Harbor:Psych patients
- 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 (x66950 or Overall Charge x66930 as backup)
- 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 18 and older and to the PED for 17 and under). The reassessment RN will be the designated receiving triage RN, but the patient can be seen by any triage team that is available.
- Exodus will transfer the patient to the ambulance entrance of the ED via wheelchair or van with both a nurse and security officer
- If applicable, the original hold (5150 or 5585) documentation will accompany the patient.
- After handoff to the triage RN, Exodus staff will be released.
- Patients needing medical clearance
- Once the patient sent from Exodus is medically cleared and deemed stable for psychiatric assessment, the patients may be discharged back 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).
- 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.).
- Discharging patient back to Exodus After medical evaluation is completed and the patient is stable and not a flight or safety risk, they will be discharged back to Exodus.
- The clerk will print a “transfer packet” (do not need EMTALA form) ... what was addressed, MDM
- The treating nurse will call the Exodus Charge RN (424.405.5888).
- Exodus staff 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.