Who should call for patient records?

The handling of advance directives and tracking patients with drug-resistant infections are two issues for which Jeff Williamson, CHAM, admissions manager at Sibley Memorial Hospital in Washington, DC, would like feedback from his peers at other hospitals. He’d like to know how other facilities proceed when a patient has been to the hospital before and has a documented advance directive in the medical record.

"The nursing staff wants admissions to call medical records when the patient is admitted and have the chart sent to the floor," he says. "My position is, this is a nursing issue and they should call medical records if they want the chart on the floor. We don’t have time to make those calls. How do others handle this? Is there an automatic notification to medical records to send something to the nursing floor? We have enough to do without remembering to call medical records to have a chart sent upstairs. The nursing unit typically asks to look at the chart, anyway, for other issues."

Tracking drug-resistant patients

Williamson also asks how other hospitals track patients with drug-resistant infections such as MRSA and VRE. "These are patients that typically do not respond to conventional antibiotic therapy, so they carry [the infection] around for a long time," he says. "Our infection control department has asked us to come up with a way to track these patients so when they show up, we’ll know to put them in a private room."

Usually, he says, such patients are admitted to semi-private rooms, then someone discovers their condition and they are moved to a private room. "We need some way to flag their information in the computer. We’re tossing around different ways to track this in our system but would welcome feedback on how others are handling it."

[To offer feedback on either issue, contact William son at Sibley Memorial Hospital, 5255 Loughboro Rd. N.W., Washington, DC 20016. Phone: (202) 537-4192.]