From Dr. Betty Chang: NEW ICU sign out process, outpatient MRI workflow

1. Getting hold of our Care Managers / Social Workers:
   Remember that the best way to reach the Care Coordination or Social Work team in real time is via the Secure Chat group below. The earlier they can be involved in a patient’s care, the better. Even if we don’t know the final disposition, they can help coordinate resources for the patient so that their stay is more efficient.  
2. NEW:  ED Primary Team to do hand-off to Primary ICU Team (effective: September 1st):
   -In order to better serve our ICU level patients and improve our communication about the care of the patient, we will be doing a verbal hand-off from ED primary team to primary ICU Team starting September 1st.  This is the similar process as regular floor admission process. PPOC will connect the two teams. 
   -If we need to contact the team, we can either chat them via “CUIMC MICU A (Admit Team)”, “CUIMC MICU B (Admit Team)”, etc. or call the ICUs directly. 
   -No change:  ICU triage consult resident / attending will still do the patient allocation between ICU and SD, will help with management of ICU level patients in the ED, etc.   ICU patients in the ED will still be the responsibility of ED primary team.
   
   
3. ED Boarding & Coverage: 
   -As many of you know, our volume is creeping up over the past few months (see below).  Every day, the ED AOC works with MAC (medical admitting clinician) to get teams for the patients. We will continue to escalate to the Hospital senior leadership, and advocate for our patients.  
   I know it may not mean much, but just want to say “thank you” for doing the best you can under the current circumstances.  Your hard work is truly appreciated.  It has not been easy.  I am hopeful that it will be better with overall staffing in the fall.

4. To end on a positive note, ED to Outpatient MRI process:
   -We just hit the 50 patients mark (since go live in April) in getting our ED patients a non-emergent MRI (in lieu of admission or doing the MRI during an ED visit).  Shout out to Eugene Kim for partnering with me on this initiative!
   -Please keep in mind, that this is for ED patients; and Neurology needs to be involved so the MRI results are passed on to the appropriate people and not to ED providers. 
   -Please make sure you consult Patient Navigators for the PCP portion (Comment: Outpatient MRI).  Neurology will arrange Neurology follow up and get the key stakeholders (call center, radiology, CM/SW, etc.) in a secure chat.