Hospitalist Service Paging Protocol – Effective June 20, 2016

Page MD Pager

RED: Urgent/Acute Change in Condition
RN page will begin with “R” and will include details of incident, RN name, callback number
AM shift (7a-5p) – Red page sent to MD pager
PM shift (5p-7a) – Red page sent to rotating pager #8074 and toANM/CN pager (or face-to-face communication of situation with ANM/CN)
When to use:
Situations requiring intervention ASAP –
  • MET Call
  • Acute Change in Condition:
  • Respiratory Status
  • Mental Status
  • Symptomatic Change in Vitals/Labs
  • New Onset Chest Pain
  • Suspected Stroke
  • New Onset Seizure Activity
  • Transfusion Reaction
/
  • Medication reaction
  • NEW need for restraint
  • Fall withinjury requiring immediate intervention
  • New suicidal ideations

/ Expected follow-up from Hospitalist:
  • Call back or at bedside within ten minutes.
If no follow-up within 10 minutes:
  • Re-page or MET call depending on patient condition.

Orange: Requires Closed Loop Communication
RN page will begin with “O” and will include details of incident, RN name, callback number ORpager number if text page back is OK(pager number preferred if no discussion required)
AM shift (7a-5p) – Orange page sent to MD pager
PM shift (5p-7a) – Orange page sent to rotating pager #8074
When to use:
  • Acute change in urine output (Decreased)
  • Critical lab values
  • Acute changes in labs
/
  • AMA requests
  • Patient needs vital signsparameters entered

/ Expected follow-up from Hospitalist:
  • Order Entry
  • Call Back
  • Return Page
  • 1st attempt to paging RN
  • If unable to reach, notify ANM/CN
If no follow-up within 30 minutes:
  • Re-page to
  • MD pager (on AM shift)
  • #8074 (on PM shift)
  • Notify ANM/CN via pager or face-to-face

Page Rotating Pager #8074

YELLOW: Requires Closed Loop Communication
RN page will begin with “Y” and will include details of incident, RN name, callback numberOR pager number if text page back is OK(pager number preferred if no discussion required)
AM shift (7a-5p) – Yellow page sent to rotating pager #8074
PM shift (5p-7a) – Yellow page sent to rotating pager #8074
When to use:
  • Asymptomatic acute change in vital signs
  • Patient requested meds
  • Orders or needs
  • Critical pain scores (new score 8 or above)
  • Family requests or would like to talk to MD (Include patient request): May send to MD if appropriate
  • New EWS 8 or higher (Code Early Warning)
  • Medication needs
/
  • Diet change or removal of NPO following procedure
  • OK to use needs (i.e. PICC, CVL, PEG Tubes, DHT, etc.)
  • Restraint renewal
  • Fall with no apparent injury
  • Positive blood cultures

/ Expected follow-up from Hospitalist:
  • Order Entry
  • Call Back
  • Return Page
  • 1st attempt to paging RN
  • If unable to reach, notify ANM/CN
If no follow-up within 30 minutes:
  • Re-page to
  • #8074 (on AM shift)
  • #8074 (on PM shift)
Notify ANM/CN via pager or face-to-face
GREEN: FYI – No Communication Necessary
RN page will begin with “G” and will include details of notification
AM shift (7a-5p) – Green page sent to rotating pager #8074
PM shift (5p-7a) – Green page sent to rotating pager #8074
When to use:
  • Patient arrival on floor
  • Expected family arrival
  • EWS of 5-7
  • Consistent EWS 8 or higher
  • Consistently high pain scores that have previously been addressed or discussed
  • Consistently abnormal lab values that have previously been addressed or discussed with treatment options in place
/
  • Consistently abnormal vital signs that have previously been addressed or discussed with treatment options in place
  • Newly positive urine or wound culture results
  • Refusal of plan of care (i.e. Labs, Meds, Procedures)

/ Expected follow-up from Hospitalist:
  • None

All bed-related matters should go through the Center for Patient Flow.