PCG Clinic Green Card

PCG CLINIC CARD JULY 2018

If a patient is >10 min late to appt, coordinator pages you for permission for the pt to be seen, if you don’t answer after 5 mins they will automatically check them in.

CLINICAL NEEDS DURING CLINIC:

DIABETES: accu-check/need to give pt insulin/ dextrose- ask your nurse

EAR CLEANING: ask a floor nurse

GYNE: Lights are in drawer in central hallway nursing station. Speculum packs are in central hallway and workroom. From EPIC, fill out and print special cytology form/lab rec and place pap specimen in a bag and deliver to utility room in back hallway. Slides and microscope are in UC or back hallway utility room.

INJECTION TEACHING: (i.e insulin or enoxaparin) Ask your nurse

MEDICAL SUPPLIES: (i.e. gauze) Contact one of the nurses at the nursing station for assistance

O2 SAT: Can ask or do it yourself. There is one at the nursing station or in the right hand drawer in UC, but bring it back.

STREP: Order POC rapid strep in Epic and ask a floor nurse to perform rapid strep test

TEMP: Can ask or do it yourself. Thermometers in triage cabinets or UC.

URINE: Order POC urine/pregnancy test in EPIC. Can either have PCG nurse run on sample or send to lab.

RETURN TO WORK SLIPS: Use slip, write on script, or write letter through epic template and print.

CLINIC PATIENT CARE

1. ADMITTING PTS: notify your nurse immediately; ask an attending as processes frequently change. Put in “RFA” or “Request For Admission” order in EPIC. If pt unstable send to ER & call expect to 2-6250 ask for ER senior
2. BRACES/CRUTCHES: Can order in Epic or write a Rx with diagnosis. Send pt to cast room 4^th floor. Stock room in back hall of clinic has hard sole shoes, cane, crutches.
3. DIABETES:
4. GLUCOMETER: Teaching- ask your nurse
5. INSULIN STARTS: Best is to send them to NP Jennifer Clark pager 2195, can place order in EPIC or clinic billing sheet. Send her an email with pt info and instructions. She will also call them and f/u on glucose levels.
6. EDUCATION/NUTRITION: Go to Diabetes Resource Center in PCG back hallway utility room for handouts, and put in referral order in EPIC for the Endo educator (checkout will schedule this)
7. POOR CONTROL: Send pt to NP Jennifer Clark (see above)
8. HbA1c screening: coverage not covered by many insurances, can order if hyperglycemic on prior lab draw
9. HOME CARE: write needs (PT, wound care, nursing, etc) on Rx w/ dx & give to your nurse. Remember you the Rx must be from someone who is PECOS certified.
10. HOMEMAKERS: pt must call Dept of aging themselves (1-800-252-8966)
11. IMMUNIZATIONS/PPD: Order in Epic. Walk pt to D11 & wait in hallway. Place paperwork in doorway folder. Nurse will arrange for PPD read.
12. INTERPRETERS: ** best to note on f/u sheet at end of visit and staff arranges
13. a) Arabic: call 21807, press 2 for interpreter 2 for Arabic, leave message
14. b) Spanish: page 5193  c) All other inc sign language: page 4331
15. d) Over-the-phone Interpreters: dial 133, the access code is 2222.
16. LOVENOX: AMS can assist w/ dosing & teaching, no samples, Page #9905. Put in AMS referral order in EPIC.
17. NARCOTICS: For Tramadol, T3, Vicodin, benzos- cannot e-prescribe. Send script to nurse to call in or print script for patient. All other narcotics need attg. Send to nurse to have attg write script and patient to pick up.
18. PT/OT: 3 options:
19. a) DCAM: Order physical therapy consult in Epic. Walk-in clinic at DCAM 4-A for acute injury not for chronic conditions LBP, RA/OA, fibromyalgia or pts req. ongoing tx.

send pt down with a Rx. 2-1687.  MWTh 8:30-4:30, T  9:30-4:30, F 8:30-1

1. b) Home: arrange via your nurse same as home care (see above)
2. c) outpt: write a Rx w/ dx & duration of tx and give to pt. (athletico has easy access)
3. TRANSFUSION/INFUSION: call infusion center 29473 & make sure T&S sent. Nurse can set up.

URGENT/SAME DAY STUDIES ** tell coordinator that it’s same-day/add-on when calling

CT:  Order in EPIC. Call for appt yourself 4-7045 or 2-6161, fax 4-7030

DOPPLER/VASC: Order in EPIC. Call for appt yourself 2-6261, fax 2-2839

ECG: Order in EPIC and send patient upstairs. Have them return to clinic with EKG.

LABS: Order in EPIC. Pt goes to 3F. Can put them in as STAT or get blood drawn in room

MRI: Order in EPIC. Call for appt yourself 4-7041 or 4-0140, fax 4-3527

ULTRASOUND: Order in EPIC. Call for appt yourself 5-9286 or 2-6161

X-RAY: Order in EPIC and have pt go to DCAM 1^st floor for the study

EMAIL ADDRESSES:

PCG.orders@uchospitals.edu; PCG.schedule@uchospitals.edu

NON-URGENT STUDIES & LABS: Results will come to your EPIC in-basket

COLONOSCOPY: Order in Epic, give pt instruction sheet and pre-made RX for prep. go over instruction sheet with pt. pt must have someone pick them up after test.  If complicated anticoag, discuss with AMS clinic

ECG: Order 12 lead EKG in EPIC and send the patient to 5^th floor. It will be loaded onto epic in about 2 days or you can have the patient bring you down a copy.

ENDOSCOPY: Order endoscopy in EPIC, checkout will schedule, make sure pt knows to be NPO, have someone pick them up, hold ASA, etc.

HOLTER/EVENT monitor: Order in EPIC and send pt to 5^th floor. Results appear in epic

IMAGING (x-ray/CT/MRI/ultrasound/mammogram/BMDdexa/echo: Order in Epic and  have it scheduled at checkout.

PFTs: Order in EPIC, make sure pt knows not to have caffeine 24 h before test

SLEEP STUDIES: Order in EPIC; same form for new study or re-titration

LABS: Place order in EPIC and have patient go to lab. Can be done at later date.

REFFERALS:

Order all referrals in EPIC as outpatient consultation and route to Ambulatory pool for scheduling (see handout or Ambulatory website).

SPECIAL REFFERAL CONDITIONS:

1. BARIATRIC SURGERY: BMI >40 or 35-40 w/ obesity-related med problems. Pt must confirm insurance covers the surgery, then contact (773) 834-0759. Pt will need to attend info session first. Place Gen Surg referral in EPIC.
2. DENTAL: no UC dental clinic, U of Illinois Dental Clinic-takes Medicaid (312) 996-7532. Sheet of area dental clinic outside SW office in back of urgent care hall
3. OPHTHO: sends many to Weiss up north. If a prob for pt can send to IEI 3241 S Michigan Avenue (312) 225-1700
4. PODIATRY: At UCMC, Dr. Zmuda in Endo dept sees pts with DM. Otherwise write a Rx and pt must find one to go to that their insurance approves.
5. PSYCH: At UC Psych, pts must call to make own appt, phone: 2-6199

CLINIC DOCUMENTATION

1. NOTES: Clinic note to be typed w/in 24 h & closed in 48hr by attending (the clinic encounter should NEVER be closed by the resident)
2. VISIT DIAGNOSIS: Must be filled out at every visit by resident
3. MED REC/ALLERGIES: to be completed at each visit on EPIC- enter/change list & press “reviewed” button every time.
4. PAPERWORK:  a folder of paperwork for your FIRM TRIO is always in the PCG mailbox. Fill out at clinic, return to LPN DAILY. Always make sure your FIRM TRIO folder is EMPTY by the end of your ambulatory block. If complicated disability form, discuss w/attending. **you will need NPI # & temp license # handy (DEA is on other side)
5. PHONE ENCOUNTER: always document phone call in EPIC. Resident closes phone encounters.

BETWEEN VISIT CARE**CHECK RESULTS IN-BASKET DAILY FOR NEW LAB AND TEST RESULTS. Use EPIC result note to document any f/u or management done re: results.

1. CT/MRI: Order in Epic and route to ambulatory pool or PCG nurse for scheduling.
2. IMMUNIZATIONS/PPD: Order in EPIC and route to ambulatory pool or PCG nurse for scheduling
3. LAB ORDERING: Order in EPIC and the patient may just go to the DCAM lab for draw. You can also give the patient a Rx for labs with a dx to take with them to lab.
4. LAB ADD-ON: Order Lab add on in EPIC. Depending on the lab and the time since the lab was drawn they may or may not be able to add on a test. They will page you if they can’t add it on
5. PAPERWORK: you may leave for pts to pick-up at 3B desk if you discuss it directly with pt (otherwise give to nurse). Place in envelope with pt name, dob, date, your name and place in bin.
6. PCG/UC APPTS: Can email PCG scheduling at PCG.Scheduling@uchospitals.edu.
7. REFFERALS: Order in EPIC and route to ambulatory pool or PCG nurse for scheduling referral
8. RESULTS: must notify pt within 1 wk of result. Abnmlàcall pt & document in PCG phone note or original clinic note. Nmlà can mail or call. Also can share results via MyChart if your patients are registered.
9. X-RAY/ ULTRASOUND: Order in EPIC and route to ambulatory pool or PCG nurse for scheduling.
10. REFILLS: must be done within 48 hours of request. Document in EPIC as refill enounter.

GOING ON VACATION/LEAVING TOWN

Sign over pager to resident covering on ATG (notify the covering resident of outstanding issues), notify your nurse you are gone & tell them who will complete your paperwork, place out of office message on your email with covering provider noted. Sign over your in basket in EPIC to the person in your FIRM trio who is on the +2.

HELPFUL SMARTPHRASES

.genap(HMFEMALE, HMMALE, HLD, DIABETES, COPD, CHF, CAD, HTN)

.gensdc(MENTALHEALTH, DENTAL, PCP, SUBSTANCEABUSE)

CLINIC STAFF DEGREES

LPN (Licensed Practical Nurse): At least 1 year training after high school. Needs to pass LPN licensing exam.

RN (Registered Nurse): multiple ways to become RN. BSN – 4 yr bachelors. ASN—2-3 year associate’s degree. Vocational nursing program- variable in length. Takes national RN licensing exam.

MA (Medical Assistant): 1-2 year programs. Can be followed by certification exam to become CMA; needs to be renewed every 5 years.