The following are policies at the DC VA Medical Center that may affect your rotation here. Please see below for further information.
If a patient is being admitted and has recently been discharged in the past 30 days and either the resident or intern remains on service, the patient will preferentially go to the team that the resident or intern is on. If the resident or intern has moved from one team to another, the patient will go to the team that the resident or intern is currently on. This preserves continuity between patients and providers and is overall beneficial for patient care.
If a patient is a bounce back to a team but that team is not on call, then the on call team will admit the patient and the patient will be transferred to the bounce back team in the AM. Please make the chiefs aware if this occurs.
The PCU is the Progressive Care Unit, where patients have a higher level of care then the floor, but do not necessarily need the ICU. When patients are being transferred from the ICU to the PCU, the ICU team will cover the patients in the PCU for 24 hours in the PCU to ensure they are stable and do not need to be re-stepped-up to the ICU. Once they are stable for 24 hours in the PCU, then the ICU team may call the floor team for sign-out. This ICU-PCU transfer can only occur between 7:00 AM and 10:00 PM. From 10:00 PM to 7:00 AM, these transitions are prohibited unless there is an attending to attending conversation.
ed / bed board policy
Medicine may accept admissions at any time from the ED, however, all admissions need to have a bed assigned to them when the ED calls for admissions. This is because medicine admissions are distributed based on the geography of the units.
Because all admissions need a bed assigned, this frequently means the patient's COVID test needs to be back as 4C and the PCU only accept COVID patients. However, if the patient is being admitted as a PUI regardless of COVID testing, they may have a bed assigned already and can be accepted.
All inpatients are tested for COVID-19 universally. COVID-19 patients are only admitted to Teams 6, 5, and 4. Please see the COVID-19 section for more specific polices regarding COVID patients.
Code Blue's are run by the MICU service and are responded to by the on-call wards teams. See the MICU Code Blue section for more detail.
Rapid responses are run by the on-call wards teams. See the Rapid Response page for more detail.
Code Strokes are run the MICU and primary/covering team should also go to help assess patient and need for Code Stroke. Code Strokes in the ED are run only by the ED. Please see CODE STROKE Section for full policy.
transferring to other hospitals
The Patient Transfer Coordinator (57877 or Vocera Clinical Coordinator) can help with all of this process as well as help identify accepting physician, request ambulance travel. They are overall the expert in the transfer process. These are the identified roles of the physicians in the transfer process:
Contact the physician at the hospital to which the patient will transfer and record their name and phone number as the accepting physician.
Walter Reed Medical Center: 301-295-2126
GWU Transfer Center: 1-855-736-3249
MedStar Georgetown University Hospital: 202-295-0520
MedStar Washington Hospital Center: 844-877-2424
Baltimore VA: 410-605-7433 (Linda Moses), 410-605-7000 x6109
Martinsburg VA: 304-620-2658 (Jim Carrol)
Fill out form 10-2649 (click here to download, also available in the Chief's office & Team 2 Room)
Fill out a Travel Beneficiary Note in CPRS
Fill out a Physician Interfacility transfer note in CPRS
For EMERGENT TRANSFER:
Call the Procare communications center first.
Then call the ED to assist if needed.