Date:

To Whom It May Concern:

The pediatric providers at including physicians , nurse practitioner , and physicians assistants have a working relationship and communication process with theEmergency Department (ED), pediatric hospitalists and pediatric intensivists at Hospital ().

When a pediatric patient requires acute services at Hospital, a provider from our practice calls:

  • The ED at --to speak with a pediatric emergency room physician. We inform the ED team that if the child requires admission, that they be admitted to the pediatric hospitalist service.
  • The “One-Call” staff at --to provide information regarding a direct admission and to talk to the pediatric hospitalist accepting admissions.
  • Pertinent clinical details such as labs, recent visit documentation, growth curves are FAXed at the time of admission or as subsequently requested to the ED at --, inpatient units at --or the pediatric intensive care unit at --.

If an emergency department patient requires admission to Hospital, either the ED staff or inpatient staff calls the practice to give an update regarding the patient’s status. This happens for EACH child requiring admission to the pediatric service whether or not the patient was referred to the emergency department (Hospital or outside ED) by the practice.

A visit summary is faxed to the practice for each patient as they are discharged from the ED. For patients not admitted to hospital, a phone call is placed to the practice’s on-call physician for patients requiring close outpatient monitoring and follow-up.

The morning after admission, there is an autoFAX system to alert the provider that a patient has been admitted to Hospital. The provider can call to request a FAX of the visit documentation / H&P and are encouraged to call for updates as needed: Hospital ED: --; acute care units: hospitalist triage phone: --or intensive care unit: --.

The hospital staff will update by phone or intermittent FAX reports when the patient’s clinical status changes or when the provider’s input is required.

At the time of discharge from an acute pediatric unit, the hospitalist service will communicate via:

  • A FAX of the discharge summary including discharge instructions within one working day.
  • A phone call from the discharging team is placed before each child leaves the hospital:
  • A message will be left with the practice staff with a call back number if there are no acute issues (the discharge summary contains the pertinent details)
  • A provider-to-provider conversation will be requested if there are labs or specific details which require follow up
  • The hospital team will request a follow up appointment for families who REQUIRE follow up (some patients only need an appointment if the clinical course is not consistently improving). Patients requiring a follow up visit include, but are not limited to, asthmatics, patients with pending lab results, patients with still unexplained or not completely resolved symptoms, etc.

We, members of the practice, have developed processes to consistently communicate among our call group when patients are admitted to the hospital and when communication is received from the ED or inpatient units. The on-call provider consistently notifies the child’s actual primary care provider or next covering provider when a child has been admitted or is being discharged.

Both our practice and members of Hospital provider team strive for great clinical care and that includes careful communication, especially during transitions of care. Each member of the team is responsible for good communication and for providing feedback when the best communication did not occur. Individual providers at our practice would like to hear when the Hospital team did receive the communication needed to care for our patients.

Specific providers at Hospital can be individually reached for direct feedback, or the leadership team including are available for appropriate information regarding individual patients or the process in general.

Agreed and accepted

(Practice)______Date______

(Hospital)______Date______

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