Harbor: ED to UCC

ED to UCC

• Revised 11-12-2025

ED to UCC Goal: Get patients age 18+ to the most appropriate level of care to facilitate expedient care and

	increase ED capacity for critical and undifferentiated patients given the beds lost to boarding.

Pilot Start Date: Wednesday, November 12, 2025 Step-by-step Process: 1. Quick Reg at Router – chief complaint and triage priority (most likely “routine”) 2. Patients to “Waiting for Triage” section of the AWR 3. RN Triage & Physician/APP MSE exam and documentation completed, and patient felt to be appropriate for UCC, defined as any ESI 4/5 who does not have an emergency medical condition (health issue that requires immediate medical attention to avoid severe harm, permanent disability, or death) and is stable to be discharged without additional stabilizing treatment prior to being seen at the UCC within the next 24 hours 4. Provider checks banner bar for “DHS/DHS Eligible” a. b. If patient is not appropriate for UCC or is not “DHS/DHS Eligible”, proceed with usual process (place all relevant orders, proceed to ED registration, tasking, FastTrack) 5. If the patient is appropriate AND eligible: a. If pain medication is needed i. Triage physician/APP orders necessary pain medication (no other orders) 1. No need to order the “OK for UCC” event in Orchid ii. Triage nurse administers the medication and documents in Orchid iii. Triage Nurse calls UCC x64110 (alt: x64111/15/18) to notify UCC RN of Name, MRN, DOB, medication, time given, and time reassessment due b. Triage physician/APP orders “Discharge Patient” in Orchid c. Triage nurse hands patient map to UCC and notes at the top if pain medications were given d. Triage nurse instructs patient to go to front desk of UCC (RED LINE) to “complete their check-in process” (do not say for registration as this often has financial connotations) i. If the patient does not know how to get to UCC, arrange for escort from ED 1. Volunteer at the Router 2. USA x66973 3. RME Charge RN x66950 for a Nursing Assistant 4. HMA x66968/9 e. Do NOT remove wrist band (helps facilitate more rapid registration at UCC f. Triage Nurse removes patient from the Tracking board (“Depart to Other Area of Facility”) g. Patient is re-registered at UCC (new FIN) and appointment made 6. UCC PAC will call RME Charge RN x66950 when all appointments are full; at this time, all patients will be seen in the ED.

If the patient is OOP after full registration at UCC: 1. UCC Registration staff will message the PAC supervisor to reactivate the ED FIN 2. UCC Registration will move the patient to Triage 2 with a note in the “RN Comments” column “from UCC” 3. UCC RN will call the RME Charge RN at x66950 to notify them the patient was OOP and will be returning to the ED 4. UCC will escort the patient to Triage 2 (same process as other patients transferred from UCC to ED); if Triage 2 team unavailable, UCC will handoff patient to the RME Charge RN 5. The triage physician/APP who initially saw the patient (reference MSE Note) should be notified so they can place any additional necessary orders (as only pain medications were ordered for patients going to UCC) a. RN i. Quickly repeat triage (“refer to initial triage note from today”) ii. If pain medications were given on the initial visit, perform the pain reassessment b. Physician/APP i. Click MSE and note “see prior MSE from today”) ii. If the initial MSE physician/APP is no longer on shift, the next available triage physician/APP can review the previous MSE note (quickly examine the patient if necessary) and place appropriate orders 6. Patient to RME Registration for full registration 7. Patient to Tasking for initiation of orders 8. Place in R4/5 for pain reassessment if additional pain medications are needed 9. Patient to AWR or FastTrack when bed available or ready for DC

CHEAT SHEETS

ED to UCC (RN role) • Completing check-in process at UCC; if no appt available, may be sent back to ED (expected 6-hour wait for care) 1. Triage Note 2. If pain med given, call UCC RN x65110/11/15/18 with Name, MRN, DOB, med, reassessment time 3. Give patient green map, circle at top if med was given 4. If escort needed, USA x66973 (backup = x66950 for NA) 5. Patient to RED LINE at UCC Check-in Window 6. Remove from Orchid – “Transfer to Other Service Area” • If patient returns from UCC: o Quick Triage (“refer to initial triage note from today”) o Pain reassessment if medication was given in ED o Have original Physician/APP place additional orders o Send patient to Tasking (reg completed at UCC)

ED to UCC (Physician/APP role) 1. Complete MSE/note • UCC Eligible: o Any ESI 4/5 without EMC (does not requires immediate medical attention to avoid severe harm, permanent disability, or death) and is stable to be discharged without additional stabilizing treatment prior to being seen at the UCC within the next 24 hours o “DHS/DHS Eligible” on Banner Bar o 2. Place order for pain medication if needed 3. Place “Discharge Patient” order in Orchid • If patient return from UCC, place orders for Tasking