Comer Children’s HospitalPediatric Emergency Department

Resident Orientation

Prior to arrival…

View entire resident orientation slideshow Access chief resident’s webpage

http://pediatrics.uchicago.edu/chiefs/PER Review all the clinical guidelines prior to starting work

in the PED – our faculty expectation is residents must be familiar with these guidelines prior to working in our PED

Contact Gail Armstrong to ensure all paperwork completed (773-702-9087)

Pediatric Chiefs Page via the Intranet

Link via “UCMC Intranet for Physicians”

Select “Pediatric Chiefs”

Pediatric Chiefs’ Page

Scroll down and select “Emergency Medicine”

Multiple resources including clinical guidelines important numbers additional resident

orientation resources

Comer Emergency DepartmentLay Out

22 exam rooms Orthopedic procedure room Trauma room

2 beds Flex up to 4 beds if needed Infant warmer for deliveries

Two isolation rooms with anterooms Negative pressure Positive pressure

One OB/Gyn room with attached bathroom

Lay Out

Central Hub – physician and nurse workspace

5 main pods Pod 1- Rms #1-3 Pod 2- Rms #4-7 Pod 3- Rms #8-12 Pod 4- Rms #13-15 Pod 5- Rms #17-20

Rm 16 - OB/Gyn room

When You Arrive…

Sign-in on the white grease board

Find a cordless phone for the duration of your shift

Sign into Epic Remember to log-off and

sign-out when changing computers and at the end of your shift

Signing up for Patients

Choose next patient based on acuity – higher acuity before lower acuity regardless of length of time in the ED

Within the same acuity level, choose next patient based on length of time in ED – longest first

Or use the “Next to See” button in EPIC Please do not “cherry pick” – your fellow

residents will notice! Please sign up for patients when you are ready

to see them, not several at a time

Epic Charting “Share” your note prior to presenting to the

attending Do not have to “accept” note if plan not determined Facilitates care as attending can view prelim note “Accept” note after plan created Reassessments can be done as “ED note”

Accept ALL notes prior to discharge and if signing out at the end of a shift

Prescriptions will print out and will need to signed and place in blue folder prior to discharge

Select “Discharge” after staffed with attending and patient ready to be discharged

Epic Observation Status

Select “ED OBS only” Use order set “912 or

“PER:IP OBSERVATION” Document updates of

patient using ED notes including patient’s status at time of final disposition: home vs. admit vs. transfer

I want to follow up on my patient from my last shift – how do I do this?

Use “My Reports” to track patients seen Select “My Reports”

Select “UCMC COMER” Select “My Patients Last 24 Hours and “My Patients

Last 7 Days” and select “Add to Favorites”

1. Select blue “My Reports”

2. Select desired report and select “run”

3. Select “view” after report is “ready to view”

1

2

3

Oops! I have pended charts – how do I find them?

Use the same “My reports” procedure Open chart to

Sign orders Accept any pended notes

Paging Directory

Access text paging system as illustrated Page by pager number or last name

Page to your cordless phone If the call bounces to main ED number

listen for coordinator to announce call Page by phone system

Dial 188 then follow prompts

How to use paging system 2 systems

Text paging via intranetPhone paging via phone or intranet

Important numbersMain ED number: 773-702-6249ED attending phone: 773-795-7696Prefixes (internal vs. external calls)

2-xxxx = 773-702-xxxx 4-xxxx = 773-834-xxxx 5-xxxx = 773-795-xxxx

Admissions RFA: Request For Admission

Locate name of floor attending physician on intranet: “Ped General On Call”

7AM-7PM Maroon: Gen Peds, Cards, ID, Rheum, Pulm

188-PEDS (7337) Silver: Neuro, GI, Nephro

188-7587 Gold: Hem/Onc

188-HONK (4665) 7PM-7AM

Call Night Float Senior for ALL admits (188-PEDS) No Pediatric admits from 5-7AM Neurology resident on consults will NOT be the

floor resident caring for the patient

Prescriptions Pitfalls Reasonable doses based on concentration

8 tsp twice a day? Start and end date

Please add total number of days in the comments section. Pharmacies call to clarify in spite of the start and end written on prescription

Use Harriet Lane for pediatric drug dosages Remember to sign the prescription and then

place in patient’s blue folder prior to discharge Pharmacy phone calls get directed to the trauma

senior for clarification

Social Services

We have 2 social workers dedicated to the Comer ED Involved in:

Trauma patients – called automatically to all traumas Physical abuse cases Sexual abuse and assault cases Neglect cases Children at risk for child abuse or neglect Social service needs of the child or family

Availability: 7 days a week for 10 hours/day Available overnight for phone consultation only

Pager #8887

Child Life & Family EducationChild Life & Family EducationAvailable Hours Vary

Patient Reward/Recognition

Treasure Boxes Welcome Gift Bags

Giveaways Stickers Spinoza Bears Warm Blankets

Songs of Love Wish Granting

Entertainment

Get Well Network

Starlight Fun Centers

Mobile DVD players/Game Systems

Movie Library

The Team

Masters Degrees

Nationally Certified

Training in Child Development/Child Life/Family

Centered Care

Medical Education/Preparation

Inpatient & Outpatient

Preparation for Hospitalization, Surgeries, Tests, & Procedures

Medical Play

Shadow Buddy Program

Pain Management

Procedural Support

Distraction

Vecta Sensory Carts

Disposition Resources Urgent Care

Limited urgent care appointments available at Friend Family Health Center Monday-Saturday

HMO patients cannot be seen

New non-HMO patients can be scheduled

Asthma clinic on Monday afternoons for non-HMO patients

Disposition ResourcesGeneral Pediatrics

Pamphlets available for primary care and general pediatrics clinic

Disposition ResourcesSubspeciality referrals Advise family a patient

advocate will call regarding follow-up with a subspecialist

Fill out paper form and place in blue patient folder

Nurse will copy paper form and leave for the patient advocate

Family to be contacted regarding subspecialty follow-up

Welcome to Comer Pediatric Emergency Room

We look forward to working with you. We hope you enjoy your rotation with us.

Questions? Contact

Lisa McQueen MD, rotation directorPager 4933 lmcqueen@peds.bsd.uchicago.edu

Gail Armstrong, section administrator773-702-9087garmstrong@peds.bsd.uchicago.edu