ED Muskoka Physicians - Living the Dream

dialysis patients admitted

If you are admitting any dialysis patient followed at OSMH nephrology want to be called with goal of admitting them at OSMH! Even peritoneal!

SMMH CT

Ct tech is now onsite ( most weekday evenings) till 11:30pm!!

THIS IS GOOD! I see Kersti already posted a post in the SMMH sleep room with this! haha!! I just edited to say weekdays!

If they are onsite on the weekday you don’t need to call radiology to protocol CT’S or approve them until after 9 pm!!

Still fill out a req for contrast studies and follow same weekend policy at present.

recovery room for consults

If a patient is waiting a surgical consult and you need the space in the ER then consider sending the patient to wait ( and/or be monitored) in the recovery room during our reno’s!! Nursing Manager has agreed to this and COS confirmed this today with me!! Another way to alleviate congestion maybe!!

Orders outside directives

Anyone else have recent examples of tests being ordered outside of any directive? I had extended lytes preordered by nursing this am and a d -dimer pre-ordered by nursing on sunday. I didn’t want either of these things done! waste of money and I and I didn’t want results.

I spoke to both nurses in SMMH about these issues and spoke to the nursing manager too. Is this only happening to me? as Manager wants to know if nurses are repeatedly working outside their scope.

Please email me or text me, within the next week, if you have examples or a concern about this and I will take either no concerns or concerns back to the manager.

PIA time

Reminder to write PIA times on all charts along with your name as attending. Our misses on this are rising again and health records requires this information!

ED Reno admissions

Reminder to write orders ( if you are doing) and move patents to the floor ( or final disposition) as soon as you know admitting. Even if this is before you have all testing back! Make sure to just handover what is outstanding to the MRP ! Again…helps reduce ED LOS and bottlenecks in patient movement.

ED reno and DI

Please consider protocoling and getting CT’s running to coincide with day staff arrival for patients you are holding overnight for CT. Example: a patient that needs a CT abdo and needs oral contrast should be starting their contrast at 6:30-7am! Likewise if you have more than one patient waiting for CT to arrive in the morning… then maybe you should consider calling in CT (on call) to expedite care and try to minimize bottlenecks in care. With our reduced capacity bottlenecks are gonna have a much bigger impact and this is more way to reduce ED LOS for patients.

Ultrasound – if waiting overnight then make sure your req is in and communicate with the ultrasound tech as early as 7:30am ( on their arrival) to see when they can do that ED ultrasound.

DI leadership and Dr Chait are aware of these issues.

If you want to talk more about this pls let me know.

ED Comm Minutes dec

Look in Media and you can see easily – the websites new format won’t let me link directly!

Reno OPP/EMS

As asked at the SMMH ER group meeting…OPP has been asked by Esther Millar to consider transfer directly to FORM 1 facility if a client is being brought into ER under the mental health act. This has been asked and explained. Not sure if we will see it happen. EMS has been asked to consider transfer out of the region after hours ( against their current policy) if we have a patient accepted elsewhere ( tex. Form one patient accepted in OSMH). They are aware that this would help our capacity and reduce potential off load delays.

Octaplex orderset

Hi all,

Octaplex orderset exists now in entrypoint.