Vanderbilt Psychiatric Hospital (VPH) Patient Transfer to VUH/VCH Inpatient Status through Emergency Department: Nursing Instructions

PURPOSE: To outline the nursing process when admitting a VPH patient to VUH or Children’s Hospital after treatment in Emergency Department.
Date of Creation: / 12/2010 / Date of latest revision:
  1. When a VPH patient is sent to the ED for treatment, this patient remains a VPH patient in Medipac and is located in a virtual ED bed in Pavilion 5. The patient is located in an ED Whiteboard bed and orders are entered on the patient in HEO/WIZ. These orders carry over to Order Tracker, where the ED Nurses document orders.
  1. The patient’s nurse needs to complete all documentation in Order Tracker prior to this transfer process. During the process, when the patient is discharged from VPH, all orders that appeared in Order Tracker for that VPH case number will no longer be present in Order Tracker.

Transfer Process:

  1. When the provider confirms that a VPH patient needs to be admitted to VUH or Children’s Hospital, the provider clicks on the Admit column on the ED Whiteboard for that patient. A pop up indicates that a bed request cannot be made.

Once “OK” is clicked, a text page is sent to the Admitting Liaison that states “Bed Name, (MRN); complete D/C – Admit process for VPH patient.”

  1. A flashing pink box appears in the Admit column on the ED Whiteboard.
  1. At this same time, a page is sent to the Charge Nurse with the following message: “Bed name (MRN): Please notify Primary Nurse to play back orders for VPH patient after Admitting Liaison completes the discharge process.”
  1. The Admitting Liaison completes their process, which includes: (see call manualdocument titled:Vanderbilt Psychiatric Hospital (VPH) Patient Transfer to Inpatient Status through Emergency Department: Admitting Liaison Instructions)

a)Notifying VPH of the admission to VUH

b) Archiving patient’s current orders in HEO/WIZ

c) Discharging patient from VPH

d)Registering patient in ED. This newly registered patient will initially appear in the Waiting Room Tab.

e)Copying information from the VPH encounter to the VUH encounter on the Whiteboard so that pertinent information is still present.

f)Once information is copied and the patient status is updated in Medipac to either observation or inpatient in Pavilion 1 (VUH) or Pavilion 3 (Children’s Hospital), the Admitting Liaison discharges the Pavilion 5 patient from the ED Whiteboard and moves the Pavilion 1 or 3 patient into that bed.

g)A new case number is generated for the patient.

h)Utilization management reviews the case and, once the process is completed, the Admit column on the ED Whiteboard reads “Complete”

i)The Admitting Liaison notifies the ED Charge Nurse that orders from HEO/WIZ can be played back. ORDERS CANNOT BE PLAYED BACK UNTIL THE ADMITTING LIAISON HAS COMPLETED ALL WORK ON THE PATIENT TRANSFER.

  1. The ED Charge Nurse or Primary Nurse for the patient plays back archived orders in HEO/WIZ

To playback orders:

a)Click on patient in HEO/WIZ Order Entry System

b)Select protocol order and enter physician name

c)Click on patient’s name in top left window of HEO/WIZ order entry screen

d)Click on “Playback archived orders”

e)You can play back selected orders or all orders. One- time orders are considered past orders and are not able to be archived or played back. If these orders were not completed prior to this process, the one- time orders will have to be re-entered in HEO/WIZ in order to view them in Order Tracker.

f)Once you have put a check in the box beside the orders to playback, click “playback selected orders”

The orders will appear in the left window in HEO/WIZ. For the orders to be finalized, click on “done” in right lower corner. Then click “accept orders.” Orders will come across to Order Tracker as new orders and will need to be addressed if already given.

  1. To view orders entered and completed under the VPH case number (while patient initially treated in ED and before transfer to inpatient/obs status):

a)Open patient’s record in StarPanel

b)Click on ED Orders under All Documents

c)There will be one set of ED Orders for the VPH visit and one set for the Inpatient visit once the patient has been moved to VUH or Children’s Hospital.

d)The orders appear in the frame below. The status of the order reflects the documentation completed in Order Tracker. Any comments completed in Order Tracker also display.