Harbor-UCLA ED Newsletter
August 15, 2025
WikiEM Harbor Main
🚨 TL;DR – Quick Hits
Mon Aug 18: no more routine COVID tests for asymptomatic admissions (psych patients still require testing)
Also, Mon Aug 18: OOP urgent referrals! – a new initiative for <12-day specialty follow-up for non-DHS patients (ICD10, phone number(s), finalized ED note required).
Sepsis compliance: 82% – recheck lactates until <2; document reassessments.
Pediatric ortho: Now handled in-house – no LA General transfer for DHS patients.
EMS: Activate all 911-retriage patients as TTA2/TTA1 as appropriate.
ORCHID: New ED Provider Discharge Process + updated interpreter documentation form.
1️⃣ ED Operations
🧪 COVID Testing Policy – Effective Mon Aug 18
No more routine COVID tests for asymptomatic admissions! (Key is ASYMPTOMATIC)
Continue testing for all psychiatric admissions (we don't want an outbreak in the entire psych ward or psych floors... again). If patient has respiratory symptoms or fever, err on the side of testing.
📅 Out-of-Plan (OOP) Urgent Specialty Referral Pilot
We can now arrange urgent specialty follow-up (<12 days) for non-DHS patients.
Process:
01
Place "request for urgent specialty follow-up" order as soon as need is identified.
02
In comments, write "OOP" + specialty + reason.
03
Enter a real ICD-10 diagnosis code.
04
Complete ED note (brief is fine, but UM needs this to send info to the OOP health plan coordinators)
05
Ensure at least one good phone number (preferably two).
PAC/UM Role:
  • Contact insurance, book appointment, aim to inform patient before discharge (~2 hrs during business hours).
  • After-hours requests handled next business day.
Backup plan:
Ask patients to call their insurance/PCP in 2–3 days if they haven't heard from us. Pilot success: All patients so far got follow-up within 1–2 days.
Contact: Dr. Parmar or Dr. Jen Roh
Details: WikiEM – OOP Follow-Up Options

wikem.org

Harbor:OOP follow up options - WikEM

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📝 Other August Ops & Flow Reminders
Specialty Booking
Review DHS Specialty Clinic Referral Guidelines for all bookings.
Missed Appointments
If a patient misses a DHS specialty appointment, they can call 855-521-1718 to reschedule.
Nephrology
For tPA dialysis access, contact the dialysis nurse directly, not the ED nurse.
Trauma Calls
Notify trauma services for all admitted patients with a traumatic mechanism, excluding isolated hip fractures.
🚑 Triage Physicians & APPs
Order pain meds for RME patients.
Don't routinely order extra labs/meds for WR patients — coordinate with RME charge if you would like 2nd round tests/orders.
Flag ready-for-discharge patients by changing team to "Teal."
YAFT: All ESI 4/5 patients age 21–25 → PED unless "NO PED" noted.
⚡ Fast Track Physicians & APPs
  • FT improvements coming — Surge Attending shift planned.
  • Create TEAMS chat for FT team comms.
  • Contact attendings for urgent questions.
  • R4s: Update dotphrase to reflect cases seen independently.
  • Peds Rooms 8–11: Use for adult FT (>25) when PED is not busy.

Contact: Dr. Jen Roh, AED Medical Director and/or Dr. Brad Chappell, VC of Operations
2️⃣ Quality Improvement & Clinical Corner
🦠 Sepsis Update
82%
April compliance
Fantastic job! This is the highest our Dept has achieved in years!
Reminders: Recheck lactates until <2 and document reassessments after IV fluids.
Shoutouts: Dr. Roh, Dr. Claudius, Crystal Gutierrez, Liz Leon, Dr. Devika Nadkarni, ED Nursing leadership, Hospital QI Sepsis Team.
Infection Prevention Reminders
Alcohol wash before/after every patient encounter; soap + water for C. diff or bloody/soiled hands.
Use sterile technique for all non-crashing patients.
Avoid placing open ET tubes pre-intubation to prevent VAPs.
📋 Patient Safety & Regulatory
  • Disclose + document incidental findings.
  • Follow coroner rules for qualifying deaths; amend notes + re-contact coroner if info changes post-discharge.
  • *see main ED Newsletter for the details

Contact: Dr. Claudius, EM QI Director
3️⃣ Pediatric ED Updates
Follow-Ups
10 a.m. intern/resident does weekend/holiday follow-ups.
Pediatric Ortho
DHS patients now handled at Harbor (Dr. Badkoobehi, Dr. Zinar on nights). OOP patients → PMD/Shriners/Luskin Ortho UC.
Peds Radiology
Dr. Chawla on call most of month; follow transfer protocols when unavailable.
YAFT Clarifications:
  • ESI 3 (21–25): Work up in AED before transfer.
  • ESI 4/5: PED can see if within scope; attending must also see patient.
  • Use Peds Rooms 8–11 for AED adult FT when PED volume allows.
Contact: Dr. Patricia Padlipsky, PED Medical Director
4️⃣ EMS & Disaster
  • Activate All 911-retriage patients as at least a TTA2 (TTA1 as appropriate — refer to your badge card)
  • Follow internal trauma guidelines for MAC transfers.
^This does NOT include MAC transfers
Contact: Dr. Kelsey Wilhelm, EMS Medical Director
5️⃣ ORCHID Updates
New ED Provider M-Page Discharge Process on ED Summary Tab now live.
Easier patient info edits from ED Provider Discharge mPage → Modify Patient Information.
New PLIN form to document interpreter services (green check to save).
New Discharge Tab
New PLIN Form
🙏 Thanks for Reading!
For updates, group photos, patient stories, or reflections, email Dr. Jen Roh at [email protected]