Hi all,
Just bringing your attention to the Charcoal issue…
you will see the memo…
Bottom line is pharmacy can’t guarantee that it works like that we are used too and we have limited supply…
Use only when clear potential aid/poison control suggests…
many hospitals in same boat…
John
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
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
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
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
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
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
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
Hi all,
Just a little reminder..
If someone out of country or doesn’t have a valid healthcare….
You need to put drivers license number/passport number ( some valid picture id) on narcotic prescriptions.
There have been several calls about this recent.
John
For HDMH staff – I am meeting with Kathy next week to chat about stocking in the ER. I have heard concerns about inconsistent stocking of certain items and have run across a few frustrations myself this summer so we are just going to do a walk-through the department to identify certain areas that need attention/feedback to our nursing staff who work through these re-stocking tasks at night.
Please let me know if you have areas of concern. My current list includes:
-Suture carts – ensuring they are stocked the same & with adequate supplies for busy days, including 25g 1 1/2 inch needles and adequate drape supplies if using the new utensil-only suture kits.
-ENT cart – plastic ear curettes, lido spray, cotton balls & cup, possibility of stocking otrivan or similar ?
-Trauma carts – ensuring radial & femoral art lines are clearly labelled and BOTH stocked along with supplies/tubing to set them up; creating a central line kit with all the materials needed (including sterile probe covers, chlorhex sponges, flushes, caps, tegaderm, mask & gown all in one bag);
Any other feedback? Thanks
Kirsten
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