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Pediatric ED to Clinic Diversion Process

Introduction:
The following describes the process by which The Mount Sinai Hospital’s Emergency Department will handle non-emergent pediatric patients during the hours of 8:30am -3:30pm Monday – Friday and 10am – 2:30pm on Saturdays.
Policy:
All patients that present to the Mount Sinai Emergency Department will receive a medical screening exam to determine level of acuity by a health care provider.   In the event the exam indicates that the visit is non-emergent, then the ED staff will refer the patient to the Pediatric Clinic if they are an established Pediatric Clinic patient in the past 12 months and participate in an insurance plan accepted by the Pediatric Clinic.
Procedure:
When a patient presents to the Mount Sinai Emergency Department, the ED-BA located at the Greet Desk will validate the patient’s name and date of birth.  During the look-up of the patient in the Cerner ADT system (between the hours of 8:30am to 3:30pm  Monday –Friday and 10am-2:30pm Saturday) the ED-BA will determine if the patient is an established patient in the Pediatric Clinic (seen within the past 12 months and participates in an insurance plan accepted by the Pediatric Clinic).  If the ED-BA determines that the pediatric patient has met the criteria as a Pediatric Clinic patient then the ED- BA will process the patient in the ADT system (Cerner) as a “Quick Registration.”  The Quick Registration will include the national patient identifiers (Name & DOB), referring source, PC (PEDS Clinic)/the reason for visit along with the onset date.
Once the patient’s Quick Registration has been completed with required data elements, then the patient’s information will be sent from the ADT system to the Emergency department’s electronic medical record system (IBEX).  The patient’s information will be viewed in the triage nurse’s queue and the patient will be called for triage.
The triage nurse will expedite all pediatric patients with the PC designation in the reason for visit field.    Once the triage nurse has assessed the acuity level of the pediatric patient (emergent vs. non-emergent), he/she will call the Attending/Fellow to validate the assessment.
Once the Attending/Fellow assesses the patient and validates the decision that the patient is non-emergent patient, the Attending/Fellow will suggest to the patient/parent that they can go to the PEDS Clinic as a walk-in patient.  If parent agrees, the Attending/Fellow will write a note in IBEX and disposition the patient as “sent to clinic”.  If parent disagrees, they are sent to the ED waiting area to wait as triaged.
The BA will then: 1) identify the patient under “sent to clinic” disposition, 2) discharge the patient from IBEX, and 3) cancel the patient visit from Cerner.

The official MS Word Document is available here.

Introduction:

The following describes the process by which The Mount Sinai Hospital’s Emergency Department will handle non-emergent pediatric patients during the hours of 8:30am -3:30pm Monday – Friday and 10am – 2:30pm on Saturdays.

Policy:

All patients that present to the Mount Sinai Emergency Department will receive a medical screening exam to determine level of acuity by a health care provider.   In the event the exam indicates that the visit is non-emergent, then the ED staff will refer the patient to the Pediatric Clinic if they are an established Pediatric Clinic patient in the past 12 months and participate in an insurance plan accepted by the Pediatric Clinic.

Procedure:

When a patient presents to the Mount Sinai Emergency Department, the ED-BA located at the Greet Desk will validate the patient’s name and date of birth.  During the look-up of the patient in the Cerner ADT system (between the hours of 8:30am to 3:30pm  Monday –Friday and 10am-2:30pm Saturday) the ED-BA will determine if the patient is an established patient in the Pediatric Clinic (seen within the past 12 months and participates in an insurance plan accepted by the Pediatric Clinic).  If the ED-BA determines that the pediatric patient has met the criteria as a Pediatric Clinic patient then the ED- BA will process the patient in the ADT system (Cerner) as a “Quick Registration.”  The Quick Registration will include the national patient identifiers (Name & DOB), referring source, PC (PEDS Clinic)/the reason for visit along with the onset date.

Once the patient’s Quick Registration has been completed with required data elements, then the patient’s information will be sent from the ADT system to the Emergency department’s electronic medical record system (IBEX).  The patient’s information will be viewed in the triage nurse’s queue and the patient will be called for triage.

The triage nurse will expedite all pediatric patients with the PC designation in the reason for visit field.    Once the triage nurse has assessed the acuity level of the pediatric patient (emergent vs. non-emergent), he/she will call the Attending/Fellow to validate the assessment.

Once the Attending/Fellow assesses the patient and validates the decision that the patient is non-emergent patient, the Attending/Fellow will suggest to the patient/parent that they can go to the PEDS Clinic as a walk-in patient.  If parent agrees, the Attending/Fellow will write a note in IBEX and disposition the patient as “sent to clinic”.  If parent disagrees, they are sent to the ED waiting area to wait as triaged.

The BA will then: 1) identify the patient under “sent to clinic” disposition, 2) discharge the patient from IBEX, and 3) cancel the patient visit from Cerner.

Written by reuben

May 25th, 2010 at 5:25 am

Posted in Peds,Policy

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