1. PHV Patients in the ED The processes of transferring patients to and from the ED and Vanderbilt’s Psychiatric Hospital (PHV) can be very confusing. This training will address the various processes involved.

2. V:sss/applications/edis/phv/phv pts in the ed.ppt 11.08 Patient is treated in ED then admitted to PHV  ED Registration is done when patient (pt) arrives  After evaluation it’s determined pt will be admitted to PHV for further treatment  Patient is departed from ED account (DCRN: ED PHV). This generates an automatic departure of the ED Registration account  A new Admission Account is created in PHV Pavilion 5 by PHV Admitting staff In this scenario, the patient is Registered as an E type pt in the ED, then departed and new PHV account created.

3. V:sss/applications/edis/phv/phv pts in the ed.ppt 11.08 Admitted PHV patient is sent to ED for Treatment & Returns to PHV  PHV Admission staff transfers patient into Pavilion 5 ED location (ED/P or EMER)  Patient’s name displays on ED Whiteboard (WB) in Waiting room  After ED treatment, patient is sent back to PHV  Patient is moved off WB by ED nurse (DCRN: PHV ED PHV) Only Medipac transfers are performed in this scenario. PHV Admission staff transfer the patient back to the correct PHV unit and bed location.

4. V:sss/applications/edis/phv/phv pts in the ed.ppt 11.08 Admitted PHV Patient is sent to ED for Treatment & is Admitted to VCH/VUH  PHV admission staff transfers patient into Pavilion 5 ED location (ED/P or EMER)  Patient’s name displays on ED WB Waiting room  After ED evaluation, it’s determined that patient should be admitted to the hospital  MD electronically indicates on the WB the request to Admit  ED Liaison: sees admission alert for PHV pt and archives orders Discharges the PHV account Creates a new account Calls Respond 327-7000 to inform that pt is not returning to PHV

5. V:sss/applications/edis/phv/phv pts in the ed.ppt 11.08 Admitted PHV Patient is sent to ED for Treatment and is Admitted to VCH/VUH  ED Charge nurse: Checks HEO/Wiz to be sure no admission orders are entered on the PHV account (can view in Starpanel under “Orders”) If Admit orders were entered, plays back ONLY the Admission & active orders. One time/STAT orders are NOT played back Chg Nurse moves PHV account to Recent Discharge board and bring new account over into a bed from the Waiting room board (DCRN: PHV ED VUH/VCH) This is the most complicated of all the Scenarios. Timing is a big issue because there are 2 account #; PHV and VUH/VCH admission #. All PHV orders should be archived by ED Liaison but only the Chg nurse should make the decision as to what is played back on the new account.