SCVMC:Main

Santa Clara Valley Medical Center: Main Page

Onboarding & Administrative Topics

• Remote Access Setup Instructions Remote Access Setup: HHSISHELPDESK@hhs.sccgov.org
• Dragon Dictation: Aaron.Lawe@hhs.sccgov.org
• Haiku Setup & Tip Sheet: Elizabeth.Serna@hhs.sccgov.org
• New Hire Orientation: Melissa.Dang@hhs.sccgov.org
• Yearly HealthLearning Mandates: Leyon.Khalili@hhs.sccgov.org
  • Need to be at hospital or remote log-in from home to access

• N95 Questionnaire

In Progress...

My dashboards > Frequently Called Numbers (bottom left)

Onboarding - PA & MD onboarding - Haiku - Network Access on personally owned device: 1 manufacturer 2 model number 3 serial number 4 Operating System - yearly health-learning - Stanford affiliation - Stanford resident evals - shift trades / discussion forum - group dot phrases - checking file cabinet in radio room - ? Room / door codes - ? dept phone list

Suboxone Induction

• We use the induction protocols as published by CA Bridge, available at https://www.bridgetotreatment.org/resources
  • COWS score >6, no methadone in last 5-7 days, clinical evidence of withdrawal (diaphoresis, yawning, piloerection, etc)
  • Business Hours Process:
    • Induce patient per posted protocol
      • Buprenorphine-naloxone 8mg - 2mg, 1 SL tab once, wait 45 - 60 minutes, if clinical improvement, dose 2 tab 8mg-2mg once
    • When decision is made to induce, contact Jill Lassettre, our Substance Use Navigator (SUN) via Amion. She will come down, assess patient, and plug patient into followup care with Substance Use Treatment Services (SUTS)
  • After Hours Process:
    • Induce patient as indicated per protocol; ensure no methadone in last 5-7 days or may precipitate withdrawal
    • Fill out a Treatment Appointment Form located on the wall in RME or XC, both by the nursing stations on a clipboard; there is a standing appointment at the Central Valley Clinic (CVC) at 8am every business day kept open for ED-induced patients
    • Send Jill Lassettre a message via EPIC or SecureMessaging with MRN and expected appointment date
    • If you have the DEA-X waiver, please prescribe a sufficient quantity of Buprenorphine-naloxone 8mg-2mg SL tablets to dose at 16mg once daily (can consider 8mg BID if concomitant chronic pain issues) until standing appointment; if un-waivered, options are to find a waivered provider on shift or tell patient to return for re-dose in ED the next day
    • Free online DEA-X waiver training (Cat 1 CME: MD 8hr, PA 24hr) available: https://pcssnow.org/medication-assisted-treatment/
  • Buprenorphine Home Induction
    • Buprenorphine Home Induction Protocol (Harbor-UCLA) File:Bup home Initiation.pdf

Processes - Suboxone - overweight CT / MRI - Orthotics - CT / US protocol timelines - COVID19 - EMS guidelines link? - On shift concern contacts (EMR message / phone Jeff, AOC / MAOC, charge RN, equipment malfunction)

Subspecialty Specific Nuances - Hosp/Med (stress test, ED consult appropriateness, medicine team admission times) - Cards (pre-hosp EKG, STEMI procedure, ACS/STEMI meds, event monitor, stat ECHO procedure) - Occuloplastics / Retina limited availability - Palliative (consult list) - Trauma admit labs - Neuro (Stroke & extended stroke) - SART work up / strangulation

Transfer Processes - OCH/SLR overflow - EMTALA out: Peds NSGY, CTS ?? - Accepting transfer: "Red box" vs rest vs Peds ortho - EMQ - EPS - Custody - Sobering center

Dispo Assistance - SW / CM / AOC - MH UC - Bus token / taxi voucher - DME (WC, etc) - Follow up labs / imaging

Pharmacy Twitter link https://twitter.com/TILEDPharmD

References

Singh 3/2020 Bergersen 3/2020