As a summary of the below corporate email –
1) E-Prescribe 100% of your discharge prescriptions.
2) You can E-Prescribe to the Elmhurst pharmacy which is open 8am-4pm M-Fri (closed weekends and holidays)
3) If a patient cannot fill a prescription from a community pharmacy after-hours; E-prescribe the medication to the Main Pharmacy then call them and let them know the script has been sent to their queue and ask them fill at least the minimum needed prescription for a safe discharge. The AOD can then be contacted to pick up the script.
As of today our e-prescribing waiver has expired, which means that all prescriptions must be transmitted to pharmacy electronically.
Electronic prescriptions for non-insured patients may be send to the facility’s Outpatient Pharmacy, which is open from 8:00 a.m. to 4:00 p.m., Mon – Friday (closed on weekends and holidays). During off hours, e-Rxs need to be transmitted to community drugstores and patients need to be advised accordingly. In urgent situations (when a patient is uninsured, must have his prescription filled and cannot access a community drugstore), the Main Pharmacy pharmacist can process the prescription from 4:00 to 11:30 p.m. provided:
- An e-Rx is transmitted to the facility’s Outpatient Pharmacy
- A phone call is made to alert the pharmacist that a prescription was send to his queue
- Arrangements are made for picking-up and signing off the medications internally (via the AOD) as Main Pharmacy is not equipped to handle patients and patient’s bags cannot be sent via the pneumatic tube.
Effective tomorrow, in order to comply with NYS law, we’ll have to discontinue the OPD med cart (see attached) and also remove from Pyxis the percocet packaged for outpatient use.
Please share this info with appropriate staff
ETOH level is needed for all Trauma Admissions (Activated and Non-Activated).
a. The ETOH level needs to be drawn on all activated trauma patients (Red and Yellow) at the time of ED arrival.
b. For Non-Activated patients getting admitted with any Traumatic Injury, it needs to be added to the first specimen sent to lab, at the time decision to admit the patient is made. These patients can be in any area of the ER
c. It must be drawn on all >=15 year old patients (even if it’s likely to be irrelevant).
Please see attached SBIRT policy, which clearly states:
Alcohol levels will be drawn for all activated trauma patients (>=15 years of age). Alcohol level will be added to the serum specimens drawn upon ED arrival on non-activated trauma patients admitted to the hospital.
Providers – please be sure to place an order for psych consults.
This should be done whenever a psych consult is going to come to the ED to see a patient.
Dr. DePena-Nowak and Dr.Givre will be monitoring the time is takes from calling for the consults to transfer to CPEP. We will be working together to improve communication and patient care between the ED and CPEP. Let me know when you have any issues.
CVS PHARMACY OPEN 24 HOURS – Store #1113
89-11 NORTHERN BOULEVARD
JACKSON HEIGHTS, NY 11372
CVS PHARMACY OPEN 24 HOURS – Store #2057
100-02 QUEENS BOULEVARD
FOREST HILLS, NY 11375
CVS PHARMACY OPEN 24 HOURS – Store #2975
7960 METROPOLITAN AVENUE
MIDDLE VILLAGE, NY 11379
CVS PHARMACY OPEN 24 HOURS – Store #7576
31-01 DITMARS BOULEVARD
ASTORIA, NY 11105
Per Dr Kessler, the two sepsis order sets in Epic are ready for use.
ED Sepsis – full order set
ED Sepsis screen positive orders
*Remember to order blood cx and urine cx BEFORE antibiotics are given.
Radiology (Dr. Solodnik) requests:
When ordering MRI for spinal trauma; please add the additional note:
“trauma, assess for ligamentous injury with sagittal and axial STIR sequences”
This is to indicate to the radiology techs (particularly nights/weekends) to include an axial STIR sequence when it’s a trauma case to allow for better assessments.
To transfer patients to other hospitals:
Disposition tab>Transfer>EMTALA Forms & AOD form for signature
Patients who get procedural sedation in the ED and get discharged MUST receive procedural sedation. These are under under conscious sedation in the discharge instruction set.
This was a deficiency found by the joint commission.
Date: November 30, 2016
From: Maria De Pena-Nowak, M.D.Director, CPEP
To: Stuart Kessler, M.D Director, Elmhurst Hospital Center Emergency Service
Re: Designated Pager 40524 for Psychiatric Consults during the daytime (8AM to 4:30PM), Monday to Friday
Dear Dr. Kessler,
Effective December 1, 2016, we are asking our colleagues from the Medical ED to request Psychiatric Consults for their patients between the hours of 8:00 AM-4:30 PM by paging #40524. Until now, medical providers have been calling the CPEP and handing off the case to one of the attending psychiatrists on duty. We are now channeling all consults requests to the above pager in an effort to increase efficiency and communication between the two teams.
This new change will also be reflected on Amion. Please forward this information to the appropriate clinicians and staff from the medical ED. As always, do not hesitate to contact me if you have any questions or concerns. We look forward to working collaboratively with the Medical ED and to your feedback regarding this new change.
Maria De Pena-Nowak, M.D.