ED Muskoka Physicians - Living the Dream

times

Hi all,
Just a reminder to fill in time you see patient and disposition times ( many , many of the disposition times in particular are left empty).

It is okay to put your deposition time for patients you are gonna admit as soon as you make that decision too ( whether orders done /mrp contacted/etc or not…).

thanks,

Our health record staff thank you!

John

SMMH NP – or no NP!

Hi everyone,

Kate has quit as ER NP in SMMH er and just finished at now.
I am waiting to have an exit interview with her and then I can fill you in more around reasons.

We are without an NP for the time being.

Also- I have learned that the “protected NP funding” that SMMh had is no longer and that the salary provided for an NP was rolled into general budget by the MOH.

Stay tuned…..I have met with Esther and talked to Deb…I am worried about the future….

John

ED education in Whistler

Asked to pass on from Pierre,

Looks fun!

Whistler!img_2015

Home

John

mental health orderset update

Good evening all,

Just a reminder if you are dealing with an aggressive mental health patient…you could consider loxepin…
We do have it in both er’s.
It is part of the OSMH mental health orderset that I circualted months ago after meeting with memebers of the OSMH mental health team.

Just a reminder….

DR Zacharias ( lead pysch hospitalist) and Dr Rodway -Norman are still planning to come to a talk or do rounds with us soon. ALthough…for many reasons we are now looking at JAN 2017 for this.

I circulated OSMH’s months ago and when I recently wanted it I actually just called OSMH Er and had them fax it to me.

John

Ghana Mission Trip

Hi All,

Copy and paste this to your browser and take a look at this video.

GRID 2015 Medical Team

This is the health team mission group I will be part of this year joined by two fantastic locals Helen Dempster and Cheryl Dove and 57 teammates!!!

I am selling Muskoka Coffee still as a fundraiser to buy supplies for the mission trip.

I have about 30 bags left ( several kinds) of Muskoka coffee.
$16 a bag ( like the store) and I get 5 dollars of that for the team . This five dollars then becomes $7.50 with the help of a team grant.

Let me know what coffee you would like!!

John

mental health clearance

Hi all,

Just a reminder that if you can’t get a urine sample from a patient you still may be able to medically clear them.
You can consider a call to the psych hospitalist at Orilla direct to discuss if unsure and bed available there ( or psychiatrist if RVH or Penatang).

Sometimes that urine sample may be needed but if you are unsure you could consider a call to discuss.

John

DI ordering

Hi all,

Question…
Would every doc be okay to fax a copy of the facesheet to DI when we write down a test to be done????

I think it is the best way to go to ensure the rads have the info they need from the chart and our clerical staff or nursing staff then don’t need to put anything in the comments box in terms of history except the indication for a test if not in their main menu.

The rads want this info!!!
It is standrd of care elesewhere.
There have been countless hours used trying to come up with a work around/electronic version/powerchart access for rads/etc….etc…etc…..

DI will take the faxed sheet and marry it with the cerner order. They wil double check the order then and all people then seem to be happy..

Thougths?

I give you one week to comment on this.

thanks
John

smmh internal med

Hi all,

A small group met this morning in follow-up to the request put forward to admin and COS in a letter penned to Natalie by Kersti that was distributed recently….

Jan Goosens, Sanjay Jinal, Dave Johnstone, Mel Mar, Marty O, Sandi Adamson and Karen Fleming. All by video or phone.

All agreed in principle to the algorithm distributed about IM support sent out recently by Jan.
All agreed a phone call to the IM on call in Huntsville to problem solve how support can be obtained , or patient transferred if capacity exists, is the first step .

Risk stratifying the patient can be done with MRP and IM feedback.

In principle all agree that if HDDM is over capacity then either criticall may need to be called or if possible gridlock may apply and a patient could potentially be moved to SMMH if that makes capacity for an appropriate patient to go to Huntsville.

Nothing new I think really but at least ongoing discussion is always helpfull.

Discussion around renumeration of internists ensued.

Please always send a copy of the patient demographics to any internist giving phone advice as they need this to bill a telephone consult if appropriate.

Any questions please ask.

John

smmh ecgs

Hi SMERPS’s

If anyone has reviewed an old ecg that just got reported ( due to delay noted and posted recently)…..and identifies a case that this “late report” changes care…please let me know MRN and example!!!

Any “miss” like this I want to know about and feed back to senior admin. as they have asked about it.

questions? pls ask

thanks
John

ecg back log

Hi everyone,

So..Dave Johnston just recently read over 200 ecgs from SMMH with some dating back almost a year.

Heads up to look at dates as these come back to your mailboxes.

These eggs where mistakingly being put in a folder and never entered into cerner and then never getting interpreted by internal medicine. It was totally dependant on who did the egg and who entered the test into corner or so I’m told…

I had no idea and I expect none of you did either.

The process of entry into corner has been fixed and this should never happen again i’m told. I have expressed our concern to all parties over this happening!!!!!

These are ecgs that you should have seen in the ER but never would have received the formal interpretation.

John