General Medicine Admitting Flow
FOR PCG CLINIC PATIENTS
For PCG clinic patients that you want to admit directly from clinic or home:
- Discuss the admission with your clinic attending or firm trio attending.
- The attending MD for the RFA (request for admission) is the attending with whom you have discussed the case.
- Page the general medicine triage pager (9100) about the expect, give sign out over the phone, and document in a phone note.
FOR OSH TRANSFER PATIENTS
If the transfer center calls you about your own PCG patient wanting to transfer here from an outside hospital:
- Return the transfer center’s page and also talk to the OSH doctor requesting transfer.
- Once you have gotten the story, call your clinic attending or firm trio attending to discuss the transfer.
- If you and your attending agree to transfer, then place an RFA and communicate to the transfer bed desk that you’ve accepted the patient.
- Again, page an expect to the 9100 triage pager, discuss the case over the phone, and document rationale for transfer as well as other pertinent information in a phone note.
FOR PATIENTS FROM OTHER SERVICES
You may also receive pages about general medicine admissions and/or transfers while carrying the GENS pager (4367). If a medicine-based subspecialist, non-medicine team (eg. surgical), or ICU team wants to admit or transfer a patient to a Gen Med service:
- Return the page to the requesting team and tell them to page 9100 with the request, as all general medicine admissions and transfers must go through the 9100 triage system.
- If 9100 deems the patient appropriate for general medicine, they will determine the service to which the patient will go. The requesting team will place a transfer order at that point.
- 9100 will page the general medicine service that will be accepting the patient (once the patient has a non-ICU bed, if applicable).
- If the patient is directed to your general medicine team, 9100 will page you with information about sign out. You should then contact the originating team (physician admitting the patient or team transferring the patient to you) as instructed in the page to get more information about the patient and officially take over care.
- If the patient is transferring from an ICU, ensure that they have a floor bed in the CCD prior to assuming care.
- If the patient is located in Mitchell or is an ICU transfer who gets a floor bed in Mitchell, a hospitalist service should assume care of the patient. Internal medicine resident teams should not be taking care of inpatients located in Mitchell. If there are special circumstances and the patient should go to the resident general medicine service for care, they need to have a bed in the CCD prior to the resident team assuming care.
Example: Dr. Cardiologist has a patient in clinic with a history of CHF who presents with pneumonia. The patient’s CHF is currently well controlled. Dr. Cardiologist wants to admit the patient to a general medicine service for inpatient antibiotics.
Any disagreements between services regarding the appropriateness of transfers or intensity of care that requires the immediate assumption of care by medicine service are escalated to the level of Clinical Operations Director Hospital Medicine. This should be done by 9100 triage.
FOR PATIENTS NOT AFFILIATED WITH U OF C
If you are contacted about an OSH transfer who is not established with any PCG physician or UCM subspecialist, please refer them to the transfer center (4-BEDS).