In an effort to improve the care of our patients, reduce redundant phone calls while prescribing physicians are away, and resolve any confusion, I have adapted the guidelines used on K15 (>8 weeks controlled substance script)
Author: Krishna Thavarajah
Death Certificate Rules
State of Michigan – Death Certificate Instructions State of Idaho – terminology for drugs and alcohol: http://www.healthandwelfare.idaho.gov/Portals/0/Health/Vital%20Records/DrugsAlcohol.pdf
No Show / Walk-in clinic
Friday 12:30 to 3pm – pm checker Eligible patients: General return or new pulmonary patients who ‘No Show’ to 2 consecutive visits (resets if hospitalized, is seen in the add-on clinic), missed appointments for hospitalizations or cancellations do NOT count Process: Patients who have ‘No showed’ twice in a row (new or return) , will not […]
Pulmonary Late Policy
Clinic Visits Return visit – If the patient arrives after the end of clinic (after 11:45am for morning clinic, after 4:45 pm for afternoon clinic, they will not be seen). If the patient arrives up to 20 minutes after appointment time, check in as on time. Physician can let patient know that they only have […]
Pulmonary Clinic Dr. Advice Line
Dr. Advice Line This will only be for outpatient pulmonary questions (when other physicians might have a question about patient being seen in clinic.) Any inpatient pulmonary questions should be directed to the ipd consult team (pager 2003). MICU-related calls will continue to the triage phone and to ICU on-call/WBH overnight staff. Secretaries to forward […]
Narcotic Script Handling
How to handle narcotic prescription: Nurses to verify contract on file à If no contract, patient can be referred back to primary care while physician is out. Patient will be sent a contract to review and bring to next visit. If contract in place, ok to refill short-term until primary pulmonary returns. Goal is for […]
Level of Service Preferences and Modifiers for PFTs or Vaccines
For any CLINIC VISIT WITH PFTs OR IMMUNIZATION on the same day, please add the Modifier ‘25’. Please see attached for how to do this. I have created favorites (I already asked, I cannot just share this with everyone) for established and new visits with and without the modifer. Adding LOS codes PFT or Immunization […]
IPF Drug Therapy
Decision for pirfenidone and nintedanib: For patients with mild or moderate IPF based on pulmonary function tests who do not have underlying liver disease -Current data are insufficient to direct a firm choice between pirfenidone and nintedanib, -diarrhea and liver function test abnormalities with nintedanib versus nausea and rash with pirfenidone 2. Nintedanib & Pirfenidone […]
Pulmonary Clinic Direct Admissions and ER Transfers
Direct Admission from Clinic Physician/APP enters EPIC order and notifies Nurse Physician/APP calls ATMO, will be transferred to medical officer to approve direct admission Bed assignment***, then Physician/APP and Nurse give SIGNOUT Patient will be accompanied by a physician/APP if being directly admitted to the ICU (NOT required for GPU or ER) ***If no bed is available immediately, […]
COPD Assessment Test (CAT) – Questionnaire and How to Add to Note
The COPD Assessment Test is a simple form that provides a standardized way to assess symptoms and impact of COPD symptoms on daily life on our patients. It focuses on CURRENT symptoms (Asthma Control Test looks at past 4 weeks). Our goal is to incorporate this into pulmonary clinic and ambulatory pharmacist visits with our […]