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Archive for the ‘Geriatrics’ Category

ED resources and personnel for patients 65 and older

as of 1/29/13

Several resources are available to ALL ED patients aged 65 and older (NOT just those physically in the Geri ED). These are available as a result of the GEDI WISE grant.

Physical Therapy Consultation
Physical therapy is on call for ED consults for geriatric patients
M-F from 8a-4p
Pager #917-218-1059>
Criteria for consult: Plan for discharge from the ED plus one of the following
– Fall or musculoskeletal chief complaint
– Failed Get Up and Go test
– In conjunction with social work, need for PT assessment for direct rehab/nursing home placement

Pharmacy Consultation
A dedicated geriatric pharmacist is available in the ED for consultations and assistance.
M-F from 11a-7p, (weekend ED pharmacist is also available 3p-11p on Sat/Sun)
X78885
Criteria for consult include:
– Use of 10 or more medications
– Anticoagulant therapy
– Diabetes therapy
– Use of pain medication
– Asthma/copd medications
-Suspicion of an adverse drug event

Social Work
A dedicated geriatric social worker is available, Lara Markovitz
M-F from 5p-8p (in addition to the usual social work coverage, soon to be extended)
X78880

Geriatric Clinical Coordinator
Billie Brown is the clinical coordinator for the Geri ED. In addition to operations for the unit, she can assist in determining the availability of space for the triage and transfer of patients to the Geri ED.
M-F from 11a-7p
X78882

Transitional Care Nurse Practitioner
Liz Sabella is available to help with care coordination and transition for elderly patients who are being discharged home from the ED.
M-F 11a-7p (hours soon to extend when NP Gloria Nimo joins)
Blackberry 347-344-7893

For any issues or questions please contact:
Denise Nassisi, Geri ED Director, denise.nassisi@mountsinai.org

Written by phil

January 30th, 2013 at 2:00 am

Posted in Geriatrics

Geri Social Work Coverage

The GEDI WISE grant provides for additional social work coverage for ED patients aged 65 and older.

For patients 65 and older, Monday through Friday from 5pm- 8pm, social worker Lara Markovitz can be reached via zone phone at x78749.

Please continue to call the on call social worker (via the operator or AMAC) if needed after 5pm for patients under age 65. We hope to further increase ED social worker availability in the near future.

Thank you,
Denise

Written by phil

January 23rd, 2013 at 3:10 am

Posted in Geriatrics

Geri Admissions

FAQs about Geriatrics for ER residents/attendings:

Bottom line from Makini: Please, when you call AMAC to page “geri,” do not say “Please page geri.” Be specific. IE, Ask for the pt’s actual PCP, ask for the MACE or phone call fellow when appropriate, or if you are calling a proper consult, you can ask for the geri consult fellow. Seriously, this is more complicated than most of our consults/provider calls, so please refer to this email.

Thanks, Makini

From Dr. Blachman:

What is the MACE team? This is the inpatient geriatrics service, comprised exclusively of Coffey geriatrics patients and residents of the Jewish Home nursing home.

How do I know if my elderly patient is a Coffey geriatrics practice patient? If you look at notes on EPIC, they would have notes from a geriatrics office visit. The person who wrote the note is the PCP.

Who do I call about a geriatrics MACE admission if it’s Monday at 9 am-Friday 5pm, at ALL hours? The PCP (found in EPIC).

What if the PCP does not call back? Please scroll down on amion (password mssm) and see if the PCP is on vacation. The covering attending will be listed, and you can contact them directly. If no one responds to your pages, please call our geriatrics call center operator at 212-659-8552.

Who do i call about a MACE admission on the weekend (Friday at 5pm til Monday at 9am)? The fellow listed under “phone call coverage” (see amion, mssm, search under geriatrics). Please do not call the general “geriatics consult” number since this is held by the other fellow.

On a weekday, why would you call Concurrent/consult fellow? If you want a consult in the ED between 9am and 4pm on weekdays.

On a weekday or weekend, why would you call MACE fellow? If you have already spoken to PCP but want to alert MACE fellow about an admission during the day (note that this is not necessary as PCP or weekend phone call fellow usually contacts MACE fellow directly).

Are the geriatrics and palliative care fellows the same? No, we are in two separate fellowship programs, taking care of different patients.

What is the Coffey practice? This is the outpatient geriatrics practice at the Martha Stewart Center (1440 Madison)

Nina Blachman via Makini

Written by phil

October 29th, 2012 at 2:29 pm

Posted in Admitting,Geriatrics

Geriatric Consultations

-Geriatric consultations are currently available for elderly ED patients Mon-Fri 9am-4pm. Reach the Geriatric Consult Liaison service through AMION or AMAC.

-Consider Geriatric consultation for assistance with high risk and complex elderly patients, particularly for help with coordination and transition of care issues in patients with a potential for discharge. See attached for further details.

-Patients do NOT need to have a prior PCP in Geriatrics/Martha Stewart to obtain consultation.

-For patients already know to Geriatrics/Martha Stewart, you may continue to call their PCP directly (via AMION or AMAC) to discuss any issues related to their care or disposition.

Please let me know if you have any questions or issues.

Thank you,

Denise

Written by phil

September 7th, 2012 at 2:25 am

Posted in Consults,Geriatrics

Geri ED Flow Feb 2012

Dear All ED Faculty, Residents, Nursing and Staff,

Thank you for all your support, comments, suggestions and constructive criticism as we launched the Geriatric ED, a work in progress. The Geriatric Operations Team has revised the Geriatric ED/East Zone Guide attached which incorporates the lessons learned from the first week, your suggestions as well as a schedule which highlights the current available staffing resources for the Geriatric ED. Briefly:

Hours: Accepting New Patients: Monday-Friday 9am-9pm, Beds 23-32 Saturday-Sunday 11am-9pm Beds 29-32
Holding Obs or Admitted Patients that meet the Geriatric ED criteria: 9pm-9am (11am Sat/Sun) Beds 29-32

Capacity: Monday-Friday 8-14 patients (dependant on Patient:RN ratio 1:8)
Saturday-Sunday 8 patients

Criteria for Care and Observation:
Age >/= 65
ESI 3,4,5
Knows their name, oriented to Self
Ambulatory to bathroom before illness or injury, Walk

Staffing:
Attending: M-F Intake/South ED E2s Attending; Sat-Sun South/Fast Track Attending
Resident: T/Th/F ED Geriatrics
PA: M-F East/+/-CB; Sat-Sun Fast Track
RN: M-F East/+/- OT RN; Sat-Sun Fast Track
ER Tech: M-Sun East
BA: M-F East; Sat-Sun Fast Track
SW: M-F ED SW; Evenings, Sat-Sun Oncall SW

This Guide will replace the posted first draft in the Main ED and Geriatric ED. We welcome your input and will continue to revise it to best serve you and our patients going forward.

Geriatric ED Care Protocol 022412 revision

Written by reuben

February 25th, 2012 at 6:29 am

Posted in Geriatrics

Geri ED

Thank you for all your support, comments, suggestions and constructive criticism as we launched the Geriatric ED, a work in progress. The Geriatric Operations Team has revised the Geriatric ED/East Zone Guide attached which incorporates the lessons learned from the first week, your suggestions as well as a schedule which highlights the current available staffing resources for the Geriatric ED. Briefly:

Hours: Accepting New Patients: Monday-Friday 9am-9pm, Beds 23-32 Saturday-Sunday 11am-9pm Beds 29-32
Holding Obs or Admitted Patients that meet the Geriatric ED criteria: 9pm-9am (11am Sat/Sun) Beds 29-32

Capacity: Monday-Friday 8-14 patients (dependant on Patient:RN ratio 1:8)
Saturday-Sunday 8 patients

Criteria for Care and Observation:
Age >/= 65
ESI 3,4,5
Knows their name, oriented to Self
Ambulatory to bathroom before illness or injury, Walk

Staffing:
Attending: M-F Intake/South ED E2s Attending; Sat-Sun South/Fast Track Attending
Resident: T/Th/F ED Geriatrics
PA: M-F East/+/-CB; Sat-Sun Fast Track
RN: M-F East/+/- OT RN; Sat-Sun Fast Track
ER Tech: M-Sun East
BA: M-F East; Sat-Sun Fast Track
SW: M-F ED SW; Evenings, Sat-Sun Oncall SW

This Guide will replace the posted first draft in the Main ED and Geriatric ED. We welcome your input and will continue to revise it to best serve you and our patients going forward. Please feel free to speak to or send your questions, comments and suggestions to: Kevin.Baumlin@MountSinai.org or Denise.Nassisi@MountSinai.org or Gallane.Abraham@MountSinai.org.

Thanks,
Gallane

Gallane Abraham, MD

Written by phil

February 24th, 2012 at 10:25 pm