Hours of Operation – 10a-9p M-F, 9a-7p Sat/Sun and some holidays
Staffing – 2 RNs, 1 tech (moving to 3 RNs, 2 techs)
Imaging Capability
M-F – CT/ Ultrasound/ Plain films 10a-9:30p
LAST STUDY MUST BE ORDERED BY 9:30p. NO IMAGING AVAILABLE AFTER THIS TIME!
(If patient needs imaging, will need transfer to ED or schedule for AM)
Sat/ Sun – CT/ Ultrasound/ Plain films 9a-7p
LAST STUDY MUST BE ORDERED BY 7:30p, WITH THE EXCEPTION OF ULTRASOUND WHICH IS 7!
Laboratory capability
Labs available to be performed on-site are in ED POE. If there is another lab test required, this will need to be ordered from Main POE and other arrangements for follow-up on the results will need to be made (PCP, etc.)
NB: Culture results are reviewed and appropriate follow-up arranged. DO NOT DISCHARGE PATIENT WITH PENDING BLOOD CULTURES UNLESS SPECIFIC MD to MD FOLLOW-UP PLAN
Special Note- Lyme testing is available and will NOT result during Urgent Care visit. If you want to send a Lyme test, please inform patient that, due to the complexities of interpreting this test, all results will be sent to the patient's PCP who will then coordinate any treatment. FOR MOST CIRCUMSTANCES, BETTER TO EITHER TREAT OR NOT TEST.
Medications
Pyxis is limited, list of meds available at desk. IV meds quite limited. IF YOU REQUIRE AN IV MED OTHER THAN SIMPLE ANTIBIOTIC, ANALGESIA, OR HYDRATION, PATIENT PROBABLY NEEDS TO BE TRANSFERRED!!
Procedures
Arthrocenteses, lumbar punctures, etc should be transferred to the ED if indicated.
Care of children under the age of 2
If a child under 2 presents physically to Urgent Care, they will be registered and brought directly back for evaluation. MD responsibility is to perform a medical screening exam. MD may choose to treat the child or refer to other pediatric resource. If MD chooses to treat and other patients are ahead in line, the child will return to the waiting room to wait until it is their turn to be brought to a room. SAME PROCESS AS BIDMC (except you may choose to treat if you would like).
Transfers to ED
Please call ED MD to inform of transfer and put in an electronic call-in (Needham call-in is under “Applications” in Portal). Note must be completed prior to transfer. RN staff will call ambulance – if patient unstable, call 911.
Direct Admission
If at all possible, this is preferred and should be directed to Needham unless BIDMC required. Instructions for this process are posted next to the attending computer.
From a MD perspective, the process is IDENTICAL to that of "e-signout" admit from the Needham ED to Derenzo (inpatient floor at BIDN).
To briefly summarize:
1. UC MD enters clinical summary/MDM in MD comments on Chestnut Hill dashboard
2. Needham hospitalist receives page -"chestnut hill direct admit John Doe"
3. Needham hospitalist accesses Chestnut Hill dashboard to review case *
4. If OK, hospitalist clicks "orders up," blue O appears in CH dashboard, MD sign-out/ acceptance finished
5. If not OK, hospitalist calls Chestnut Hill Urgent Care to discuss case
* All Needham hospitalists have been given access to the Chestnut Hill Dashboard. There is a link to this at the top of the Needham ED Dashboard.
Chestnut Hill staff have been educated NOT to transfer patient unless there is a blue O (same as Needham ED).
If you need your password reset, refer to the instructions below.
QUESTIONS IN REAL TIME: Call BARB MASSER – 774-286-1000, OR DAN NADWORNY (on page)