E-Prescribing now mandated 100% of the time and other tips on filling prescriptions at Elmhurst.

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:

  1. An e-Rx is transmitted to the facility’s Outpatient Pharmacy
  2. A phone call is made to alert the pharmacist that a prescription was send to his queue
  3. 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

Alcohol levels in Trauma

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.
 

Elmhurst Updates February 2017

1) Psychiatry Consults:

a) Providers – please 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.

b) Consult Call pager –
Daytime (8AM to 5PM), Monday to Friday – (Consultant is an attending) — Pager: 40524
Nighttime:   (Consultant is a resident) Pager: TBD

If you have any issues reaching the consultant, please let your attending know who will reach out to Dr.DePena-Nowak

2) Overnight CT:
We now (apparently) have proper full time nursing on overnights for CT nursing to push IV contrast; barring any other unscheduled sick-call, or emergent IR cases. Please let your attending know if this is not the case

3) Central Lines:
When charting all central lines, please document how the line was placed as either FULL STERILE or NOT.

4) Trauma

a) Trauma Patient Admissions:
Almost all Trauma Patient Admissions MUST GO TO A SURGICAL SUBSPECIALTY.  The Goal is <10% to go to non-surgical specialities.   Despite any argument from a surgical resident, these patients MUST go to surgery.     Any sicker patient who requires care can be admitted to their step down beds, or if needed to the SICU.  If there are any issues, please address with the attending who will discuss with the Director of Trauma.   Example:elderly patient who syncopized and found to have a non-op arm fracture

b) Trauma patients and alcohol levels

An ALCOHOL LEVEL must be sent for ALL patient who get admitted with a trauma diagnosis ( these must go to  surgical service even if the main reason for admitting is non-surgical, such as the elderly patient with syncope with a ulnar styloid fracture).  This is a directive from Dr Agriontonis.

Psychiatry Consults

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.

Dr.Givre

CVS 24-hour Pharmacies near Elmhurst, NY

CVS PHARMACY OPEN 24 HOURS – Store #1113

89-11 NORTHERN BOULEVARD
JACKSON HEIGHTS, NY 11372

718-426-2508

CVS PHARMACY OPEN 24 HOURS – Store #2057

100-02 QUEENS BOULEVARD
FOREST HILLS, NY 11375

718-520-2334

CVS PHARMACY OPEN 24 HOURS – Store #2975

7960 METROPOLITAN AVENUE
MIDDLE VILLAGE, NY 11379

718-326-4910

CVS PHARMACY OPEN 24 HOURS – Store #7576

31-01 DITMARS BOULEVARD
ASTORIA, NY 11105

718-545-0128

 

MRI

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.

Psych Consults

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.

 Regards,

 Maria De Pena-Nowak, M.D.