ED Muskoka Physicians - Living the Dream


Morning all,
This is the week of accreditation so just a heads up/reminder!

Kirsten and Adam I expect you maybe working this week when the surveyors will be dedicated to the ER ( me too).

ALTHOUGH..They could walk through the ER or see any of us in the hall at any time!

Most hot ER topics – BPMH ( how do we do PMH and med orders with admission), What is our role as ED doc in Code orange ( team lead) , how is our access to specialist care, etc!

Best not to focus on negative things but how we create a safe environment for our patents ( Ie they don’t want to hear about our issues with plastics as an example)….

Admissons of patients with NP primary care

Hi all,

if you are admitting a patient with a primary care NP to Bracebridge please ask…

Do they know what MD they are assigned too? ( all have been assigned to a MD and should have a card with that). This is not true of the patients at the NP led clinic in Huntsville as they are a different model of primary care ( L Lefebvre, A Kitchen, M and C Dove, A Erickson).

if that MD looks after inpatients then you may be admitting to that MD ( or the MD covering) instead of orphan MD.

if patient doesn’t know what MD they are rostered to then a phone call to the NP office may provide that.

In Huntsville ( with our inpatient system) this is not needed.


march break locum

Hi everyone,
an MD couple may be able to do some locum work during march break.
If you are interested in giving up shifts that week please let me know!

They are interested in summer locum work too so if anyone planning to cut back or wants specific time off please consider voicing that now too!

Radiology contacts!

Hi all,

Please start to use the electronic schedule for who to call when you need to speak to a radiologist.
There is a permananet link on the MAHC homepage (right hand bottom MAHC radiologist schedule).

So – just click on internet – get our homepage which is the default and then one click shows you who to call.

This is the most up to date radiologist list always!!
We have had a few calls ( and delayed return calls) recently due to not using the most up to date schedule.

If you can’t find just ask me and I will show you.

We will soon be getting rid of the paper schedules…SOON!…as they are impossible to keep up todate

Just like we use medevison as our most up to date schedule ..this is what the rads use and they have asked us to only use this schedule as the one you trust.


CT survey

Just a reminder…

Any abdo CT please full out the surveys in each ER for Dr Roldan’s study…

He doesn’t need many but still doesn’t have enough!!

HDMH Sleep room

Please have all your personal stuff out of the sleep room/lounge by nov 12th!
Nov 12th bed and minimal furniture will get moved to sleep room ( quiet room)
expect that area closed nov 12 – dec 13 for carpet/paint/new shower enclosure.


MOCK codes

Our code committee needs to do at least one mock code ( blue or pink or …) per year.

If called please make every effort to present yourself as the ED doc.
If you are super busy you can literally show up and then explain you need to leave!

Huge value in just getting there as that is what they are trying to track ( ie who comes, what equipment comes and what doesn’t, etc) more so than actually the content of the code.
If you are able to run things they are cases made on real scenarios and always good practice!!!

If you are doing a resuscitation and can’t go then just get someone to send that message to the team running the Mock!

Thanks for your support in these!


D/C instructions

Hi all,

Just closing a complaint that has brought to front how important our discharge messaging is!!

The patient and mom understand clearly heard that a fracture could be missed on first ED visit from the verbal discharge instructions, by the ED doc, ( due to growth plates) but didn’t seek care for over three weeks after the initial injury because it ” was getting better slowly” and they understood it shouldn’t be if a break was missed.

It was actually a missed tibial fracture by the ED doc and radiologist. It is clearly on the x-ray but is a commonly missed break in this case!

If they had been told “if still any pain in one week to 10 days see an MD” that would have prevented a delayed presentation of a missed fracture.
That is now how specific I have become on my discharge instructions and I think super helpful for all to hear about this case.

ALSO – reminder to use written d/c instructions whenever possible!! In HDMH I am even sending our PA away to write these up for me and then when ready bring them to me to edit or give to patient.


MD Names

Please write your name in the attending MD spot for all patients you see!!
Switchboard and med records is struggling!
Its our responsibility.

It needs to legible too!!



Please always right the time you see a patient.
Our complaince with this is dropping and leads to huge issues for coding and data tracking.
It may be even tied to funding again at some point!

Please write the PIA time ( along with your name) on every patietn’s chart you see!

THank you