Transcript Comer Emergency Department

Comer Children’s Hospital
Pediatric Emergency Department
Resident Orientation
Prior to arrival…
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View entire resident orientation slideshow
Access chief resident’s webpage
 http://pediatrics.uchicago.edu/chiefs/PER
 Review
all the clinical guidelines prior to starting work
in the PED – our faculty expectation is residents must
be familiar with these guidelines prior to working in
our PED
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Contact Gail Armstrong to ensure all paperwork
completed (773-702-9087)
Pediatric Chiefs Page via the Intranet
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Link via “UCMC Intranet
for Physicians”
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Select “Pediatric Chiefs”
Pediatric Chiefs’ Page
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Scroll down and select
“Emergency Medicine”
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Multiple resources
including
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clinical guidelines
 important numbers
 additional resident
orientation resources
Comer Emergency Department
Lay Out
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22 exam rooms
Orthopedic procedure room
Trauma room
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Two isolation rooms with anterooms
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2 beds
Flex up to 4 beds if needed
Infant warmer for deliveries
Negative pressure
Positive pressure
One OB/Gyn room with attached bathroom
Lay Out
Central Hub – physician
and nurse workspace
 5 main pods
 Pod
1- Rms #1-3
 Pod 2- Rms #4-7
 Pod 3- Rms #8-12
 Pod 4- Rms #13-15
 Pod 5- Rms #17-20
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Rm 16 - OB/Gyn room
When You Arrive…
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Sign-in on the white
grease board
Find a cordless phone
for the duration of
your shift
Sign into Epic
 Remember
to log-off
and sign-out when
changing computers
and at the end of your
shift
Signing up for Patients
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Choose next patient based on acuity – higher
acuity before lower acuity regardless of length of
time in the ED
Within the same acuity level, choose next patient
based on length of time in ED – longest first
Or use the “Next to See” button in EPIC
Please do not “cherry pick” – your fellow
residents will notice!
Please sign up for patients when you are ready
to see them, not several at a time
Epic Charting
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“Share” your note prior to presenting to the
attending
 Do not have to “accept” note if plan not determined
 Facilitates care as attending can view prelim note
 “Accept” note after plan created
 Reassessments can be done as “ED note”
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Accept ALL notes prior to discharge and if
signing out at the end of a shift
Prescriptions will print out and will need to
signed and place in blue folder prior to discharge
Select “Discharge” after staffed with attending
and patient ready to be discharged
Epic Observation Status
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Select “ED OBS only”
Use order set “912 or
“PER:IP OBSERVATION”
Document updates of
patient using ED notes
including patient’s status
at time of final disposition:
 home
vs. admit vs. transfer
I want to follow up on my patient from my
last shift – how do I do this?
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Use “My Reports” to track patients seen
Select “My Reports”
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Select “UCMC COMER”
Select “My Patients Last 24 Hours and “My
Patients Last 7 Days” and select “Add to
Favorites”
2
3
1.
2.
3.
Select blue “My Reports”
Select desired report and select “run”
Select “view” after report is “ready to view”
Oops! I have pended charts – how do I find
them?
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Use the same “My reports” procedure
Open chart to
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Sign orders
Accept any pended notes
Paging Directory
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Access text paging system as illustrated
Page by pager number or last name
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Page to your cordless phone
 If the call bounces to main ED number
listen for coordinator to announce call
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Page by phone system
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Dial 188 then follow prompts
How to use paging system
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2 systems
 Text
paging via intranet
 Phone paging via phone or intranet
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Important numbers
 Main
ED number: 773-702-6249
 ED attending phone: 773-795-7696
 Prefixes (internal vs. external calls)
2-xxxx = 773-702-xxxx
 4-xxxx = 773-834-xxxx
 5-xxxx = 773-795-xxxx
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Admissions
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RFA: Request For Admission
 Locate
name of floor attending physician on intranet:
“Ped General On Call”
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7AM-7PM
 Maroon: Gen Peds, Cards,
 188-PEDS (7337)
 Silver: Neuro, GI, Nephro
 188-7587
 Gold: Hem/Onc
 188-HONK (4665)
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7PM-7AM
 Call
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ID, Rheum, Pulm
Night Float Senior for ALL admits (188-PEDS)
No Pediatric admits from 5-7AM
Neurology resident on consults will NOT be the
floor resident caring for the patient
Prescriptions Pitfalls
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Reasonable doses based on concentration
8
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tsp twice a day?
Start and end date
 Please
add total number of days in the comments
section. Pharmacies call to clarify in spite of the start
and end written on prescription
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Use Harriet Lane for pediatric drug dosages
Remember to sign the prescription and then
place in patient’s blue folder prior to discharge
Pharmacy phone calls get directed to the trauma
senior for clarification
Social Services
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We have 2 social workers dedicated to the Comer ED
Involved in:
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Availability:
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Trauma patients – called automatically to all traumas
Physical abuse cases
Sexual abuse and assault cases
Neglect cases
Children at risk for child abuse or neglect
Social service needs of the child or family
7 days a week for 10 hours/day
Available overnight for phone consultation only
Pager #8887
Child Life & Family Education
Available Hours Vary
The Team
Masters Degrees
Pain Management
Medical
Education/Preparation
Procedural Support
Inpatient & Outpatient
Distraction
Preparation for Hospitalization,
Surgeries, Tests, & Procedures
Nationally Certified
Training in Child
Development/Child Life/Family
Centered Care
Vecta Sensory Carts
Medical Play
Shadow Buddy Program
Entertainment
Get Well Network
Starlight Fun Centers
Mobile DVD players/Game
Systems
Movie Library
Patient
Reward/Recognition
Treasure Boxes
Welcome Gift Bags
Giveaways
Stickers
Spinoza Bears
Warm
Blankets
Songs of
Love
Wish Granting
Disposition Resources
Urgent Care
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Limited urgent care
appointments available at
Friend Family Health
Center Monday-Saturday
HMO patients cannot be
seen
New non-HMO patients
can be scheduled
Asthma clinic on Monday
afternoons for non-HMO
patients
Disposition Resources
General Pediatrics
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Pamphlets available
for primary care and
general pediatrics
clinic
Disposition Resources
Subspeciality referrals
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Advise family a patient
advocate will call regarding
follow-up with a subspecialist
Fill out paper form and place in
blue patient folder
Nurse will copy paper form and
leave for the patient advocate
Family to be contacted
regarding subspecialty followup
Welcome to Comer Pediatric
Emergency Room
We look forward to working with
you. We hope you enjoy your
rotation with us.
Questions? Contact
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Lisa McQueen MD, rotation director
 Pager
4933
 [email protected]
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Gail Armstrong, section administrator
 773-702-9087
 [email protected]