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Toxicologist and Specialist in Poison Information

Plan for Conducting and Scheduling Follow-Ups

 

Follow-Up (FU) Terminology:

  1. “In-House” case/ “HIGH FIVES”
  • All case from the participating hospitals with Emory Medical Toxicology and GPC Clinical Toxicology Program: – Grady Health System – Emory (Crawford Long) Midtown – Emory University Hospital – CHOA-Egleston – CHOA-Hughes Spalding
  1. “New Health Care Facility (HCF)” cases
  • All New HCF cases are new hospital FU’s set within the last 24 hours.
  1. “Chronic” On-going HCF Open FU cases
  • Open HCF (not including “In-House”) cases that require multiple FU’s for >24hours.

– Usually due to the severity of the poisoned patient

  1. Home FU cases
  • Cases that are managed at home with pending follow-up for outcome purposes

Who will be conducting the FUs?

  1. Medical and Clinical Toxicology Fellows – MD, DOs, and PharmDs
  • M-F: Mostly in-house cases, some other new HCF cases, some chronic cases
  1. Medical Rotators – Emory Emergency Medicine Residents /Toxicology Rotation
  • M-F: Mostly in-house cases, some other new HCF cases, some chronic cases
  1. CSPIs/SPIs
  • Every day: Home follow-ups cases every day
  • Every day: In-house cases, new HCF cases, chronic, home cases

Coding plan when scheduling FUs.

  1. Code system for recognizing the 3 categories of FU’s.

This will let the toxicologists recognize the types of FUs ToxSentry FU “Type/Priority” Code

  • TOX REQ= Only to be set or requested by the TOXICOLOGIST/ FELLOW, indicates that the tox fellow on-call must be updated AFTER this follow-up is completed.
  • HIGH= All “In-House Cases” (Grady, Emory University, Midtown, CHOA- HS, CHOA- EG) … even if they are >24 hours old.
  • MEDIUM= All other NEW HCF Cases < 24 hours old
  • LOW= Chronic HCF Cases  > 24 hours old + all HOME follow-ups

Note: All SPIs are responsible for setting the codes correctly when scheduling follow-ups Follow-up list distribution:

  1. Night shift will send the FU list to the “toxicologists@georgiapoisoncenter.org” group.
  2. Day Shift supervisor will send the list out again/ or just send information on the new case(s) to the “toxicologists” if new cases should arrive before 10am.
  3. Directions for generating and emailing the FU list:
  4. Generate the “Pending Follow-ups” list in ToxSentry.
  5. “Export” this list to Excel.
  6. Once in Excel, adjust columns so that only these fields shown are:
    • “Follow-up Date/ Time — Follow-up Type — Priority — Case Number — Primary Substance — Hospital”
    • Delete all other columns by holding down the CTRL button and selecting Columns A, F, G. While these columns are highlighted, RIGHT click on any column and select “delete” from the menu.
    • For the Grady pts, please type in the medical record number of the pt’s row in the column beside the HCF column.

7. Click “File” then “Save” to your computer as an excel file (.xlsx). Save the file as “FU <date>”        i.e.  “FU 10.2.12” 8. While logged-on to your GPC email, start a new blank email, attach the excel FU list to the email selecting INSERT, then ATTACHMENT. 9.The email subject heading should read something like “Follow-ups 10/2/12” 10. In the email body, it’s okay to let the toxicologists know that there are “3 new Grady patients”… or “no new Grady patients”… for example. 11. Send email with Excel attachment to the “toxicologists@georgiapoisoncenter.org” list serve. F/U Report Example:

1/31/2014 8:00      Hospital  Medium 1931135 CLONIDINE, LORTAB 5/500 from U Wayne Mem Hosp
1/31/2014 10:00   Hospital   High        1931120 PERCOCET 5 (IMPRINT CODE): PER Grady Health System
1/31/2014 10:00   Hospital   Medium 1931219 SUPER TECH ANTIFREEZE/COOLANT  Atlanta Medical Center/South Campus
1/31/2014 11:00   Hospital   Medium 1930757 ANTIFREEZE (GENERAL FORMULATIO Northside Hosp – Cherokee
1/31/2014 11:00   Hospital   High         1931087 AMITRIPTYLIN Children’s Healthcare Atl Scottish Rite
1/31/2014 14:00   Hospital   Medium 1929266 SEROQUEL 400 (IMPRINT CODE): S Phoebe Putney Mem Hosp
1/31/2014 14:00   Hospital   Medium 1929382 DIGOXIN 234 ALRA (IMPRINT CODE St. Joseph’s Candler
1/31/2014 14:00   Hospital   High        1930311 PHENYTOIN  Emory University Hospital
1/31/2014 14:00   Hospital   Medium 1930493 MORPHINE SULFATE EXTENDED-RELE Medical Ctr of Columbus
1/31/2014 14:00   Hospital   Medium 1930843 DIGOXIN  Northside Hosp – Cherokee
1/31/2014 14:00   Home      Low          1930990 LITHIUM  Own Residence

 

SH rev 8.4.16