ED via wheelchair or van with both a nurse and security officer
- The patient will be evaluated by the triage team with pertinent orders placed or by the senior resident in the PED then taken directly to a room with a sitter. Any necessary tasking will occur in the ED room.
- If there are no available rooms in the AED, tasking can occur in RME and the patient will stay in RME 12 with a sitter until a private room is available.
- If there are no rooms available in the PED, the patient will remain in triage until a room with a sitter is made available.
- During the process of medical evaluation, the ED provider may consult Psych for any reason (medication recommendations, concern due to a change in behavior, etc.).
- The patient will be evaluated by the triage team with pertinent orders placed or by the senior resident in the PED then taken directly to a room with a sitter. Any necessary tasking will occur in the ED room.
- Discharging patients back to Exodus
- After the medical evaluation is completed and the patient sent from Exodus is medically cleared and deemed stable for psychiatric assessment and not a flight or safety risk, the patients will be discharged back to Exodus.
- The treating nurse will call the Exodus Charge RN (424.405.5888)
- The clerk will print a “transfer packet” (do not need the EMTALA form)
- Providers: try to complete the physician documentation so the Exodus staff can see what was medically addressed and view your MDM
- Exodus staff (RN + security) will transport the patient back to Exodus.
- If there is any safety or elopement concern, or there is no longer space at Exodus, the patient will be transferred to the Psych ED.
- At their discretion, Psych may initiate a Sheriff-accompanied transfer to Exodus.
- Any patients INITIALLY presenting to the Adult ED needing psychiatric evaluation should be sent to the Psych ED where they may then be triaged to Exodus.
- After the medical evaluation is completed and the patient sent from Exodus is medically cleared and deemed stable for psychiatric assessment and not a flight or safety risk, the patients will be discharged back to Exodus.
Dr. Chappell & Melissa Trejo (Exodus Asst. Director) 9-12-2022