ED Muskoka Physicians - Living the Dream

Criticall documentation sheet

Hello again,

It was requested by our internal medicine colleagues at rounds a few months back that we clearly document our conversations with specialists (especially neurosurgeons) via Criticall on the chart of patients that are being admitted for monitoring at our hospitals.  Specifically, the inpatient doc needs to know who we spoke with and their recommendations for follow-up. This information too easily gets lost in the busy ER chart, so I have created a template sheet to use that will hopefully make this easier (and remind us what to ask on the phone!).  It can be used for other specialist consults as well (i.e. ortho) and should be stickered and included in the patient chart.

Copies of these template sheets can be found in the drawer to the right of the physicians desk in Huntsville under the (scribbled) label “Criticall”.  I will be bringing copies to Bracebridge today to include in the physician resource drawer there too. Please let me know if you have or hear feedback about these forms – is there any way to make them better/more useful?

Kirsten

HDMH Backup sign in Binder

Hi all –

As discussed at our HDMH ER group meeting, I have created a binder with ‘sign-in’ sheets in order to help us document our back-up calls.  It is a white binder, clearly labelled, located on the shelf behind the ‘captain’s chair’ .  When you are called in on back-up, please remember to grab this binder and sign in. It should be fairly self-explanatory (name, date, time, reason for call-in i.e. how many patients waiting). The more we remember to do this the better our data will be!

This should help us defend our back-up usage if god-forbid the ministry ever tries to claw back our funding, and it may be able to help us identify some trends about our high-needs times.

If the Bracebridge group is interested in doing something similar let me know.

 

Kirsten

holiday/leaves

Hi everyone,

In looking ahead to the next year there are a few docs who would like to be away for a month or so for a variety of reasons.

In the interest of planning Kirsten and I feel that putting up a master sheet /board/calendar may be a huge aid to not have many overlap leaves if possible.

Individuals can write up the times they are hoping to be away and that then means that it may help avoid many away at one time.

A GOOD EXAMPlE…is if I know that 3 docs are away at the same time ( say even for a week) then rather taking the same week of I would /could consider taking different week off….

Any one against this?

All would have to think about using or it won’t really work….

If okay then I will just put a board or calendar in each site in the call room…!?!?

thoughts?

John

extra shifts!

Hi all,

Uxbridge Cottage hospital has an urgent need to cover 4 to midnight this sunday!
they also have 3 uncovered shifts in july and many in august if anyone interested.

Good work, good people and I can set u up with friends there to take care of you!

Just spreading the word.

John

posts

ps….I make typos in my posts to draw you in!!!
communication strategy!!
lol

pps…the alarm in room 7 is finally on a switch!! Flip it on if you indeed have someone needing a negative pressure room. The negative rpessure fans are always on so this is just an alarm to say if door ajar and system not fully pressurized.
Be sure to tell Angela how this switch is saving your mental sanity!!!

OSMH mentla health meeting

Hi everyone,

I have an upcoming meeting this wednesday with psychaitry , a couple psy hospitalists, and several key admin in OSMH this wednesday from 11 am to 1 pm…

Esther, Debbie, Angela, Nancy, and Kathy are all participating in person or by teleconference.

The purpose of this meeting to help improve our flow of mental health patients./form one patients ( specifically), and open dialogue on many fronts !!

If anyone would like to join in you are more than welcome! I have a list of key issues to discuss but if there is any burning question you want answered please let me know.
Having had a chat with their Lead psy hospitalist on the weekend ( Rose Zacharias) they are not well informed of barriers to care we encounter and they are super keen to work togethor to move forward!!
Let me know if any burning issues. I will report back be weeks end I hope with an update of our discussion on wed.
cheers
John

suture kits

Last update I hope.

Can’t put 4 by 4 s in the sterilized kits due to sterilization standards. Grab ten pack or individual ones when setting things up. This will not change with our current equipment.

Grab a disposable drape if you want one at the moment as they are separate. This is the best way to go at the moment.

Please be happy that these changes have happened. Just seeing if you are reading this!!…although I am serious.

John

primary care

Hi all,

Please be aware that the NPLC in Huntsville is now seeing patients that signed up to join the clinic last summer. They have a very structured intake process and their wait time to “get in the door” has grown.

Patients are being told to “go sign up with them” which is fine but be aware of the wait time to an appointment.

I encountered another patient in Huntsville ER tonight ( seeking benzo renewals) that was told he would get in “very soon” by the doc that referred him there.

Just a little info to help inform patients with.
John

MQA cases/autopsy/deaths

If anyone has a case they want reviewed at MQA just let me know!!
It is an affective way to improve process!!

I have sent a few cases there recent and have had usefull results in nursing protocols/ED flow etc.

ALSO:(2) if you are involved in a case which is having an autopsy and want to see the autopsy report then please request it!! A formal process needs to be followed but I can walk you through and/or Liz Parrott will do it for you.

ALSO: (3) a Any death in ER try to dictate a note as so much more clear for MQA review as all deaths in ER automatically go to MQA. Probably a good thing to do for CMPA purposes too.

John

suture kits

Hi all,

A little healthy reminder!!

We have 12 autoclaved re-usable suture kits in each ER!! Don’t throw out!!

We have disposable as a back-up and will be upgrading the needle driver. Every non – surgical weekend at your host site we have no way to clean instruments and hence the back-up!!

You will need to add a sterile towel( packaged on own) and 4 by 4’s as you want at the moment. Packaging may change in the near future.

We also have many more sterilized individual re-usable instruments at both sites ( mosquitos, Kelly’s etc…)
If you aren’t sure if an instrument is disposable or not then don’t throw out as MDRS will sort….

If you see someone “borrowing” our equipement they shoudl sign it out with the clerk/lead nurse and bring back too!!

thanks
John