Harbor:Psych patients

  • Exodus Psychiatric Urgent Care patients needing medical clearance
    • Once the patient from Exodus is medically cleared and deemed stable for psychiatric assessment, the patients may be discharged back to Exodus. (Any patients INITIALLY presenting to the Adult ED needing psychiatric evaluation should be sent to the Psych ED where they may then be triaged to Exodus).
  • Initiating the transfer from Exodus to the AED or PED for medical clearance:
    • Exodus Charge RN calls the ED to initiate transfer.
    • Adult Attending (310.222.3900 x23202 or 23206 backup) or PED attending ( 310-222-6931 or 310-222-3900 x23211) places a pre-arrival note (include the reason for medical evaluation, presence of 5150, and any safety concerns).
    • RME Charge (310.222.3900 x23930 or 23910 backup)
      • Ascertain patients on a hold so a sitter can be identified.
      • Note any patients that are safety risks (high flight likelihood or history of aggressive/violent behavior).
    • Exodus will transfer the patient to the ambulance entrance of the ED via van, then take the patient directly to triage (to the adult ED for 18 and older and to the PED for 17 and under). The reassessment RN will be the designated receiving triage RN, but the patient can be seen by any triage team that is available.
    • If applicable, the original hold (5150 or 5585) documentation will accompany the patient.
    • After handoff to the triage RN, Exodus staff will be released.
  • The patient will be evaluated by the triage team with pertinent orders placed or by the senior resident in the PED then taken directly to a room with a sitter. Any necessary tasking will occur in the ED room.
    • If there are no available rooms in the AED, tasking can occur in RME and the patient will stay in RME 12 with a sitter until a private room is available.
    • If there are no rooms available in the PED, the patient will remain in triage until a room with a sitter is made available.
    • During the process of medical evaluation, the ED provider may consult Psych for any reason (medication recommendations, concern due to a change in behavior, etc.).
  • Discharging patient back to Exodus After medical evaluation is completed and the patient is stable and not a flight or safety risk, they will be discharged back to Exodus.
    • The clerk will print a “transfer packet” (do not need EMTALA form)
    • The treating nurse will call the Exodus Charge RN (424.405.5888).
    • Exodus staff will transport the patient back to Exodus.
  • If there is any safety or elopement concern, or there is no longer space at Exodus, the patient will be transferred to the Psych ED.
    • At their discretion, Psych may initiate a Sheriff-accompanied transfer to Exodus.
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