PART II
Department Information
Interns and Residents
2016 – 2017
Department Information
Table of Contents
Admissions and Transfer Center ...... 3 Cardiac-Vascular Services ...... 5 Care Management ...... 8 Chaplaincy Services ...... 11 EEG ...... 12 ECG ...... 13 Emergency Department ...... 15 Family Health Care Center ...... 17 Epidemiology, Infection Control, and Prevention ...... 18 Health Information Management ...... 19 Information Management Services ...... 26 Laboratory ...... 30 Library Services ...... 33 Media Services ...... 35 Nursing Services ...... 38 Nutrition Services ...... 44 Occupational Health Services ...... 46 Outpatient Services ...... 47 Pharmacy ...... 50 Physical, Occupational and Speech Therapy ...... 51 Outpatient Physical Therapy Services ...... 51 Post-Acute Continuum ...... 55 The Rehabilitation Center ...... 55 Transitional Care Center ...... 55 The Rehabilitation Clinic ...... 55 Psychiatry ...... 57 Radiology ...... 60 Respiratory Care ...... 62 Speech and Hearing Center ...... 64
II – O - 2 Admissions and Transfer Center
LOCATION: C2 PHONE: 484-628-5200 HOURS: 24/7
SCHEDULING PROCEDURES
The Admissions and Transfer Center may be contacted 24 hours a day for scheduling elective or emergency admissions. Call the Operating Room Scheduling Office at 484- 628-8008 for the appropriate procedures and PreAdmission testing time. The OR Scheduling Office is open weekdays 0730 to 2300.
Emergency Admissions – The physician is responsible for calling the Admissions and Transfer Center from the Emergency Department, outpatient department, or physician office, and providing pertinent information and diagnosis. The physician will indicate whether a critical care bed, regular nursing unit bed, isolation bed, or telemetry bed is required.
Elective Admissions – Advance reservations will be taken for elective admissions. Physicians should be prepared to give the following information on all admissions:
Attending physician’s name (for residents, the chief admitting resident and the attending physician supervising) Patient’s name Medical record number or patient’s date of birth Admitting diagnosis Type of bed required – critical care, regular nursing unit bed, telemetry, isolation
Admission can occur at any time, but the bed availability should be checked before giving the patient a time to report to the Admissions and Transfer Center.
PATIENT ASSIGNMENTS
When possible, patients are admitted to nursing units according to the service listed below. However, if a bed is not available on the preferred nursing unit, Admissions will assign the patient to another location.
Extension 8228 B3 ...... Pediatrics 8014 E1 ...... Medical, Surgical, Medical Telemetry 4144 E1SU ...... Stroke Center 4486/4496 E2N/E2S ...... The Rehabilitation Center 8225/8220 E3N/E3S ...... Transitional Care Center 8384 N1 ...... Outpatient Cardiovascular Services 8812 N1 ...... Interventional Cardiology Recovery 8367 N2S ...... Congestive Heart Failure, Cardiology 8901 N2W ...... Cardiology, Epidural, OHS 8379 N3S ...... Oncology, Medical 8019 N3W ...... Respiratory (vents),CAPD patients, cardiology 9950 N5S ...... Joint Care Center 9950 N5W ...... Orthopaedic, Trauma service, Urology 8237 R3E ...... Neurosurgery, GYN surgery, med/surg 8646/4225 R1E/R2E ...... Postpartum II – O - 3 8267 R2S ...... LDR 8016 R3S ...... General Surgery, Bariatric Surgery, Trauma service 9207 Spruce Pavilion ...... Psychiatry
Critical Care
8471 N4S ...... SICU 8274 R2 ...... NICU 8423 N4W ...... MICU
II – O - 4 Cardiac-Vascular Services (The Reading Hospital Regional Heart Center)
LOCATION: N1
CARDIAC REHAB LOCATION: Spring Ridge Medical Center, 1320 Broadcasting Road, Wyomissing
Outpatient Scheduling 484-628-8052
Inpatient Non-invasive Scheduling 484-628-4546
HOURS:
Weekdays 0800-1700 Saturday 0800-1200 (Non-invasive vascular only)
Invasive Cardiac-Vascular Cardiac Catheterization (staff on-call 24/7) 484-628-8675 Cardiac Rehab & Cardiac Ultrasound (staff on-call 24/7) 484-334-6461
KEY STAFF:
Director ...... 484-628-8747 Program Coordinator ...... 484-628-8923
SERVICES PROVIDED
The Reading Hospital Regional Heart Center provides emergency and elective cardiac and vascular procedures to inpatients and outpatients. Cardiac ultrasound and holter monitoring are available to infants through geriatric patients. All other services are primarily provided to adults.
Cardiac Ultrasound: Transesophageal Echo (patient must be evaluated by a cardiologist) Stress Echo Dobutamine Echo 2-D Echo
Vascular Transcranial Doppler PVR Studies Renal Artery Duplex Vein Mapping Carotid Duplex Venous Doppler
II – O - 5 Exercise Studies Stress Test Myocardial Perfusion
Tilt Table Tests
Holter Monitor
EKG Interpretation
Invasive Services include:
Cardiac Catheterization Diagnostic Interventional, Angioplasty, Stents
Temporary Pacemaker Insertion
Electrophysiology Diagnostic Interventional, Ablation Permanent Pacemaker Implantable Defibrillators
Peripheral Angiography Diagnostic Interventional, Angioplasty, Stents
Prep and Recovery:
Services provided pre- and post-cardiac or Vascular invasive procedures, Outpatient Heart Failure Infusions, Cardioversion, Transesophageal Echo. Patients admitted to Prep and Recovery are either discharged post procedure, recovered overnight, or are admitted to the Hospital.
Test Ordering: Inpatient, Non-invasive – Written order on medical record chart. Outpatient, Non-invasive – Call 484-628-8052. Cardiac Catheterization – Consult cardiologist to evaluate patient. Electrophysiology Study – Consult cardiologist to evaluate patient. Peripheral Angiography – Consult cardiologist, vascular surgeon, or interventional radiologist. Transesophageal Echo – Consult cardiologist to evaluate patient.
Report Access: All Non-invasive cardiac and vascular procedure results are dictated into the Hospital Dictaphone System. Invasive cardiac and vascular procedure results may be obtained through NetAccess.
II – O - 6 Cardiac Rehab is available to patients, Monday – Friday, at the Spring Ridge Medical Center in Wyomissing. Monitored and non-monitored programs are offered. Patient needs to have one of the following diagnoses for insurance coverage: stable angina, post coronary bypass surgery, post valve surgery, post coronary stent, post MI. More information may be found on the Hospital’s website.
II – O - 7 Care Management
LOCATION: C2
KEY STAFF:
Director of Care Management ...... 484-628-5334 Manager of Social Service ...... 484-628-8789 Manager, Case Management ...... 484-628-9770
CARE MANAGEMENT PROGRAM
One of the guiding principles of the Care Management approach is to assist physicians in the patient care coordination/discharge planning process. To facilitate this process, integrated Care Management Teams, comprised of nurse case managers and social workers, are assigned to each patient care area. Within the first business day of admission, the Care Management Team will open all cases to determine appropriateness of level of care, begin care coordination, perform utilization review, and determine the potential need for post-acute services. The Care Management Team will then begin to arrange for services that the patient will need at discharge, and this process likely involves discussions with the attending physician regarding the plan of care.
It is key that the Care Management Team and the attending physician discuss discharge options as soon after admission as possible to facilitate timely discharge. These “early-on” discussions will decrease the need for staff nurses, nurse case managers, and social workers to make numerous calls to physicians throughout the patient’s stay, allowing physicians to continue with patient rounds and decrease interruptions during office hours. Additionally, early discussions and planning will decrease physicians’ workload regarding discharge planning, better allow for patient education needs to be met, and improve discharge planning with families.
The Care Management Team will be available to assist physicians in arranging for many post-acute service needs, including:
home health services (e.g., wound care, home PT/OT, and skilled nursing) home infusion devices (e.g., antibiotics, TPN, and enteral feeding) acute rehab placement transitional care placement long-term nursing home and assisted living placement
The Care Management Team is also responsible to facilitate care needs during the Hospital stay, such as diagnostic testing, PT evaluations, and other therapeutic services. The underlying goal is to expedite physician orders and coordinate services that patients need during their Hospital stay.
As patients progress and clinical goals are met, the Care Management staff will implement the discharge plan. This coordinated effort will decrease potential complications (e.g., deep vein thrombosis) and delays (e.g., missed therapies). The Care Management Team is responsible for facilitating discharge plans throughout the patient stay, including weekends. II – O - 8
Nurse case managers will have additional responsibilities within the Care Management Department. Utilization review is conducted on all admissions, and nurse case managers will continue to review a patient’s clinical status and ordered services against standard criteria. The Care Management Department is currently using InterQual criteria when reviewing clinical status/ordered services. There will be occasions when nurse case managers will need to speak with attending physicians regarding a given patient’s continued stay based on utilization review. In most cases, the payer is making approval/denial decisions based on clinical status and services being received.
It is important to work with the nurse case managers in identifying why patients continue to require acute care services or to determine discharge options. Nurse case managers will track acute care denials to determine if appeals or other actions are indicated, and will provide contact information to the physicians for peer-to-peer review of the case appeal.
Care Management Team Credentials
Nurse case managers are RNs and BSNs with five or more years of clinical nursing experience; care coordination/discharge planning experience in home care, disease management, and post-acute facility care; and utilization review experience in acute care hospitals and managed care settings. Social workers are bachelor- and master-prepared professional staff, many with more than 10 years of healthcare- and community-based social work experience, including children and youth services, domestic abuse/addiction/high-risk behavior, crisis intervention, oncology, and gerontology.
Benefits to Physicians, Hospital Staff, and Patients
Improved patient outcomes and satisfaction Decreased physician workload for discharge planning Decreased calls and interruptions to physicians during office hours Improved physician and Hospital staff satisfaction Decreased complications (e.g., deep vein thrombosis) Decreased service delays (e.g., missed therapies) Improved patient education and family discharge planning process Increased Hospital service capacity to meet patient and community needs
II – O - 9
II – O - 10 Chaplaincy Services
OFFICE LOCATION: R1 PHONE: 484-628-8210 PAGER: 484-338-8003 (Speed Dial #0883) VOCERA: 3300 say “Duty Chaplain”
CHAPEL LOCATION:
Darrah Chapel – C2 Auxiliary Chapel – R1
HOURS: Office is staffed weekdays 0800-1700 Services available 24/7 Chapels open 24/7
KEY STAFF: Rev. Dr. Thewodros (Ted) Asfaw, BCC, ACPE – Director Ruth Ann Wiswesser – Administrative Assistant
SERVICES PROVIDED
Counseling and Support Services – Chaplains see patients and families by referral. Chaplains will assess patient’s emotional and spiritual support needs and provide supportive counseling within the context of the patient’s own values and beliefs.
Crisis Support Services – Chaplains respond to all “Code Blue” calls, “MI/Stemi” calls, and “Trauma Alert” calls to assess and provide for family support needs. Chaplains also provide the family information and support function at the time of a patient’s death.
Religious Services – Chaplaincy staff make provision for the specific needs of Roman Catholic and Jewish patients. The Department will contact or refer patients with specific religious needs to the appropriate community clergy representative.
II – O - 11 EEG
LOCATION: EG 484-628-8140
HOURS: Weekday 0700-1900
PROCEDURES FOR REFERRING PATIENTS
Inpatients – EEG orders for patients are computerized; any special instructions are communicated to the nursing unit. The EEG procedure requires: ninety minutes for awake testing and a portable EEG study takes 2 hours.
Outpatients – Private patients are scheduled by the physician’s office through the EEG Department. EEGs are read by staff neurologists Drs. Sowmya Lakshiminarayanan, Clifford Reed, Lawrence Brzozowski. Reports will be available in EPIC for physicians with EPIC access other physicians will have a copy mailed to them. The actual tracing is stored in digital format.
II – O - 12 ECG
PROCESSING LOCATION: N1 484-628-8319
HOURS:
Weekdays 0700-1200 Saturday & Sunday 0800-1000 no holidays
PROCEDURE
Inpatients– ECGs are ordered through the Epic and performed by a diagnostic technician or nurse. The ECGs are then uploaded in the MUSE ECG Management System. Clerk on N1 processes ECGs for physicians to read. A cardiologist interprets the ECG in the MUSE ECG Management System and a copy prints on the nursing floor. Results can be found in Epic.
Outpatients– ECGs are ordered through referring physicians and performed by a diagnostic technician. The ECGs are then uploaded in the MUSE System. Clerk on N1 processes ECGs for physicians to read. A cardiologist interprets the ECG in the MUSE ECG Management System and a copy prints to the referring physician. Patients can go to any lab facility equipped to perform ECGs.
OUTPATIENT TESTING
The Reading Hospital Laboratory Services in West Reading Doctors Office Building, Suite 110, 301 S. Seventh Avenue, West Reading
Monday, Wednesday, and Friday: 0700-1700 hours Tuesday and Thursday: 0700-1900 hours Saturday: 0730-1200 hours
The Reading Hospital Laboratory Services at Exeter
Exeter Medical Center, Suite 100, 4885 DeMoss Road, Reading Weekdays: 0630-1400 hours Saturday: 0630-1200 hours
Exeter Medical and Professional Building, 6 Hearthstone Court, Reading Monday – Thursday: 0600-1800 hours Friday: 0600-1600 hours Saturday: 0630-1200 hours
II – O - 13 The Reading Hospital Laboratory Services at Muhlenberg 1000 Tuckerton Court, Reading
Weekdays: 0600-1600 hours
The Reading Hospital Laboratory Services at Spring Ridge, 2603 Keiser Boulevard, Wyomissing
Weekdays: 0600-1630 hours Saturday: 0700-1200 hours
II – O - 14 Emergency Department
LOCATION: NLL ACUTE 484-628-8219 INTERMEDIATE 484-628-5997
HOURS: 24/7 OBSERVATION 484-628-8029
KEY STAFF: Charles Barbera, MD – Chairman 484-628-8908
SERVICES PROVIDED
The Emergency Department is in operation 24 hours a day, seven days a week, serving patients who require emergency and urgent care. The unit is staffed with emergency physicians and nurses at all times.
The Emergency Department is subdivided into five separate patient care areas:
1. The Acute Care Services area, serving the most seriously ill and injured patients.
2. The Trauma area, serving the acute, multiple trauma patients during the initial phase of their treatment and resuscitation.
3. The Intermediate Services area, staffed by physicians and physician assistants; designed to treat people with urgent problems in a timely and efficient manner.
4. Orthopaedic Services, serves as a diagnostic and therapeutic area for patients with orthopaedic injuries.
5. The Fast Track area serves minor illness and injuries that can be treated and released in 90 minutes
6. The Observation Services area on R4, serves as a diagnostic and therapeutic center and an observation unit. Patients from other sections of the Emergency Department may be referred to the Observation Services area for further observation and treatment. Members of the Medical Staff may see patients directly in this unit. The criteria for placement in the Emergency Observation Unit follow:
Patients whose diagnosis is in question and whose admission into the Hospital hinges upon the establishment of the correct diagnosis Patients undergoing treatment whose positive response to therapy may prevent unnecessary admission Patients presenting with disposition problems requiring observation while discharge planning consultation is being obtained
All patients in this unit must be seen by an emergency physician, physician assistant, or another attending physician from the Medical Staff. Patients who are seen here for minor procedures, such as transfusions or intravenous therapy, should have a pertinent medical history and physical examination immediately available on the patient’s chart in case an emergency should arise. Patients in the unit are the responsibility of either the II – O - 15 actively treating emergency physician or the attending physician who has assumed responsibility for the patient. If a patient in the unit becomes critically ill and requires immediate stabilization, nurses will inform the emergency physician on-duty if the attending physician is not immediately available. The emergency physician will stabilize the patient until the attending physician arrives.
RESIDENT ROTATION
Residents from various specialties may be scheduled for rotations in the Emergency Department as a part of their core curriculum or as an elective rotation. During these rotations, the resident will be actively supervised by Emergency Medicine physicians and physician assistants. Residents in various specialties may see patients in consultation for their services or those of the attending physician. During these situations, the residents are supervised by the attending physician responsible for that individual service.
II – O - 16 Family Health Care Center
LOCATION: DOB Suite 200 484-628-8198
HOURS: Office hours are by appointment Monday 0830 – 2000 Tuesday 0830 – 1700 Wednesday 0830 – 2000 Thursday 0830 – 1700 Friday 0830 – 1700
KEY STAFF: Jane Weida, MD
SERVICES PROVIDED
The Family Health Care Center (FHCC) is a Hospital-based primary care service. The physicians are specialists in the delivery of: comprehensive, primary medical care to the entire family (adults, adolescents and children) including prenatal care, obstetrical care and care of the newborn. Services provided in the Family Health Care Center include: long-term and acute care for illness and injury; referral to medical specialists; nutritional and mental health counseling; pediatric care and immunization and inpatient care. An emphasis is placed on the prevention of disease through appropriate patient education, counseling and screening.
The doctors of the Family Health Care Center make house calls whenever necessary for the care of the patient. If hospitalization is necessary, the patient will be admitted on the Family Health Care Center service at the Hospital where the Center’s physicians will assume primary care and consult appropriate specialists when necessary.
CHARGES AND INSURANCE Family Health Care Center expects payment at the time of service. We participate with many insurance plans, including Medicare, Medicaid and many commercial insurance plans. There is financial assistance available through the Reading Hospital if the patient does not carry insurance. The office accepts payment in the form of cash, check or credit card.
II – O - 17 Epidemiology, Infection Control, and Prevention
LOCATION: G2 484-628-8744
Medical Director: Robert Jones, DO Director: Marie Keim
Infection Preventionist: Susan Garceau Helen Marshall Jean VonNieda
Infection Prevention Technicians: Dina Wendling
Healthcare Associated Infection Liaison: Gwen Bednarz
EPIICP hours: 0730 – 1630 M-F; after hours available for emergencies via pager: 484- 338-9182 (speed dial 1611)
INFECTION PREVENTION MANUAL, EPIICP Plan Act 52 and Hand Hygiene – available via the Online Communications Center
Select Policy Manager Select Browse Manuals Select Organizational (Administrative) Manual Select Infection Prevention and Control Manual Select Policy of Interest (or Folder for specialized policies) o Bioterrorism folder o Exposure Control Plan folder o ICRA for Construction, Renovation and Repair o Mycobacterium (TB) Respiratory Protection Plan
Related Hospital Committees and Teams
Infection Prevention Committee Infection Prevention Liaison -Hand Hygiene Subcommittee Sharps Subcommittee Urinary Tract Infection Team (UTI) Highmark – Infection Prevention Metric team
II – O - 18 Health Information Management
LOCATION: A3/B3 Transcription & Support - BPB Records Center – DOB Suite 10
HOURS: 24/7
KEY STAFF: Cynthia Henry, RHIA – Director ...... 484-628-8833 Manager, Record Management Services – DOB ...... 484-628-8602 Record Completion Manager ...... 484-628-5617 Release of Information ...... 484-628-8835 Transcription Supervisor ...... 484-628-8612 Coding Hotline ...... 484-628-8831 Cancer Registry ...... 484-628-8829 Radiology ...... 484-628-4444 Medical Records, CVL, Cine ...... 484-628-8252
TRANSCRIPTION SERVICES
Transcriptionists in Medical Records will transcribe dictation on the following reports dictated by residents:
History and Physical Examinations Operative Notes (Inpatient and Outpatient) MATT Notes ICU Notes Clinic History and Physical Discharge Summaries Consultations
Formats for these reports are posted at all dictating stations. Please follow these guidelines and dictate concise, well-organized reports. Dictate no faster than you would speak to another individual. State numbers clearly.
Dictation Instructions
The following are instructions for all telephones.
1. Lift handset, dial 8357 or push “Dictation” button, and enter your three-digit Physician ID number.
2. Select the two-digit Work-Type button on the station: 01 - History and Physical Inpatient Operative Report Outpatient Operative Report Discharge Summaries Clinic History and Physical 30 – MATT Note
II – O - 19 80 – ICU Note 20 – Consultations
3. Enter seven-digit Medical Record Number. 4. Begin dictating at the tone.
5. Speak directly into the mouthpiece.
6. At the beginning of the dictation, give the following information: Physician’s name (for residents, your name and the attending physician’s name) Type of report Patient’s name – PLEASE SPELL Room number Dates of services: admission date, discharge date, date of surgery
7. Dictation Controls (phone keypad): 1 – Listen 2 – Record/Pause Toggle (This will toggle between Pause status and Record status. When on Pause, you will hear beep.) 3 – Review (Rewind) 4 – Pause (When on Pause, you will hear beep. To begin recording, press 2.) 5 – Complete (End this job and continue to dictate. Job ID # will be given at this time. It will then prompt you for two-digit work type and seven-digit medical record number.) 6 – Go to end of report 7 – Fast forward 8 – Go to beginning of report 9 – Disconnect (End this job and disconnect. Job ID # will be given at this time, and then you will hear Good Bye and be disconnected.) 0 – Help Menu – (Review all keypad functions.)
For Priority reports: To mark a job high priority, press *9 (asterisk and 9 key) anytime during dictation. You will hear a message that says you have made this a high priority. This will be done by the next available transcriptionist. We ask that you save this function for true priorities (patient’s going on transfer to another facility) this privilege can be turned off on an individual basis if it is being abused.
COMPLETION OF MEDICAL RECORD PROCEDURE
Physicians are responsible for completion of History and Physicals, Progress Notes, and Discharge Summaries on patients assigned to them. For residents, any exception to this rule should be cleared with the staff physician.
Abbreviations – A list of abbreviations approved by the Medical Staff for use in the medical record is on file in the Medical Record Department, on each nursing unit, and on the Hospital Intranet. Do not use abbreviations that are not on the approved list. If there is an abbreviation that your service uses and you do not find it on the approved list, please email the Director of Medical Records, Cynthia Henry at
II – O - 20 [email protected] and provide the abbreviation and definition. This will be forwarded to the Medical Record Committee for review.
Additional instructions follow:
History and Physical
Personal History and Physical Examination shall be completed within 24 hours of admission and shall include: Chief complaint History of present illness Past medical history Family history Social history Review of systems Findings of Physical Examination (including vital signs) Diagnostic impression Plan Date and signature of examining physician
A History and Physical shall be dictated and on the chart prior to surgery. If a patient is readmitted within a month’s time with the same or related condition, an interval note showing reason for readmission and physical findings must be documented. Dental patients, in addition to a History and Physical Examination by a physician, shall have a detailed description of the oral cavity by the oral surgeon. This may be in the form of an admission note.
Obstetrical patients shall have Prenatal History and Physical Records completed including Health History Summary, Initial Pregnancy Profile, and Prenatal Flow Record. Newborn Infants – Initial Newborn Profile shall be completed by the infant’s physician.
Progress Note
There shall be an admission note which documents the reason for admission. All patients having surgery shall have an Immediate Post-Op Note documented on the day of surgery, the first post-operative day, and frequent informative notes thereafter.
Physicians shall write notes with the frequency necessary to describe the patient’s changing condition. The notes shall document reasons for continued hospitalization, what is being done, and how the patient is responding. Complications and problems arising during care should be reflected in the Progress Notes.
Physicians, nurses, and other authorized personnel write notes chronologically on the patient’s Progress Sheet. Physicians use the full width of the page, and other personnel indent beginning at the thin green line.
II – O - 21 Operative Record
Shall be completed immediately following surgery (within one hour) and shall include the following: Pre- and post-operative diagnosis Title of procedure Identification of the patient Findings Description of procedure Signature of surgeon
Delivery Record
Shall be completed within 24 hours following delivery and shall include: Title of procedure Findings Description of procedure Signature of obstetrician
The OB record is on line and as part of documenting in the on line record you will be completing the required delivery record.
Physician Orders
Physicians shall sign all their orders whether written, verbal, typed, or stamped. Order for discharge shall be written and signed. Verbal orders shall be signed/dated and timed by the responsible physician within 24 hours. (At RH, physician’s printed name is the accepted “signature.”)
Discharge Instructions
A patient Discharge Instruction Summary Sheet must be prepared and given to each patient. Specialized instructions shall continue to be used and noted appropriately on the Discharge Instruction Sheet. The Discharge Instruction Sheet must be signed by the physician.
Discharge Summary (Including Deaths), C-Section, and Sterilization
Shall be dictated (within 30 days of discharge), including the following: Final diagnosis, listing diagnosis explaining admission first and all secondary diagnoses Why patient was admitted — medical necessity Pertinent findings (laboratory and physical) What was done — brief resumé of case — explain need for extended stay and consultation Condition at time of discharge Specific instructions at time of discharge, including medication, diet, and activity
II – O - 22 A final Progress Note may satisfy this provision in the case of normal deliveries and patients with problems of a minor nature who require less than a 48-hour period of hospitalization. The final Progress Note shall include any instructions given to the patient and/or family. The Newborn Discharge Summary (Hollister Maternal/Newborn Record System) shall be completed on all infants.
Summary Sheet
Shall be completed at the time of discharge. Shall include: All diagnoses with the diagnosis causing admission listed first Complications Operative procedures Disposition of the case Date of the dictation of the discharge summary Signature of the physician Date of signature
Records of discharged patients will be kept on the nursing floor until the morning following discharge at 06:30 to expedite completion of the record. Medical records will receive the records and prep and scan the documents within 24-48 hours of their receipt. At the point they have been scanned they will be viewable for all caregivers.
DELINQUENCY RULE
Physicians should complete records upon discharge of the patient. Records with items outstanding will be sent to your Digital Record Work list.
Weekly chart count is performed by Medical Records personnel. Physicians with incomplete records remaining for 7 or more days will receive a weekly notification letter, and are reported to the Department Director and VP of Medical Affairs when records reach 30 days or more.
RECORD STORAGE AND RETRIEVAL
Records Storage Information: The Medical Records Department maintains inpatient, Ambulatory Surgery, and Emergency records for all patients in hard copy format for four years. After four years, the records are placed on optical disk/microfilm, and retained for 25 years. Beginning with January 20, 2008 the Medical Record department began scanning the following records: Inpatient records, Ambulatory surgical records, urgent care records, and ED records.
Previous Records of Admitted Patients: These will be sent to the floor automatically. Records with a discharge or date of service prior to January 20, 2008 may be requested by calling x-8254. If these records are for a study/audit they must be reviewed within the medical record department on A3/B3.
Records Needed for Conference: Records needed for a conference may be signed out on the day of the conference, and must be returned upon its conclusion. II – O - 23 Radiology Films, Cine, CVL
All radiographs obtained by The Reading Hospital and its Imaging Centers are stored in the Records Center, Suite 10, Doctors Office Building.
Radiographic films are available to physicians for review in the Radiology Department, and can be loaned to physicians for further evaluation from the Record Center.
1. Release of Films
Call the Records Center at 484-628-4444, or fax the request to 484-628- 4416 to make arrangements for release of films. The following information should be provided at least 24 hours prior to film pick up:
Patient’s Medical Record Number or social security number Patient’s name and date of birth Study requested Name and location of physician requesting the films Specify if originals or copies of the films are needed Specify if copies of the reports are needed Specify if personnel from the doctor’s office or the patient will pick up the films Date the films will be picked up
Personnel from the doctor’s office should pick up x-ray films in the Records Center. INSTRUCT PATIENTS TO REPORT TO THE MAIN DESK IN THE RECORDS CENTER (DOB SUITE 10) TO PICK UP FILMS.
2. Cine Film
All Cine Film obtained by The Reading Hospital is stored in the Records Center. Cine Film is available for review, and should be requested from the Records Center. Cine Film is stored for seven years unless the patient is pediatric; then the film is kept seven years past majority (18 years old).
3. CVL
The Records Center stores the following Regional Heart Center information:
Cardiac Rehab Ultrasound Vascular Stress Test EKGs
II – O - 24 Cardiac Caths Holter Monitor Stress/Echo
Cardiovascular information is stored 10 years unless the patient is pediatric; then the information is kept 10 years past majority (18 years old).
II – O - 25 Information Management Services
LOCATION: AG & The Reading Hospital at Wyomissing
PHONE: 484-628-8863 HELP DESK: 484-628-8151
HOURS: Information Center/Help Desk
Weekdays 0700-1700 Saturday 0800-1200 Off-hour support provided by Operations
Operations 24/7
Data Communications Weekdays 0800-1700 On-call support provided off hours
PC Support and Services Weekdays 0800-1700 On-call support provided as needed
Systems Services Weekdays 0800-1700 On-call support provided off hours
Network Services Weekdays 0800-1700 On-call support provided off hours
Systems Development Weekdays 0800-2300 On-call support provided as needed
KEY STAFF: Mac McKnight – Vice President and Chief Information Officer
SERVICES PROVIDED
Information Center/Help Desk – Provide first-line support to our customers; diagnose and solve problems; educate customers; document requests for enhancements; and forward any problem that requires further intervention to appropriate staff.
Operations – Monitor all computer systems; notify appropriate staff of any computer malfunctions; back up all systems; schedule and initiate the execution of computer processes; schedule, print, and deliver reports.
Data Communications – Establish, troubleshoot, maintain, and monitor the network infrastructure of the organization that encompasses not only the local area network requirements but also the wide area network; provide hardware support for printers and miscellaneous equipment.
PC Support and Services – Build, troubleshoot, and maintain desktops and PCs for the Hospital and all affiliated entities; all procurement of PCs, servers, and peripheral equipment. II – O - 26
System Services – Install, troubleshoot, and support operating systems and databases across the multitude of hardware platforms.
Network Services – Install, troubleshoot, and maintain network operating systems and databases across all Intel-based servers.
Systems Development – Support, maintain, adapt, and implement all computer applications, install, maintain, and implement practice management software in physician offices.
II – O - 27 APPLICATIONS INSTALLED
Clinical NetAccess/Results History Physicals Opnotes Discharge Summaries Vitals Orders Medication Administration Record Lab Radiology Reports Radiology Images EKG Physician Order Management Clinical/Other Micromedex Up-to-Date (only available at the Hospital) EBSCO Physician Paging Medical Library Catalog Online Chart Port Discharge Electronic Signature Emergency Department Patient Tracking Orders (not medication) Trauma Alert Pharmacy Department Medication Administration Pharmacy Information System Suremed Kinetidex (dosage calculator) Drug Mixing Software (IVs) Rx Toolkit Lab Lab Information System Radiology Radiology Information System PACS Powerscribe Scheduling Cardiology Imaging EKG Scheduling Respiratory Care Treatment Tracking and Billing Speech and Hearing Audiology Software O/R O/R Information System Spring Ridge O/R Information System OB/GYN EMR Fetal Monitoring Infection Control Out Patient Information System Electronic Medical Record Patient Management Scheduling – Radiology
II – O - 28 Nursing Automated Kardex Plan of Care Orders Transfer Assessment Education Documentation Admission Assessment Discharge Management and Medical Reconciliation Care Management Automated Tools Medical Records Deficiency Coding Speech Recognition Data Quality Dictation/Transcription Registries Core Measures Digitized Records Financial Contract Management Cost Accounting ERP Payroll Decision Support Imaging Patient Accounting Patient Access Scheduling.com HDX Technologies Voice Over IP Wireless Access PDA
II – O - 29 Laboratory
LOCATION: C3 PHONE: 484-628-5227
HOURS: 24/7
KEY STAFF: William K. Natale, MD – Medical Director
SERVICES PROVIDED
Availability of Laboratory Services: The full complement of laboratory services is available Monday through Friday, 0700 to 1530 hours. The more clinically important and commonly ordered services are also available evenings, nights, weekends, and holidays; at these times, staffing in the Laboratory is reduced. Whenever possible, please order testing so it can be performed during the day shift. For more detailed test information, refer to the Laboratory Services Manual. If you need a copy of the Laboratory Services Manual, please call the Laboratory at 484-628-8615.
Test Ordering Priorities Routine Test – Collected on morning pick-up seven days a week, 0500 to 0800 hours. STAT – Immediate and imperative (anytime); clinically indicated. Do Today – Collected within three hours of request according to specified date and time. Timed Test – Collected within 1/2 hour of request according to specified date and time.
If the need exists for a test after AM collections but it is not an emergency, please order “DO TODAY” or for the following morning. If the test is urgent, order STAT. Do not abuse the STAT order. STAT procedures take approximately 45 minutes of turnaround time from the receipt of blood in the Laboratory. All STAT results are expedite-printed to the floor when completed.
Preoperative transfusion orders should be in the Laboratory by 1500 hours the day before surgery in order to have blood available for surgery the following day.
Glucose tolerance tests and other tests requiring serial blood collections at specific times must be scheduled with the collecting team. Call collecting at 484-628-8169 to schedule.
Recurring orders must be reviewed every three days.
Outpatient Tests – Specimens can be collected at any of our Laboratory Drawing Stations. The locations and hours of operation are listed on the Laboratory Request form. Please do not send patients outside listed hours.
II – O - 30 Service Concerns
STAT Abuse is a problem for the Laboratory and your physician colleagues. The “real STATs” are often obscured by a large number of tests which are ordered STAT for convenience. Be thoughtful in your use of STATs. Be aware that not every test is offered STAT and many cannot be done STAT — example, immunoassay procedures.
Venipuncture Repetition – Patients are plagued by multiple venipunctures, a phenomenon aggravated when several physicians participate in the care of the same patient. Multiple sticks also result when orders are written at random intervals during the day because tests were forgotten or omitted. Be organized in your ordering patterns.
Turnaround Times – Turnaround on tests ordered on holidays, evenings, nights, and weekends will vary, reflecting the Laboratory workload on that shift. These shifts are staffed to handle the normal workload, not peak workloads. Laboratory Costs – Repetitive testing runs up Laboratory charges. Order what you need for patient care, but avoid repeat testing which serves little function.
Special Procedures or Lab Problems – Please consult the Laboratory Services Manual on each unit; or contact the Lab Director’s Office at 484-628-8615.
Referral Testing – Tests which cannot be performed cost effectively on site are referred to accredited reference labs. Turnaround time for some of these tests is extended.
Patient Identification – All inpatients must have a wristband containing the patient’s full name, location, and social security number or medical record number (MRN). If this band is not available, Laboratory personnel will not collect samples for testing.
Requisitions and Labeling – All specimen request forms must contain the following:
Patient’s full name Room number or location Hospital medical record number (MRN) or social security number ICD-9 Code or narrative diagnosis to support medical necessity per HCFA requirements Physician name Date/time to be collected Priority Source (throat, conjunctiva, etc.) if appropriate Initials of collector Date and time of collection
All specimen labels must contain the patient’s name, location, and date and time of collection. Specimens and accompanying requisition forms must have a second patient identifier in addition to name, per JCAHO. The hospital accepts either birth date or MR
II – O - 31 number. It is institutional policy not to use social security numbers. The Laboratory policy is to refuse to accept specimens which are improperly labeled.
Emergency Release of Blood – The physician is required to sign for units of blood or blood products which are satisfactory for transfusions but do not satisfy every requirement of Blood Bank regulations.
Histopathology and Cytology – Comprehensive, rapid services are available as well as consultations with a pathologist.
Autopsies – Permission to perform an autopsy must be obtained from the appropriate individual as detailed on the Consent for Autopsy form; generally this is the closest living relative. Phone permission is acceptable. Phone permission can be conveniently arranged by having the Hospital Operator call the family, make the identification of the next of kin, and stay on the line as a witness while the physician makes the request. Physicians must sign the autopsy request after the permission is obtained. Physicians are encouraged to specifically list the clinical questions that they would like the autopsy to address.
Call Back and Critical Values are phoned immediately to the appropriate nursing unit (inpatient) or the ordering physician (outpatient). Inpatient critical values also expedite- print to nursing units. Refer to the Laboratory Service Manual or the Hospital Intranet for specific critical values.
Reflex Testing – In general, the Laboratory will perform only those tests which have been specifically ordered. However, in the interest of efficient, quality patient care, several “reflex” test patterns have been implemented which automatically direct the Laboratory to perform supporting or clarifying procedures in instances where it would be illogical not to do so. A list of these reflex tests can be found in the Laboratory Services Manual. On a case by case basis, requests for exclusion from, or modification of, these patterns will be evaluated by the Laboratory Medical Director.
OUTPATIENT TESTING
The Laboratory maintains 17 satellite locations throughout Berks County for the convenience of our patients. Appointments should be made for glucose tolerance testing, and this is done by calling the specific facility to which the patient is being directed. For information on their locations and hours, contact the Laboratory for a copy of the Laboratory Locations brochure (4-4227).
II – O - 32 Library Services
LOCATION: EG General Services: 484-628-8412 Library Director: 484-628-8418 Librarian’s Desk: 484-628-8359
HOURS: Monday – Thursday 0800-2100 Friday 0800-1700 Monday – Friday 0800-1700 (July and August)
24/7 access for RH residents via activated Hospital ID badge.
Research and borrowing privileges are for Hospital Medical Staff, residents, employees, and students.
KEY STAFF: Alexandra Short – Director, Library Services Cindy Spayd, MLS – Librarian Barbara Fichthorn – Library Assistant Valerie Schaeffer – Library Assistant
SERVICES PROVIDED
Objective – Library Services provides educational and informational resources and services to the Medical Staff, residents, employees, and students of The Reading Hospital. The staff is here to serve you. Please ask for assistance.
Resources – The Library contains more than 9,000 books, 15,000 bound volumes, and 150 active journal subscriptions. Audiocassettes, video programs, and CD -ROM education materials are also available.
There are 10 computers available for use, all with internet access. The Library is also wireless.
The Library actively collects materials in the areas of clinical medicine and allied health and healthcare management.
The Library has various database searching capabilities, such as Medline and PubMed. Other databases are available through EBSCOHost. In addition, Micromedex and Up- to-Date are available on the Hospital’s intranet.
Over 3100 journals are available online. For more information on which online journals are available, please ask the Library staff. These resources on the library system are networked throughout the Hospital, and may be accessed from various departments in the Hospital.
The Library has a special collection donated by the Michael Dunitz Crisis Foundation which includes books, video, and journals on the topics of death, dying, bereavement, and cancer.
II – O - 33 The Library staff can aid patrons on the use of the Library, show how to use the various resources available, and suggest means for carrying out a search.
REFERENCE SERVICES
Ready Reference – Answers to general questions, such as the address of a hospital, editor of a publication, etc., are available by walk-in or telephone requests.
Literature Searches – Professional reference help is available from 0800 to 1700 hours on weekdays.
Instruction on database searching is available on request from the Librarians. Various database computer searching is available on request from the Librarian.
Selective Dissemination of Information – Available upon request to provide a monthly bibliography of current articles on a specific subject.
Serials – The current issue of each journal is on display in the Hildreth Reading Room. Journal volumes and back issues are arranged alphabetically in the main stacks of the Library. Problems – If you cannot locate material, please ask the Library staff.
OBTAINING MATERIAL
Circulation Services – Borrowing privileges are accorded RH physicians, residents, students, and employees. Other individuals must ask the Librarian.
Reference books and unbound journals cannot be removed from the Library.
Books may be signed out for three weeks with two renewals. To renew, please call the Library.
Audiocassettes, CDs, and videos can also be borrowed.
Interlibrary Loan Services – Materials not owned by the Library can usually be borrowed or photocopied from other libraries. Forms for requesting interlibrary loans are available from the circulation desk. Urgent requests can be e-mailed or faxed within hours.
GENERAL INFORMATION
Photocopier – Available in the Library for use by RH physicians, residents, employees, and students. Personal copying will be charged per page.
Restrooms – Located in the Library.
Learning Resource Room – There is a private room in the library equipped with a computer, color printer, scanner and interactive whiteboard. This room can be reserved for group use. Please contact the library staff to reserve this room.
II – O - 34 Media Services
LOCATION: D2 and RG 914 (IN THE RG CONFERENCE CENTER)
HOURS: D2 Weekdays 0800-1700 RG 914 Weekdays 0700-1700
The Hospital offers a variety of media services that are common in most teaching hospitals. These services include audiovisual support for conferences, media production, and medical photography.
SERVICES PROVIDED:
Audiovisual Support
LOCATION: TV Studio – Thun/Janssen on D2
KEY STAFF: Greg Rakow – Manager of Media Services 610-988-8479 Jennifer Shumard – Sr. Media Specialist 610-988-8182
• Audiovisual hardware and software may be scheduled by using the e-application on the home page of the Hospital’s intranet. All requests must be scheduled well in advance.
• Users assume responsibility for the safety of all AV equipment, and are responsible for the return of the equipment to the location indicated on the e-application requisition form.
• Users of the podium/equipment in TJ Auditorium, R-Ground Conference Center or the B2 Seminar Room must be instructed in the use of the podium/equipment, and are responsible for securing the podium when finished using the equipment. Call Media Services at ext. 8182 for additional information.
• Problems with equipment are to be reported to the Media Services at ext. 8182.
• Arrangements for videotaping and other special production requests must be scheduled through the Manager of Media Services at ext. 5382.
Medical Photography
LOCATION: Photo Laboratory –G 2
KEY STAFF: Dennis Wojtowicz – Medical Photographer 610-988-8207
• Clinical Slide File: A file containing more than 2,500 slides on diseases, injuries, and other medical subjects is available in the Photography Lab. Slides may be signed out and must be returned after use. Slides are listed chronologically or by disease.
II – O - 35 • Production of Lecture Slides: slides for use in lectures can be produced in the Photography Lab. Please discuss your specific needs with the Photographer. A Photo Requisition Form (RH 2524) must be completed to request photo services.
• Photographic Services must be ordered at least five working days prior to the date needed.
• Patient Photography: The photographer can take photographs of patients during the regular work week (Mon-Wed-Fri 0800-1700 hours). Requests for service at other times must be submitted to Greg Rakow, Manager of Media Services. A Photo Request form (RH 2524) must be completed by the person requesting the photographic service. A full written description of the picture requested must be entered on the Photo Request form. In addition, a Consent to Photograph form (RH 2130) must be completed by the patient, next of kin, or legal agent and by the physician before the photographer will take the picture. This signed consent form should then be placed on the patient chart.
• Forms: Photo request and Consent to Photograph forms are available from Duplication Services. No photographs will be taken without completion of the Consent form.
Conference Room Scheduling
LOCATION: RG 914 (IN THE RG CONFERENCE CENTER)
KEY STAFF: Jennifer Shumard – Sr. Media Specialist 610-988-8182
The major conference rooms in the Hospital are scheduled through the Meeting Room Coordinator. These rooms are:
B2 Seminar RoomR2, R3, R4 Classrooms C2 Conference RoomN-Building Multipurpose Rooms Thun/Janssen AuditoriumTraining Center Conference Room Education Center – Rooms A, B, C, DR-Ground Conference Center
• Audiovisual hardware or software that is used in any of the conference rooms must be scheduled well in advance through the AV Coordinator. AV requisitions are found on-line, in the E-Apps section under “Meeting Rooms, A/V, Food Services”. Audiovisual hardware and software may be scheduled by using the e-application on this home page of the Hospital’s intranet. All requests must be scheduled well in advance.
Residents in charge of conferences scheduled in the Thun/Janssen Auditorium must meet with the AV Coordinator a minimum of one week prior to the conference to confirm their needs. If the AV Coordinator is not available, contact the Manager of Media Services.
II – O - 36 Media Production
Specific questions about media production that cannot be answered by either the Audiovisual Coordinator or the Medical Photographer should be referred to the Manager of Media Services. These topics could include special lecture slides or assistance in managing a presentation.
Specific Assistance
If the AV Coordinator or the Medical Photographer is not available and an extreme need exists, contact the Manager of Media Services at 610-988-5382, or have the Hospital Operator page the Manager of Media Services
II – O - 37 Nursing Services
Location(s) Nursing Administration office is located on B2 Office Contact: 484-628-8240.
A complete directory of patient care units with contact names and extensions for division directors, unit nurse managers, and educators is maintained on the hospital intranet online communication center/employee resources/contacts/patient care units
http://occ/empresources/contacts/Documents/hospital_patient_care_unit_contacts.pdf http://occ/empresources/contacts/Pages/ContactList.aspx?div=Hospital+Nurse+Managers http://occ/empresources/contacts/Pages/ContactList.aspx?div=Hospital+Nursing+Directors
The Department of Nursing Services encompasses the following care areas and services:
Inpatient Nursing
Critical Care Division o Medical ICU (N4W) o Surgical ICU (N4S) o Progressive Care Unit (R3S) o Inpatient Hemodialysis (R3) o Infusion Center (E Ground) o Vascular Access Team
Cardiac Respiratory Division o N2S – Heart Failure Unit (Mixed Acuity – Medical and PCU) o N2W – Cardiac Surgical (Mixed Acuity – Surgical and PCU) o N3W – Respiratory Unit (Mixed Acuity – Medical and PCU) o C1 – Medical Cardiac Unit o Central Monitoring Room (CMR) Services
Medical Division o E1 Stroke Unit (Mixed Acuity) o E2 Medical Unit o E3 Medical Unit o N3S Oncology Unit
Surgical Division o C3 Surgical Unit o N5S- Joint Replacement Center o N5W – Orthopedic Unit o R3E – Medical Surgical Unit
Psychiatric Services o Spruce P1 o Spruce PG II – O - 38 o D2 Psych Transition Unit
Maternal Child Health Services o R2S, R2E – Labor and Delivery, High Risk Perinatal o R1E – Mother Baby Unit o C2 Pediatrics o Neonatal Intensive Care Unit (R2)
Emergency Services o Emergency Department (NLL) o R4E Observation Unit
Cardiac Vascular Interventional Radiology Services o Invasive Cardiac o Non-Invasive Cardiac o Interventional Radiology
Additional Patient Care Services under the administrative oversight of the VP/Chief Nursing Officer (CNO) are:
Respiratory Services Chaplaincy Services Center for Mental Health
The CNO has oversight for nursing practice standards for all care settings in Reading Hospital, Reading Rehabilitation Hospital, and Reading Hospital at Spring Ridge and works collaboratively with vice presidents and directors who have administrative oversight for these areas.
Nursing Team Members and Responsibilities
1. VP/Chief Nursing Officer: Member of senior leadership team with administrative oversight for nursing services department, respiratory services, chaplaincy services and the Center for Mental Health. The CNO also has dotted line oversight for nursing practice standards for all of Reading Hospital (including Perioperative Services and Ambulatory Clinics); Reading Rehabilitation Hospital’s Acute Rehabilitation Unit (ASU) and Transitional Subacute Unit (TSU); and Reading Hospital at Spring Ridge. The CNO participates in Advanced Practice Nursing (APN) credentialing and serves as liaison to Reading Home Care.
2. Senior Director Operations: Oversight for clinical operations, budget, staffing office, and policy and procedure
a. Staffing Office, Nurse Manager: manages staffing support services i. House Supervisors: provide off shift and weekend supervision of nursing operations ii. Float Pool: Registered nurses and patient care assistants who “float” to units in need of staffing resources; maintain competency for all areas to which s/he floats II – O - 39 b. Nursing Office Manager: oversees nursing office administrative support staff; provides administrative support for the CNO and senior directors of nursing i. Office Support Staff: secretaries and time clerks support nursing operations, education and practice
3. Senior Director Clinical Practice: Oversight for clinical practice, patient experience, research, quality, education and patient education; serves as nursing representative to Patient Care Committee and other clinical practice interprofessional teams
a. Director Nursing Research: oversees nursing research and EBP activities b. Staff Development Core Educators: coordinate nursing orientation, continuing education and mandatory education; provide hospital wide education programs as needed c. ACLS and BLS Instructors: coordinate programs for all employees in the health system d. Patient Education Coordinator: oversees all patient education and health literacy for Reading Hospital, Reading Rehabilitation Hospital and Reading Hospital at Spring Ridge; serves as consultant for the rest of the health system e. Wound Ostomy Nurses: provide wound care consultation and clinical expertise for Reading Hospital and Reading Health Rehabilitation Hospital f. LMS Manager: oversees the Health Stream Learning Management System for all employees in the health system
4. Director Professional Practice: Oversees professional practice for the health system, including shared governance, nursing recognition programs, career advancement program, model of care, professional development, the Magnet project and the Center for Nursing.
a. Center for Nursing Web Coordinator: maintains Center for Nurses web portal
5. Division/Department Directors: Oversee operations of each division and development and implementation of programs within the divisions; administrative supervision of unit nurse managers, divisional clinical practice educators and clinical nurse specialists/nurse specialists.
a. Clinical Practice Educators (CPE): Each division has at least one masters prepared educator who is responsible for the coordination of staff orientation, training, and continuing education b. Clinical Nurse Specialists (CNS)/Nurse Specialists: Clinical nurse specialists are masters prepared advanced practice nurses, certified as a clinical specialists for a specific high risk patient population; CNSs work within divisions to drive quality improvement initiatives, evidence based practice improvements, collaborative protocol development, and nursing research; the CNS serves as a clinical expert resource for bedside nurses and provide interdisciplinary QI and program team leadership. A nurse
II – O - 40 specialist is a nurse enrolled in a CNS academic masters program or in a post masters CNS certificate program who is working in the specialist position under the direction of a certified CNS.
c. Nurse Managers: One nurse manager has 24/7 responsibility for each unit and manages all unit operations and quality of nursing care
i. Assistant Nurse Managers: larger units have assistant nurse managers who assist with unit operations ii. Core Facilitators: a core group of experienced nurses on each unit serve as facilitators who provide shift leadership; coordinate patient progression (admissions, discharges and transfers); assign patient care; conduct shift huddles; assure patient safety risks are addressed; oversee the unit’s care delivery; and is the immediate unit shift leader to whom issues are addressed. iii. Registered Professional Nurses: the RN is responsible for the holistic care of the patient and family and works collaboratively with other members of the health care team to assure care delivery is coordinated and patient/family centered. The RN oversees all nursing care of the patient. The RN assesses, plans, implements, and evaluates care. Registered nurses are provided orientation and continuing education and maintain competence specific to their specialty and the patient population they serve. The RN is supported in achieving national specialty certification to validate that expertise. iv. Licensed Practical Nurses: LPNs practice in TSU (transitional subacute unit), Cardiac Vascular Interventional Radiology Services, and in ambulatory clinics and physician offices. LPN Surgical and Anesthesia techs also practice in the perioperative setting. There are no LPNs practicing in ED, ARU (Acute Rehab Unit), or inpatient nursing units. v. Patient Care Assistants: PCAs are unlicensed assistive personnel who work under the direction of the RN and who assist in the provision of hands-on patient care that is delegated by the RN; PCAs are also assigned to 1:1 patient observation for patients who meet the criteria a 1:1 level of patient safety monitoring. PCAs are assigned “clerk” responsibilities as well, such as directing phone calls and unit visitors and assisting with arrangements for patient progression
Nursing Practice, Care Delivery and Assignment of Care
Nursing practice at Reading Health System is evidence-based and founded in the caring theories. Practice is congruent with the Pennsylvania State Code/Nurse Practice Act and the American Nurses Association Standards of Care and Professional Practice. In addition, specialty practice is congruent with nursing specialty practice standards. Nursing care delivery follows the Relationship Based Model of Care (RBC), which is a patient/family centered approach that focuses on the caregiver-patient relationship, healthy colleague relationships and care of self, without which optimal patient-centered
II – O - 41 care cannot be achieved. RBC builds on the foundation of the Reading Experience standards, so that nursing care not only provides the optimal experience for patients, but also a therapeutic relationship between patients and nurses that optimize healing, recovery, health promotion and outcomes.
Patient/family centered nursing care o Patient care is assigned to support continuity of care between care providers and patients. o Unit environments are designed to be caring and healing for patients, families, and care providers. o Units uphold the Reading Experience standards, including the No Pass Zone. o The RN conducts shift report at the patient’s bedside and includes the patient and family in the handoff and in the review of the plan of care. o The unit staff conducts meaningful rounds during each shift so that care is pro-active and anticipatory of patient needs. o At each patient bedside is a whiteboard that designates care team members and provides pertinent information for both patient and care team members. o Units use a variety of practices to get to know patients as individuals and to personalize care. o Nurses use “teach back” to assure effective patient education.
Nursing care is collaborative and nurses foster strong collegial relationships o Nursing teams uphold the Reading Experience standards in their interactions with colleagues. o Interdisciplinary care team rounds and discharge planning are essential components of nursing practice and patient care. o Nursing care is interprofessional and nurses are expected to effectively collaborate and communicate with physicians and colleagues to assure optimal quality and care experience. Nurses use SBAR communication. o Nurses participate in interdisciplinary MATT Simulation training.
Nurses and nursing team members practice self-care to more effectively care for others o Nursing staff encourage and support each other to schedule meal breaks and time “off stage” away from the patient care area to refocus and recharge.
Nursing Care Documentation and Patient Care Resources
Nursing assessment, care plan, care delivery, medication administration, and evaluation of care are documented in Reading Health Connect (RHC); Nurses follow RHC downtime procedures. II – O - 42 Nurses use Krames on Demand patient education enterprise, which is integrated into RHC. Nursing policies and procedures are available in the Policy Manager on the hospital intranet.
II – O - 43 Nutrition Services
LOCATION: H1 Kitchen 484-628-8323
OUTPATIENT NUTRITION COUNSELING LOCATION:
Inpatient RDs 484-628-8721 The Reading Hospital at Wyomissing ~ Outpatient RDs 484-628-8926 Food Service Supervisor 484-628-8330
KEY STAFF: Margaret Kipe, MS, RD – Director Jill Zelinsky, RD – Assistant Director
The Nutrition Services Department provides two levels of services: Clinical Nutrition Services Food Services.
CLINICAL NUTRITION SERVICES
Clinical Nutrition Services provide nutritional assessment, nutritional support, and nutrition education throughout the continuum of care. The Hospital is staffed with 22 Registered Dietitians, 20 who function exclusively in the delivery of Clinical Nutrition Services to all levels of patients. Clinical Nutrition Services operate under guidelines which are outlined in the Nutrition Care Manual information on the Hospital Intranet.
Inpatient Services Clinical Nutrition staff members provide nutrition care to patients identified to be at nutrition risk.
Outpatient Services Medical nutrition therapy and diet counseling are available for outpatients on an appointment-only basis. Physicians should contact 484-628-8926 to arrange the appointment. A written description of the diagnosis information and nutrition recommendations should be provided to the RD. HMO referral forms may also be necessary. Written reports of all education activity will be sent back to the referring MD or clinic.
FOOD SERVICES
Nutrition Services operates the patient feeding, cafeteria service, retail outlets and catering operations throughout the Hospital.
Retail Food Operations
Cafeteria
Breakfast: 0630-0900 Limited Service 0900-1100 Lunch: 1100-1400 Limited Service 1400-1630 Dinner: 1630-1900
II – O - 44
Patio Grille E Ground
Monday – Friday 0630-1400 Closed Weekends and Holidays
Tower Café R Ground Lobby
Monday – Friday 0700-2000 Weekends and Holidays 1100-1900
Counter Clockwise (Starbucks) B1 South
Monday – Sunday 0600-0400 Holidays 1730-0400
Catering Services Catering services are available for special educational meetings or functions. All requests for food/beverages must be processed via the Meeting/Room/AV/Food Services request found in the Electronic Applications section of the Intranet home page. Food orders must be submitted 72 hours in advance, beverage orders must be submitted 24 hours in advance. All catering requests must be approved by a department head and a department charge number provided.
II – O - 45 Occupational Health Services
LOCATION:
DOB Suite 2070 484-628-8437 The Reading Hospital at Muhlenberg 484-628-4000
HOURS: DOB – Weekdays 0700-1630
Muhlenberg Monday – Thurs 0730-1730 Friday 0730-1700
KEY STAFF: Margaret Atwell, MD - Medical Director Vera Guertler, MD – Staff Physician Tim Ferenchick – Staff Physician Beverly Pattillo – Staff Physician Charlotte Werner, RN BSN, Employee Health Manager Beth Roussel, RHIA – Program Director
SERVICES PROVIDED
Full range of occupational medicine services Employee Health Services for Reading Hospital employees and students Initial and follow-up treatment of work-related injuries and illnesses (workers’ compensation) Urine drug testing related to employment Breath alcohol testing related to employment Physical examinations and medical surveillance exams related to employment or state or federal requirements (DOT/CDL, fitness for duty, etc) Consultations on occupational health problems such as chemical exposure, occupational asthma, etc.
PROCEDURE FOR REFERRING PATIENTS
Outpatient referrals are made by calling 484-628-4000.
II – O - 46 Outpatient Services
LOCATION: A4 484-628-8103
HOURS: Weekdays times vary
KEY STAFF: Ellie Alderfer, MSN RN – Nurse Manager
SERVICES PROVIDED
The Reading Hospital offers the following outpatient clinics:
Clinic Day Time Notes Arthritis Friday, 2nd (all arthritis docs) 0800 - 1130 Friday, 4th (Dr George) 0800 – 1030 Cardiac Tuesday, Every week 0900 - 1200 Cleft palate Wednesday, 2nd, 4 times a year 0800-1200 Dermatology Wednesday, 1st and 3rd week 1230 – 1630 Friday afternoon, occasional (prn) 1230 – 1500 Endocrine Friday, 1st and 3rd 0800 -1100 Already on Epic Eye Mon, Tues, & Thurs, varies 0700-0900 Times vary Friday, every week 0700-0900 GI Monday, 1st thru 4th (no 5th) 0800-1200 Want to go on Epic GU Tuesday, every week 0700-1000 Infectious Dis. Friday, 2nd & 4th 0900-1200 Want to go on Epic Neurology Wednesday, First 0800 – 1200 Dr. Kolva Wednesday, Third 0800 – 1200 Dr. Reed Wednesday, Last 1300 – 1600 Dr. Brzozowski Thursday, Fourth 0900-1100 Dr. Lak Podiatry Thursday, Every week 1330 – 1630 Want to go on Epic Pulmonary Thursday, Third 0900-1200 Surgical Monday, every week 1230-1430 Already on Epic Thursday, every week 1230-1430 Trauma Monday, every week 1230-1430 Already on Epic Thursday, every week 1230-1430
* needs referral
Children’s Health Center
LOCATION: Children’s Health Center (U-Building) 484-628-5437
HOURS: Weekdays
KEY STAFF: Robert Paul – Director Louis Mancano, MD – Medical Director
SERVICES PROVIDED
Primary care for pediatric patients
II – O - 47 Women’s Health Center
LOCATION: B1 484-628-9797
HOURS: Monday – Thursday 0700-1700 Friday 0700-1630
KEY STAFF: Maria Phillips, CRNP – Director
SERVICES PROVIDED
The Reading Hospital offers the following outpatient clinics (located on B1):
SERVICE DAY HOURS Gynecology Srevices Mon – Fri 0800 – 1630 Prenatal Appointments Mon – Fri 0800 – 1630 Colposcopy Tues 1300 – 1630 Wed 0800 – 1130 Every other Fri 1300 – 1630 Leep 4th Wed 0800 – 1130 2nd Fri 1300 – 1500 Family Planning Mon – Fri 0800 – 1630 Urodynamic Testing* Mon, Tues, Wed 0800 – 1200 Urogynocologic Clinic Every other Fri 0830 – 1200 Bladder Retraining & Biofeedback* Thurs 1200 – 1600
* ALL urodynamic testing and bladder training/biofeedback sessions are conducted in Suite 325 of the Doctors Office Building.
General Information
ATTENDANCE
The Program Director will assign outpatient services rotations and responsibilities. If for some reason a resident is unable to be present at the scheduled time, a substitute must be provided to cover that session, or at least one month advance notice must be given to modify the schedule. The Outpatient Services Department, Children’s Health Center, or Women’s Health Center should be advised as to who is covering for the absent resident.
In the event of vacation, military leaves, out-of-town seminars, and other activities which cause a resident to be absent from assigned rotations, please advise the Outpatient Services Department, Children’s Health Center, or Women’s Health Center well in advance so that the patient appointments may be reassigned.
Residents are responsible for rescheduling their time in order to meet their respective Program requirements.
II – O - 48 APPOINTMENTS
All patients are scheduled by appointment only. The level of the resident and the illness of the patient are taken into account when scheduling the amount of time needed for a visit. If there are any problems associated with patient scheduling, please discuss the matter with the Nurse Manager.
NEW PATIENTS
As much as possible, new patients are not registered during June or July. In an effort to provide continuity of care, a letter of referral is requested from the referring physicians as well as records of previous treatment received.
II – O - 49 Pharmacy
LOCATION: Central Pharmacy – D3 484-628-8105 STAT Parenteral Satellite – Emergency Department 484-628-5092 Cancer Infusion Center – N-Ground 484-628-0942 Reading Health Rehabilitation Hospital Pharmacy 484-628-2632
HOURS: Central Pharmacy: 24/7 STAT Parenteral Satellite: 24/7 Cancer Infusion Center: 0700–1700/Weekdays Reading Health Rehabilitation Hospital Pharmacy: 0700–2100/7
SERVICES PROVIDED
The Pharmacy Department offers 24 hour service at the Reading Hospital. The utilization of automated dispensing technology minimizes the amount of dispensing that is required of staff pharmacists. The institution utilizes computerized medication administration records in conjunction with bedside bar-code technology to maximize patient safety. Pharmacists validate medication orders from the pharmacy as well as on nursing units where they interact with patients, physicians, nurses, and other healthcare professionals. Members of the pharmacy staff participate in multi-disciplinary rounds with teams from the Departments of Surgery, Medicine and Pediatrics. The Pharmacy offers a one year residency program and provides experiential education for pharmacy students through affiliations with five Schools of Pharmacy. Pharmacy Medication Collection technicians working in the Emergency Department interview patients, caregivers and outpatient providers to obtain the most accurate list of medications taken prior to admission along with allergy information.
The Hospital has an approved Formulary, which may be accessed electronically via the weblinks on Hospital home page. The Pharmacy performs generic and therapeutic substitution by policy as approved by the Pharmacy and Therapeutics Committee (a Medical Staff Committee).
Dosing by pharmacy is available to physicians as an option on a variety of commonly prescribed parenteral antimicrobials including aminoglycosides, beta-lactams, vancomycin. acyclovir and levetiracetam. Pharmacists may automatically convert approved medications from parenteral to enteral routes of administration by protocol. Pharmacists from the Reading Hospital manage patients in the Reading Hospital Anticoagulation Clinic via protocols and collaborative practice agreements and participate in Advancing Wellness and Primary Care Plus initiatives providing discharge and follow-up patient education.
II – O - 50 Physical, Occupational and Speech Therapy
Outpatient Physical Therapy Services
LOCATIONS: Reading Hospital at Wyomissing Plaza, 2101State Hill Road, Wyomissing, PA 19525 Reading Health Rehabilitation Hospital, 2802 Papermill Road, Wyomissing, PA 19525
PHONE: 610-741-0300 HOURS: Weekdays 0700-1900
Referrals
Provide the patient with a written prescription that indicates: The referral diagnosis and diagnosis codes Therapy Discipline and desired evaluation/treatment (indicate evaluate and treat) Length of therapy program (in weeks) Specific precautions to be observed, if any
Have the office or patient call 484-628-0300 to schedule the initial appointment:
Communication/Information Provided to the Referring Physicians Formal written evaluation following the patient’s initial visit:
Therapy progress report as appropriate indicating: Current status of problems and goals Additional treatment recommended
Therapy Services Provided See Brochure
Specialists: See Directory
INPATIENT THERAPY SERVICES
LOCATION: Administrative office area located on D2 North
PHONE: 484-628-8884 FAX: 610-628-5196 HOURS: Weekdays 0645-1700 Weekend therapy is provided to priority patients 0700-1630, that if seen most likely will be discharged from the hospital.
DIRECTOR: Carol DeLapp – Director – 484-628-0250
II – O - 51 Referral Process in EPIC
On admission, an OT/PT/SLP screen is performed by the bedside nurse on every patient to assist in identifying those individuals who are in need of skilled therapy services. If the need for skilled therapy services is identified based on this screen, an order will be generated by the RN and sent to the attending MD via EPIC for co-sign. Once the order is co-signed by the physician, therapy will receive notification of a pending consult. Based on OT/PT/SLP state practice acts, therapy orders must be signed by a licensed MD, PA, or NP working in collaboration with a MD, prior to the initiation of therapy evaluation.
OR
At any time a physician can write a consult for Occupational, Physical or Speech Therapy via order entry in EPIC.
To consult Physical Therapy: Select Physical Therapy Eval & Treat To consult Occupational Therapy: Select OT Eval & Treat (Occupational Therapy) To consult Speech Therapy for bedside swallowing evaluations: Select SLP Clinical Swallow Eval & Treat To place an order for a video swallow study: Select Videofluroscopic Swallowing Study (panel) For all other Speech Therapy needs (language, voice, cognition,..): Select Speech Eval & Treat
* Please note, if you receive a “duplicate order notification” please, DO NOT continue to write another order.
You will be triggered by EPIC to answer the following questions
Reason for PT consults?
o If consult is not generated by a protocol order then please appropriately select the patient type classification.
. Example: patient admitted with UTI = general, patient s/p femoral- popliteal bypass = vascular
Anticipated Discharge?
o Identify the patient’s discharge plan to help with prioritizing the delivery of therapy services. The three levels are:
II – O - 52 . DC today: if seen by therapy the day of referral, patient with potential for D/C on date consult was placed . D/C tomorrow: if seen by therapy the day of referral, patient with potential for D/C within 24 hours . DC is within 2-3 days of order. Therapy to be initiated within 24 hours of order . DC is not likely for 3 days or more. Therapy to be initiated within 24 hours of order, unless affected by priorities.
In addition, please identify specific precautions to be observed, as appropriate
Communication/Information Provided to the Referring Physician
Initial findings about transfer and ambulation skills (PT), Activities of Daily Living (ADL), safety, functional status and problem solving (OT), and swallowing and speech/language/cognitive-linguistic skills (SLP), can be found in the “notes” section of EPIC.
Initial problem list, goals and the treatment plans are recorded on the multidisciplinary Plan of Care.
Therapy evaluation, progress, missed and discontinuation of services notes are located in the “notes” section of EPIC. These notes include the current functional status, treatment provided, established goals and any recommendations or concerns.
How to Contact a Therapist
The therapists utilize the Vocera system. You can contact a therapist by dialing x-3300 and stating their name. If you do not know what specific therapist you are attempting to contact, please state the floor of the patient and the discipline you desire to contact. Example: E3 Physical Therapist, N2 Speech Therapist
Additional Information: If you place the column “Treatment Team” on your EPIC my-list, you will know what therapist is seeing your patient on that specific day. This list is updated daily by the therapy staff.
Therapy Services Provided
Occupational Therapy
Activities of daily living (ADL’s – this includes but is not limited to: bathing, dressing, eating, toileting, transfers) ROM exercises – upper extremity Strength testing and exercises – upper extremity II – O - 53 Neuromuscular re-education to facilitate purposeful motion Perceptual motor retraining Cognitive skills Sensory re-education Introduction and training of the use of assistive and adaptive equipment Orthotics/splints – primarily upper extremity Positioning Activity modification, safety education NICU evaluation and treatment – positioning, tone, feeding
Physical Therapy
Balance and coordination training Therapeutic exercise for improving range of motion and strength Postural re-education Functional mobility, gait training Transfer training Neuro-muscular re-education to facilitate purposeful motion Equipment recommendations for safe ambulation Cardio-pulmonary education and energy saving techniques NICU evaluation and treatment – positioning, tone
Speech Therapy
Bedside swallow studies Speech/language evaluation and treatment Cognitive/ linguistic evaluation and treatment Video fluoroscopic swallow studies – modified barium NICU – swallowing assessment, feeding
If there are questions about what therapy services are provided, please contact:
Inpatient Therapy Department at 484-628-8884 Ask to speak with the Therapy Director (x0250) Clinical Supervisors (x8884).
II – O - 54 Post-Acute Continuum The Rehabilitation Center Transitional Care Center The Rehabilitation Clinic
HOURS: 24/7 PHONE: Referrals 610-752-263 (Speed Dial 2321)
The Rehabilitation Center LOCATION: E2N / E2S ...... PHONE: 484-628-4496 / 484-628-4498
Transitional Care Center LOCATION: E3N / E3S ...... PHONE: 484-628-8225 / 484-628-8220
The Rehabilitation Clinic LOCATION: E3 ...... PHONE: 484-628-4560
Post-Acute Continuum general information ...... PHONE: 484-628-9066
POST-ACUTE CONTINUUM
The staff offers an array of inpatient and outpatient services for individuals who have experienced functional loss or disability as a result of accident, illness, or injury. Our goal is to help patients achieve their maximum level of functional independence with measurable outcomes.
We are patient-focused and provide family-oriented care. Individualized and flexible treatment plans are provided by interdisciplinary teams.
Quality care is the cornerstone of our services.
INPATIENT SERVICES
The Rehabilitation Center
44-bed, Hospital-based comprehensive physical rehabilitation program, located on E2. Most intensive inpatient service of The Reading Hospital, offering a minimum of three hours of physical, occupational, and speech therapy per day for a minimum of five days per week. Program physicians are located in The Rehabilitation Center for regular coverage. Accredited by CARF, the Commission of Accreditation of Rehabilitation Facilities (CARF) for Comprehensive Integrated Inpatient Rehabilitation.
II – O - 55 Transitional Care Center
50-bed, inpatient unit providing subacute medical and rehabilitation services, located on E3. This is a transitional level of care between acute Hospital care and home, or between acute care and comprehensive rehabilitation. Services may include a combination of nursing and therapy interventions. Our Medical Director is available to follow patients.
ADMISSIONS TO THE REHABILITATION CENTER OR TRANSITIONAL CARE CENTER
Call 610-752-2639 (or speed dial 2321) to make a referral for a patient assessment/evaluation, or to learn how a patient can be admitted from The Reading Hospital, Emergency Department, another hospital, extended care facility, personal care home, or home.
II – O - 56 Psychiatry
LOCATION: Spruce Pavilion 484-628-9027
HOURS: 24/7
SERVICES PROVIDED:
Inpatient Psychiatric Care Adult Partial Hospitalization Program Adolescent Dual-Diagnosis Intensive Outpatient Program Adolescent Partial Hospitalization Program Outpatient Mental Health Services Geriatric Extended Care Facility Services Geriatric Assessment and Outpatient Services
KEY STAFF: Kolin Good, MD – Department Chair and Medical Director for CMH and the DAC James Hehn – Department Administrator Vicki Miles – Assistant to the Chair
Introduction:
The Department of Psychiatry represents the Behavioral Health component of The Reading Hospital. The Department of Psychiatry consists of a number of programs and services, including inpatient, outpatient, residential treatment and intensive outpatient services. Inpatient treatment is provided by the Spruce Pavilion, which is a 40 bed psychiatric facility. Outpatient services are provided by The Center for Mental Health (TCMH), which is a comprehensive behavioral health treatment center. The department also has a residential drug and alcohol program and an Assertive Community Treatment Team (ACT).
The department provides mental health and substance abuse treatment to individuals of all ages, races, and socioeconomic status. The department serves both public and privately funded patients. Prospective patients come from a wide geographical area that includes but is not limited to Berks County and five surrounding counties. The types of patients served range across the entire spectrum of psychiatric disorders.
The department is committed to a Recovery-based philosophy that encourages consumer empowerment and active participation in treatment.
II – O - 57 Services Provided:
Inpatient Services – The Spruce Pavilion provides short-term acute care psychiatric treatment.
The unit is divided into 2 component programs;
General Adult Program Geriatric Program
Outpatient Services – TCMH offers an array of services, which include psychiatric and psychological assessment, medication evaluation, monitoring, intake, psychotherapy (group, individual, marital, and family), and consultation & education. Component programs include:
Outpatient Mental Health Services Willows Program Nursing Home Consultation Services Senior Assessment Program (with the Department of Internal Medicine) School Based Services (Student Assistance and School Based MH Satellites) Drug & Alcohol Residential Detoxification Program and Rehabilitation Program The Group Center Adult Partial Hospital Program Geriatric Psychiatry Services Partners Adolescent Partial Hospital Program Transitions Alternative Mental Health School Classroom Program College Counseling (at Albright College, and Penn State-Berks) Employee Assistance Program Assessment Service For Hospital Employees Tobacco Free Wellness Center Assertive Community Treatment Team (ACT) DBT Emergency Services through the ED and the Psychiatric Transition Unit Work Closely with Berks County MH/DD Crisis Services
Service Delivery:
Both the Spruce Pavilion and TCMH utilize a multidisciplinary team approach. Treatment is provided by staff from a variety of disciplines including psychiatry, psychiatric physician assistants, psychology, social work, nursing, activity therapy, and substance abuse counseling. Staffing patterns from all the programs meet the requirements of governmental regulating bodies.
In addition, the department complies with the requirements of provider panels of various managed care companies, many of which require an extensive credentialing process in order to ensure that staff are competent to perform their duties.
The department employs a biopsychosocial treatment model, taking into account multiple factors leading to psychiatric disturbance. Patients are evaluated prior to treatment. Treatment methods are in accordance with the established standards of each discipline. Treatment is provided in the least restrictive manner with level of care assignment being based on medical necessity.
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Collaboration within the department is essential to providing quality services. In order to facilitate collaboration intradepartmental staff meetings (including intradepartmental treatment team meetings) are scheduled on a regular basis, with a goal to provide a seamless service within the department.
Additional Services:
The Department of Psychiatry interacts with other departments within the hospital concerning patient issues. Consultation/liaison services are provided to patients and their families in the Reading Hospital and the Post Acute Continuum. In addition the department serves as the primary assessment and referral service (Employee Assistance Program) for all hospital employees and family members.
The Department of Psychiatry conducts psychiatric conferences and other training sessions that are both departmental and interdepartmental. It sponsors three continuing educational series (Psychiatric Grand Rounds, Treating Teens Series, and the Willows Program Senior Mental Health Series). It also provides educational seminars for the Departments of Pediatrics and Family Medicine on Child and Adolescent Psychiatric topics, as well as teaching sessions for the RH Family Medicine and Internal Medicine residencies and OB GYN and Internal Medicine Grand Rounds.
The Department of Psychiatry provides a comprehensive consultation service available to all departments within the hospital. This service is available on a 24 hour a day, 7 day a week basis by psychiatrists, psychologists, and other mental health professionals as indicated. Psychiatric Assessment and Crisis Intervention are also carried out in the Emergency Department through the Emergency Department Social Work Team, supervised by Department of Psychiatry attendings on-call.
The Department of Psychiatry participates in the life of the hospital in a number of additional ways. The Chair of the Department of Psychiatry sits on the Patient Care Committee, Graduate Medical Education Committee, the Ethics Committee and other committees throughout the Reading Health System. The former Chair of Psychiatry is the Chairman of the Physicians Health Committee. Faculty in psychiatry sits on the Continuing Medical Education Committee, Pain Management Committee, and on other significant committees within the medical staff.
The Department of Psychiatry provides comprehensive teaching and educational services as well as training services, including an APA approved pre-doctoral internship in psychology.
The Department of Psychiatry also oversees the Tobacco Free Wellness Center, which provides bedside consultations to any tobacco-using individual within the hospital and the “Breathe Easy” tobacco cessation classes to hospital employees and the community at large.
II – O - 59
Radiology
LOCATION: C1 484-628-8108 HOURS: 24/7
KEY STAFF: Elaine Lewis, MD FACR – Department Chair Beverly Stoudt – Administrative Director
SERVICES PROVIDED
Staff Information
A Staff Radiologist is on-site 5:45 AM to 23:00 PM 7 days a week. . During other hours, a Staff Radiologist is available on an on-call basis. Radiological technologists are on duty in the department 24/7.
Sections of the Department The Radiology Department is comprised of four sections: Diagnostic Imaging, Interventional Radiology, Nuclear Medicine, and Radiation Oncology.
The Diagnostic Imaging Section provides physicians with a full range of radiological studies, including ultrasound, computerized tomography (CT scans), and magnetic resonance imaging (MRI).
The Interventional Radiology Section, staffed by 6 interventionalists including 3 neuro interventionalists, provides a wide range of diagnostic and therapeutic services, including peripheral and pulmonary arteriography, thrombolysis, angioplasty and stenting, biopsy, IVC filters, vertebroplasty, embolization, port insertions, and central venous catheter placement.
Nuclear Medicine offers complete diagnostic and therapeutic services using radioactive isotopes. Imaging studies include bone, lung, CNS, renal, endocrine, lymphatic, cardiovascular, gastrointestinal, and hepatobiliary examinations. A wide variety of tumor imaging agents are available, including radiolabeled monoclonal antibodies. SPECT, SPECT/CT, and PET/CT imaging is available. White blood cell labeling is performed through radiopharmacy. Therapeutic services include thyroid (hyperthyroid and thyroid cancer), palliative treatment for painful boney metastases, and Xiofigo administration for extension of life of prostate cancer patients. Bone densitometry is offered through Nuclear Medicine.
The Radiation Oncology Section delivers precision radiation therapy primarily for the treatment of cancer. The department is equipped with a Trilogy® stereotactic system, two dual energy linear accelerators with electron beam capability and multileaf collimators, sophisticated treatment planning computers that are capable of intensity modulated radiotherapy, stereotactic radiosurgery, and radioactive sources for intracavitary and interstitial brachytherapy. Radiation therapy is given weekdays from 0700 to 1630. Physicians are available after- hours and weekends for emergency consultation.
II – O - 60 Support
The Radiologist should be viewed as a consultant. The staff is available for consultation on interpretation of images and the proper selection of examinations. The newer diagnostic modalities are complex procedures, and the Radiologists are glad to assist in the proper sequencing of these studies.
Reports
Every effort is made to perform and dictate all examinations within 24 hours of the request. The reports are available on Epic in preliminary and finalized statuses. A PACS system provides access throughout the Hospital for viewing the images from a patient’s examination via Epic or on hospital desktops.
An examination-based history should be provided for each imaging study ordered. Although “Rule out _____” may be quite useful to both the clinician and the Radiologist as shorthand for the reason for the exam, it, by itself, is not adequate. What is generally required is a diagnosis (i.e., asthma, colon cancer), a sign (i.e., fever, tachycardia), or a symptom (i.e., pain, shortness of breath, etc.). The care of your patients will benefit from the availability of this pertinent information.
OUTPATIENT TESTING
The Radiology Department offers outpatient testing, including MRIs and CT scans, at 11 satellite locations throughout Berks County. Appointments are required. For information on locations, hours, and services available at each site, contact Radiology for a copy of the Radiology Locations brochure (4-4228 Rev 10-13).
II – O - 61 Respiratory Care
LOCATIONS:
OUTPATIENT SERVICES: EG PHONE: 484-628-8677 INPATIENT AND ADMINISTRATIVE SUPPORT: A3
HOURS:
Inpatient Care 24/7
Pulmonary Function – EG Monday & Friday 0700-1530 Tuesday & Thursday 0700-2000
Sleep Center – EG 7 nights/week
Pulmonary Rehabilitation – EG Weekdays 0700-1530
KEY STAFF: Richard Bell, MD – Medical Director Ronald Sherman, RRT – Director of Department
SERVICES PROVIDED
Respiratory Care Department PHONE: 484-628-8677
arterial punctures aerosol therapy incentive spirometry chest percussion and postural drainage – consult only respiratory therapy consult bedside spirometry high humidity – via aerosol mask (continous or prn) assist in mechanical ventilation (adult and neonatal) breathing exercise (diaphragmatic breathing, lateral costal breathing, coughing techniques) metered dose Inhalers patient education pulse oximetry (adult and pediatric) bronchodilator assessment protocol bedside pulmonary parameters (VC, NIF, VE, rr, VT) peak flow measurements
II – O - 62 Pulmonary Function Laboratory PHONE: 484-628-8026
spirometry spirometry before and after bronchodilators mecholyl provocation testing lung volumes diffusing capacity (single breath) arterial blood gas punctures resting/exercise testing (oxygen desaturation)
Sleep Center PHONE: 484-628-8749
sleep disorder testing multiple sleep latency testing infant pneumograms
Pulmonary Rehabilitation PHONE: 484-628-9860
Inpatients: physicians should write an order for a consult on the Physician Order sheet in the patient’s chart. After discharge, a full patient evaluation will be completed to assess patient needs, and an individual program will be tailored to that patient.
Outpatients: Physician offices may schedule outpatients by contacting the Pulmonary Rehabilitation Department.
Special Services Offered:
cardiopulmonary stress testing calorimetry testing
II – O - 63 Speech and Hearing Center
LOCATION: Location: R1 & State Hill Road 610-741-0302
HOURS: Weekdays 0800-1630
KEY STAFF: Elca Swigart, PhD – Director
SERVICES PROVIDED
Audiology – Neonate, Pediatric, Adolescent, Adult
audiologic evaluations (pure tone and speech) middle ear impedance test (tympanometry, stapedius reflex, and reflex decay) auditory brainstem response (ABR) for hearing sensitivity of infants and patients difficult to test by standard audiometry for site-of-lesion assessment otoacoustic emission testing central auditory processing evaluation hearing aid evaluation hearing aid dispensing baseline and serial audiograms for toxicity monitoring cochlear implant assessment for candidacy rehabilitation follow-up diagnostic evaluation for newborn hearing screening refers supervision of Reading Hospital’s universal newborn hearing screening program
Speech-Language Pathology: Evaluation and Therapy – Pediatric (2 ½ through 17 years)
For disorders involving any of the following; articulation expressive language language comprehension resonance fluency voice auditory processing pragmatics (social skills)
II – O - 64