FW: Inpatient updates

Sorry, it has been awhile since I sent updates, so there are quite a few. Let me know if you have any questions.

 

Medicine:

 

NIHSS education classes being offered for staff

There are in-person NIHSS educational classes being offered that any staff can participate in. Critical care and ER docs routinely do this education, but if you are interested in hospital medicine and would like to get certified in this you can register by searching “SANHC In-Person NIHSS” in LEARN. (the dash needs to be put in or it won’t come up)

 

Two Tier Stroke Protocol Education

We have a new stroke protocol going into effect. Please see my separate email on the modules to complete by 1/31/19

 

Antibiotograms are here!

I have left the new antibiotic books in the resident room and will bring to res-fac as well.

 

Obs vs Inpatient Status

Tanya Fritz, one of the case managers, is happy to answer any questions on patient status. Her cisco phone is 510201.  She works M-F and can usually be reached from 8:30am to around 4:30pm.   She can discuss status with any FM MD that has a question.  She can also assist with what  documentation needs to be in the chart to help justify the appropriate status. Please use her to make sure we have patients in the appropriate status as soon as possible during their stay.

 

Change to Centura Connect Transfer Process

Starting 12/3 Centura Connect will now discuss all transfers with an ER physician at the intended transfer facility. They will obtain all the necessary patient information and discuss the transfer with the requesting physician. They will then discuss the case with the admitting physician and facilitate any communication with specialists if needed. This is being done to decrease the time to acceptance of transfer and unify the admitting process.

 

Clears okay for low-risk stress test patients

If low-risk patients (neg troponins, no NSTEMI) are tentatively scheduled for a stress test they can have clears up until 0700. This should enhance patient satisfaction and will not interfere with the testing.

 

Multidisciplinary rounds Reminders

  1. Be on time- In order to help with nursing efficiency and to be mindful of time for all parties involved, please be on time to multidisciplinary rounds (10:15 for Team B, 10:45 for Team A). If there is a large census and the Team A attending still has patients to see, they may continue to round with the intern while the senior starts MDRs.
  2. Involve all disciplines- make sure you are not just talking to the nurses. At the end, ask if anyone else has any questions or concerns (CM, pharmacy, etc)
  3. Discuss patient disposition- In order to facilitate timely discharge, please try to get CM involved early in the hospitalization if you are anticipating need for SNF, home services, etc and when you think the patient will be leaving

 

Response to CDI (clinical documentation inquiries) in-basket messages

Please see the attached tip sheet on how to respond to these queries

 

OB:

 

New nurse midwife Kim Windels

Most people have met Kim. She will be spending time on L&D in the mornings seeing post-partum patients and helping to manage our laboring patients. She will also be attending ICHC clinic Wed mornings and may be doing some gyn clinic there as well. Please help welcome her to the team and know she is a wealth of new information that can help enhance the experience of our OB patients.

 

Preterm Labor Algorithm

Trevor helped to update our preterm labor algorithm. Please see attached and it is also posted on L&D

 

 

 

From: Tamura, Krystal
Sent: Thursday, December 06, 2018 7:25 AM
To: Diaz, Sara <SaraDiaz@Centura.Org>; Flint, Ryan <RyanFlint@Centura.Org>; Groff, Elizabeth <ElizabethGroff@Centura.Org>; Harrington, Trevor E <TrevorHarrington@Centura.Org>; Insel, Kimberly J <KimberlyInsel@Centura.Org>; Liegl, Sarah <SarahLiegl@Centura.Org>; Ludemann, Matthew MD <MatthewLudemann@Centura.Org>; McGee, Colleen M. <ColleenMcGee@Centura.Org>; Ochs, Genevieve <GenevieveOchs@Centura.Org>; Price, Bethany R <BethanyPrice@Centura.Org>; Strickland, Laura E. <LauraStrickland@Centura.Org>; Tamura, Krystal <KrystalTamura@Centura.Org>; Veres, Sharry <SharryVeres@Centura.Org>; Walter, Kimberly <KimberlyWalter@Centura.Org>; Zarza, Christina <ChristinaZarza@Centura.Org>; Beukema, Kylie <KylieBeukema2@Centura.Org>; Karozos, Stephanie <StephanieKarozos@Centura.Org>; Knaus, Chad J <ChadKnaus@Centura.Org>; Mathern, Seth A <sethmathern@centura.org>; Mettler, Lisa <LisaMettler@Centura.Org>; Rudolph, Michael R <MichaelRudolph@Centura.Org>; Baxter, Kelly <KellyBaxter@Centura.Org>; Blumberg, Drew T <DrewBlumberg@Centura.Org>; Bowie, James W <JamesBowie@Centura.Org>; Bross, Theodore L <TheodoreBross@Centura.Org>; Buehrer, Beth <BethBuehrer@Centura.Org>; Davies, Sofia <SofiaDavies@Centura.Org>; Hart, Taylor V <TaylorHart@Centura.Org>; Sherman, Kelsey J <KelseySherman@Centura.Org>; Troutman, Jesse E <jessetroutman@Centura.Org>; Weniger, Kate C <KateWeniger@Centura.Org>; Aquila, Emily C <EmilyAquila2@Centura.Org>; Baker, Stephanie <StephanieBaker2@Centura.Org>; Cammarano, Julian A <JulianCammarano@Centura.Org>; Del Moral, Spencer R <SpencerDelMoral@Centura.Org>; Galbraith, Bryce K <BryceGalbraith@Centura.Org>; Heng, Peter <PeterHeng@Centura.Org>; Holland, Hailey B <HaileyHolland@Centura.Org>; Maurer, David E <DavidMaurer@Centura.Org>; Pigott, Christine <ChristinePigott@Centura.Org>; Sterry, Brandon <BrandonSterry@Centura.Org>; Vollmer, Jeremy C <JeremyVollmer2@Centura.Org>; Zerba, Emily S <EmilyZerba@Centura.Org>; Brown, Cory J <CoryBrown@Centura.Org>; Dill, Jessica C <JessicaDill@Centura.Org>; Edwards, Gray K <grayedwards@Centura.Org>; Gayer, Corinn L <corinngayer@Centura.Org>; Mahony, Gwyn E <gwynmahony@Centura.Org>; Mathias, Tanner D <tannermathias@Centura.Org>; McClenahan, Kaitlin E <kaitlinmcclenahan@Centura.Org>; Neisler, Justin B <JustinNeisler@Centura.Org>; Pearson, Lindsey J <LindseyPearson@Centura.Org>; Saad, Amira O <amirasaad@Centura.Org>; Stowers, Lucas K <lucasstowers@Centura.Org>; Wendt, Rebecca A <rebeccawendt@Centura.Org>
Subject: Inpatient updates

 

Sorry, it has been awhile since I sent updates, so there are quite a few. Let me know if you have any questions.

 

Medicine:

 

NIHSS education classes being offered for staff

There are in-person NIHSS educational classes being offered that any staff can participate in. Critical care and ER docs routinely do this education, but if you are interested in hospital medicine and would like to get certified in this you can register by searching “SANHC In-Person NIHSS” in LEARN. (the dash needs to be put in or it won’t come up)

 

Two Tier Stroke Protocol Education

We have a new stroke protocol going into effect. Please see my separate email on the modules to complete by 1/31/19

 

Antibiotograms are here!

I have left the new antibiotic books in the resident room and will bring to res-fac as well.

 

Obs vs Inpatient Status

Tanya Fritz, one of the case managers, is happy to answer any questions on patient status. Her cisco phone is 510201.  She works M-F and can usually be reached from 8:30am to around 4:30pm.   She can discuss status with any FM MD that has a question.  She can also assist with what  documentation needs to be in the chart to help justify the appropriate status. Please use her to make sure we have patients in the appropriate status as soon as possible during their stay.

 

Change to Centura Connect Transfer Process

Starting 12/3 Centura Connect will now discuss all transfers with an ER physician at the intended transfer facility. They will obtain all the necessary patient information and discuss the transfer with the requesting physician. They will then discuss the case with the admitting physician and facilitate any communication with specialists if needed. This is being done to decrease the time to acceptance of transfer and unify the admitting process.

 

Clears okay for low-risk stress test patients

If low-risk patients (neg troponins, no NSTEMI) are tentatively scheduled for a stress test they can have clears up until 0700. This should enhance patient satisfaction and will not interfere with the testing.

 

Multidisciplinary rounds Reminders

  1. Be on time- In order to help with nursing efficiency and to be mindful of time for all parties involved, please be on time to multidisciplinary rounds (10:15 for Team B, 10:45 for Team A). If there is a large census and the Team A attending still has patients to see, they may continue to round with the intern while the senior starts MDRs.
  2. Involve all disciplines- make sure you are not just talking to the nurses. At the end, ask if anyone else has any questions or concerns (CM, pharmacy, etc)
  3. Discuss patient disposition- In order to facilitate timely discharge, please try to get CM involved early in the hospitalization if you are anticipating need for SNF, home services, etc and when you think the patient will be leaving

 

Response to CDI (clinical documentation inquiries) in-basket messages

Please see the attached tip sheet on how to respond to these queries

 

OB:

 

New nurse midwife Kim Windels

Most people have met Kim. She will be spending time on L&D in the mornings seeing post-partum patients and helping to manage our laboring patients. She will also be attending ICHC clinic Wed mornings and may be doing some gyn clinic there as well. Please help welcome her to the team and know she is a wealth of new information that can help enhance the experience of our OB patients.

 

Preterm Labor Algorithm

Trevor helped to update our preterm labor algorithm. Please see attached and it is also posted on L&D

 

 

Krystal Tamura

St. Anthony North Family Medicine Faculty

Inpatient Medical Director

St. Anthony North Health Campus | 14300 Orchard Pkwy Westminster, CO 80021

 

krystaltamura@centura.org

Office: 303.430.5560 | Cell: 720.352.4874

 

 

centura.org

 

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intended recipient of this communication, any disclosure, copying, further
distribution or use thereof is prohibited. If you have received this
communication in error, please advise me by return e-mail or by telephone and
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