mssmem.com

Hello,
Attached please find the pager numbers for our current PICU attendings. If you feel that communication is not going well with the resident in the PICU then ask which attending is on and ask to speak with them or page them directly. thanks,
Adam

PEDIATRIC CRITICAL CARE UNIT

MD Ext. Beeper Short Range

Joanne Hojsak 46529 (917)706-0765 7897

Margaret Satchell 44277 (917)729-9205 6183

Steven Yung 40011 (917) 205-1460

Sheemon Zackai 47696 (917)252-0529 0289

Christine Zawistowski 43732 (917)641-0235 0550

EXTENSIONS
PICU 3rd floor 48132
PICU 6th floor 42086
PCICU 43467
Nurse Manager 41855

FAX
(212)876-3255(Ped Pulmonary)
(212)534-5207(NICU)

And patients who are sources in needlestick cases who cannot consent, in some cases can be tested without consent. See the document link below.

August 11, 2010
TO: (New York State)
Chief Operating Officers
Medical Directors
Emergency Medicine Chairs
Emergency Department Administrators
Legal Affairs Committee

FROM: Susan C. Waltman, Executive Vice President and General Counsel

RE: Enactment of Bill to Promote HIV Testing

On July 30, 2010, Governor David Paterson signed into law S.8227/A.11487, which allows patients to agree to HIV testing as part of a general signed consent to medical care that remains in effect until it is revoked or expires. The law also requires health care providers, including hospitals and emergency departments, to offer testing to all patients between 13 and 64 years of age, as recommended by the Federal Centers for Disease Control and Prevention (CDC), and facilitates authorization for testing in the case of certain occupational exposures to HIV infection. The new law takes effect September 1, 2010, but authorizes the New York State Commissioner of Health to adopt regulations necessary to implement the law prior to that date.

The law will require a number of operational changes within health settings, including: hospital inpatient areas, emergency departments, outpatient departments, as well as other primary care settings. To assist its members, GNYHA is working with the New York State Department of Health (DOH) to identify and address the barriers and burdens that these requirements will create for providers. GNYHA will keep you apprised of its progress on these efforts.
The law aims to increase HIV/AIDS testing rates so that individuals who are HIV-positive can seek treatment earlier and reduce transmission of the disease to others. The law, therefore, updates New York State’s laws to encourage such testing and to reflect medical technologies and advances.

Overview of Law

The following provides a summary of the main features of the law:

Testing – Requires that an HIV-related test be offered to every individual between 13 and 64 years of age (or younger/older if there is evidence of risk activity) receiving health services as an inpatient or in the emergency department of a hospital or receiving primary care services in the outpatient department of a hospital or freestanding diagnostic treatment center or from a physician, physician assistant, nurse practitioner, or midwife providing primary care. Such offering must be “culturally and linguistically appropriate.”

Consent to Testing – Authorizes HIV-related testing to be part of a signed general consent to medical care or documented oral consent when the test being ordered is a “rapid HIV test.” Such consents would be durable and remain in effect until they are revoked or expire. Patients must be provided an opportunity to decline HIV testing, and testing may only be done with full patient consent after the patient is provided with pre-test counseling information. In all instances, a physician must provide oral notification to the patient whenever an HIV test is performed and the notification must be noted in the patient’s medical record.

Occupational Exposures – In situations involving occupational exposures that create a significant risk of someone contracting or transmitting HIV infection, HIV testing will be allowed in cases where: (1) the source person is deceased, comatose, or unable to provide consent, and his or her health care provider determines that mental capacity to consent is not expected to be regained in time for the exposed person to receive appropriate medical care, as determined by the exposed person’s health care provider; (2) an authorized representative for the source person is not available or expected to become available in time for the exposed person to provide appropriate medical care; and (3) the exposed person would benefit medically by knowing the source person’s HIV test results.

HIV Counseling – Require that HIV counseling messages be tailored based upon whether the HIV test indicates infection. Required positive test counseling remains consistent with existent law, but positive test counseling will now require the person ordering the test to provide or arrange for follow-up medical care if the patient consents. In cases with negative test results, counseling can be accomplished via oral or written reference to information previously provided but must emphasize the risks associated with high-risk behaviors.
Consent Forms – Designates the informed consent forms for HIV-related testing and disclosure that the Commissioner must develop as “standardized model” forms and removes the requirement that providers obtain prior authorization for the use of alternative consent and release forms, provided that the forms contain information consistent with the standardized model forms.

A copy of the new law is attached. If you have any questions regarding the new law, please contact Maria Woods at (212) 259-0767 or mwoods@gnyha.org.

GNYHA_HIV_Consent_Update

For sinai wireless phone users

You can change the location of where your phone is answered if you miss a call.

There is a “Zone” icon on the main screen. Navigate to the icon and select it. Then choose the area such Adult, Peds, Admin or East and save. Please set to “adult” if you don’t know where you are going to be as a default.

We have been getting some feedback about an excessive amount of “adult” phone calls going to pediatrics inadvertently. Adam and the BA’s would appreciate everyone using the adult option

Please check your phone before you start so your calls go to the correct area

Thank you

Kevin

Kevin Chason, DO

a few changes in the disposition section …

– you will notice there is no option for “observation” anymore – to do it, you must enter an order to “admit to observation” – the department is “emergency medicine” and then enter the diagnosis. accept the order & then you can then make this a favorite by clicking the star to the right of the order. once you sign the order, it will automatically change the disposition to “observation”. this will also help in our obs billing as we will now always have the order in place.

– you will also notice that you can dispo to “cath lab”, “to clinic”, & to “L&D” … so less confusion as to where to find it. you can still find other dispositions, if needed, if you click the magnifying glass.

we will continue to work to improve the functionality of epic & keep everyone up to date.
vaishali

At a meeting today with the heads of General Surgery, Trauma Surgery, SICU, Neurology and Jim Harris the following was agreed to and will be added to the ICU admission policy shortly:

1) All RED and YELLOW trauma patients needing ICU care MUST be admitted to the SICU with the Trauma Surgery as the admitting service.

That means patients with isolated neuro-surgical or orthopedic injuries, for example, who would have in the past gone to the SICU on the NS or ortho service should now be admitted to the to the SICU on the trauma service. Understand that this is new and the surgical residents may not know of this policy for a few days.

2) Critical surgical patients needing SICU care should be admitted to the unit whether or not the attending or fellow in the unit has discussed the plan of care with the admitting surgical team.

That means, after you have come to an agreement with the admitting team or you decide it’s best for the patient that they are admitted to the unit, you don’t have to wait for the unit fellow/attending to track down the chief resident of Surgery, ENT, Orthopedics, etc. before admitting the patient and sending them upstairs. If there is a bed available the ED nurse staff should give report and get them upstairs ASAP.

3) Neurology cases needing an ICU should first be admitted to the RICU with neurology as a consultant. If the RICU is full then they should be admitted to the SICU under the neurology service as the primary team.

That means neurology patients managed in the SICU the same way that current surgical patients are managed.

4) NO more waiting in the ED for repeat CT at “6 hours” for patients with traumatic intra-craninal hemorrhages. They must all be admitted to neurosurgery and sent to the unit or step-down.

Thanks,
Phil