Exceptions

• Following IR procedures, patients are admitted from the PACU to the Hematology service by default except for:
  • Presence of specific indication to admit to other involved services (e.g. ORL, maxillofacial, ophthalmology, etc) and ICU.
  • Patients requiring surgical care (wound management, drain, etc.)
  • Presurgical procedures (e.g. preoperative embolization).
  • Adult patients scheduled to be admitted to other services or BWH
  • Chronic patients who are particularly familiar with another care team

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Notifications

• Notification to Hematology
  • IR NP emails an updated list of anticipated VAC IR anticipated admissions to Heme Program Coordinator Miriam Johnson ([email protected]) and the Hematology  schedulers ([email protected])
  • This list contains Patients name, MRN, diagnosis, procedure, date of procedure, IR physician and reason for admissio
  • The list contains the patients scheduled for the next two weeks and can be updated as needed.
  • If the patient is not admitted the IR NP will send the resident a text page
  • Heme schedulers book admissions to Hematology. The Heme Program Coordinator will pass this information on to the covering hematology team (attending and fellow) to be incorporated into the Heme Sign-Out document. Heme attending and fellow review the IR admission list on the Heme Sign-Out each day with the Heme resident team so they are aware of the patients to expect for admission.

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Admission

• Admission to Hematology
  
  • Once the admission is confirmed, IR NP will page the Hematology resident (HRT) to sign-out the patient. The text page is also sent to the Heme fellow and attending.
    
  • In the paging system and under Hematology on Call today, choose the “Hematology Inpatient Floor Supervising Resident (Not Consults)” (also called “6th Floor Subspecialties Resident, DOM Subspecialties” in the title) and is covered by the appropriate resident (not a virtual pager).   

• Sign-out will include:
  1. Patient
  2. Diagnosis
  3. Procedure
  4. Possible issues and When IR should be notified
  5. Management and Plan
  6. Post-procedural criteria for discharge

 

• If the IR and PACU team are unable to reach the hematology team:

1. If the HRT resident does not call back within 10 minutes of paging please call the HRT resident’s Spectra link phone.
   • HRT Junior Resident (supervisor): 5-4616 (617-355-4616)
   • HRT Intern                                              : 8-3967 (857-218-3967)
2. If HRT residents don't answer the Spectra link, page the Heme Fellow and/or Heme Attending.
3. If you ever get any bad interactions with the HRT resident please let the Heme Attending know ASAP. 
4. To report an interaction with a Heme Fellow or Attending, please let Dr Matt Heeney know ASAP.  Second line for calls is Dr Denise Adams.

 

• 5 PM should be the goal for calling the residents about admissions.  The residents sign-out their patients from 5:30 to 6:30 PM. It is best that the decision for admission and sign out happen prior to 5pm for patient safety and transfer.

 

• Unexpected admissions:
  • If there are any unexpected IR admissions, the IR attending will call the Heme attending with sign out then the process of admission between IR NP and the Heme team described above is followed.
  • Unexpected IR admissions may include postoperative or regular admissions of IR patients with vascular anomalies requiring inpatient care.