ED Muskoka Physicians - Living the Dream

Admits turned down

If anyone has an orphan doc or family doc say that they will not accept an admission …

We have had some recent cases in both sites!!!

My suggestion is please just say ” I understand you don’t think this patient does not need to be admitted but since I do and I can’t come up with an appropriate care plan other than admitting I appreciate you coming to assess the patient and help plan alternate care”

WE ARE ALL stressed and feeling the heat …I am not trying to be mean or unprofessional…but a consistent message to our peers is why I post this.

I am not suggesting using this line for areas of care that the receiving MD may feel out of their scope ( like with internal medicine issues and we have no bloody internal medicine support again in Bracebridge) but for routine admits…

A few of us felt just some consistent scripting may be helpfull…..

Stroke protocols

Hi All,
Emma and I attended the EVT meeting last night as Huntsville looks at if/how it can support the process the province is trying to role out. NNT of 2 with right criteria to consider.

On that – please let me know at my mahc email (john.simpson@mahc.ca) the MRN and initials of any patient that is automatically excluded with EMS arrival using out stroke protocol criteria.

I have an upcoming meeting with EMS to try and reduce the false positives brought on stroke criteria to Huntsville ED and any real examples can help.

thanks
John

lab critical results at night!

Hi all,
The lab critical result pathway has been modified slightly…

Between 11pm and 7 am if a critical lab/micro result comes available ( blood culture, csf result, etc) ordered through the ER and the patient was sent home….

The result will be called direct to the ER doc at the treating hospital site. Please take this result and decide on appropriate action. May need to call patient in middle of night? or call the ordering doctor in the am? or call the family doctor in the am and confirm they can follow it up? I would suggest always letting the ordering MD know that a result has come up and how it was handled.

Just a few examples. Please then document what you did. I just document these things directly in the cerner chart of the patient as a clinical note.

This supports good patient care and supports each other as docs.
If you wish to review the full lab/micro curtail result pathway please just look on sharepoint or I can get it sent to you.
thanks
John

White demo sheets

If you see the white demographic validation sheets not done in a chart of patient you are seeing..
Either..
1)give to ward clerk to do when available
2)give to nursing to allow them to delegate the task or do themselves
3) do it yourself! It takes about 20 seconds maybe…
even if you just validate the phone number it may be super helpfull later when soemone needs to call them!

Nursing is supposed to take responsibility to do when ward clerk not there but soemtimes I find just easier to do myself.

This sheet was created to flag info because of patient that was never contacted ( about his positive bllod cultures from which he died) due to lack of info to reach or find him. Same reason for the new line on the d/c sheets reminding yuo to get a contact number.

John

summer plans

Hi all,

Please start thinking ahead if you have ideas to help us all to manage the upcoming summer boom!

I am meeting with radiology to try and plan re early morning CT’s, ensuring ultrasound coverage as good as can be, etc!

We could use the 6 hours overlap money differently if wanted? maybe do 4 hour overlap shifts and then have shift overlap other days instead too…
These kind of thoughts…

Novel ideas of flow/efficiency may be lurking in your head so thing about brainstorming with all!

John

Critical lab results

If anyone gets a critical result in their mailbox for a micro/lab test that they didn’t get a call from or the patent wasn’t admitted…
Please let me know!!

I just got one for a joint culture for a patient with a septic joint!!

the critical result pathways of a phone chain exists to timely get this info to the MD that needs to know and for the patient!!
If you don’t know the pathway of phone calls let me know or it is on sharepoint.

John

open shifts extra money!

Hi all,

Please look at the 7 remaining open shifts in Bracebridge between feb 26th and end of march…

$25 per hour incentive now approved for anyone picking up these hours….

I am not anticipating open shifts in the next schedule ( Tony sending out this evening)….

This incentive can apply for Jeffs feb 26th afternoon shift too ( which he posted and needs covered for its c section day!!)

Ask your friends and feel free to direct them to me.
HFO has posted a locum add for us to try and get these filled too admit many other things explored!!

Any questions please text me or email me direct.
thanks
John

KING vision

Hi all,

FINALLY…FINALLY
after over a year of negotiation.

We have final approval to order the KING VISION ( “a” blade system with ET tube track, along with paediatric adaptor and peds blades). I think the KING vision peds addition will be a great replacement for the airtrac peds as they expire.

Does anyone feel strongly we need to trial them before we just buy them for both ER”S??
Admin wants me to ask this question.

If anyone wants the full story from me just text or call me. If anyone feels strongly that this is something we don’t need or want ( and need to trial before buying) then let me know.
No response means you are ok with each department getting this and will consider using it!!
John

Tie it up – feedback

6.0 absorbable and non – absorbable is the vote by the majority!

Both stay!
thanks for the feedback

Tie it up results!

Hi all,
overwhelming majority want 6.0 absorbable and non – absorbable !
Both stay!
thanks for all the feedback!!