“Your patient is here!” A review of the transfer process UNM Hospitalist Best Practices 1/7/11

Objectives Familiarize faculty with the history and functions of UNM PALS (Physician Access Line Service) Review the flow of patient information involved with a “PALS transfer” Describe the process of “Patient Placement” Discuss potential improvements

Brief history of PALS 1988 “Mini-PALS” designed by Dr. Ben Curet (MFM OB) for rural NM support/tranfers 1996 Expanded under UPA to provide telephone consultation with all UNM SOM specialty faculty Several departmental incentives initially tied to response time

A few changes since 1996 Medical databases (i.e. Up to Date) More specialties, procedures Amion NM population increased 20%* * US Census Data

PALS 2011 Supervisor: Keith Drummond Manager: Deborah Gonzales Operators: 9 FTE + 1 PRN 60,000 calls/year 30,000 consultations 4000 transfers - PALS does not manage patients at home -

Flow of Information for Transfer Referring Provider PALS Accepting Provider Administrative Supervisor Patient Placement aka Bed Control

Bed Waitlist Priority 1. UNM ED/Clinics 2. Non-UNM Clinic 3. Patients at home 4. Transfers

A patient is discharged… Charge Nurse Administrative Supervisor PALS Referring Provider Accepting Provider

The transfer patient is coming Administrative Supervisor Admitting “Butt in Bed” Accepting Provider

Discussion Points Update at time of transfer Advance admissions