Acute Care Clinic
Administrative Contact
Peggy Simons
Peggy.Simons@stanford.edu
725-9282
Rotation Director
Larry Hammer
Message from Dr. Peoples (October13, 2009):
CDC/Public health rec on how long to keep a kiddo out of school:
The Centers for Disease Control (CDC) and the Santa Clara Dept.of Public
Health tell us to stay home for at least 24 hours after your fever is
gone except to get medical care or for other necessities. (Your fever
should be gone without the use of fever-reducing medicine.)
Also - have attached some docs forwarded by Robyn, excellent parent
handouts from the CDC.
http://www.cdc.gov/h1n1flu/flyers.htm
Message from Dr. Peoples (October 9, 2009):
Hey team - here a few pointers on H1N1 for the flu season, and there is
a nice 3 page handout from the Department of Public Health outlining who
should recieve flu vaccine, and the intricacies of the live vaccine v.
killed vaccine. Definitely worth a read - you WILL be answering
questions on this from your parents!
For LPCH inpatient care:
1. Any patient with suspected influenza: contact infection control, send
DFA.
2. DFA: This is run 3x/day during the week, 2x/day on the weekend. It
is 87% sensitive, 100% specific. What does this mean? You will have
some false negatives. If you have a negative result and a symptomatic
patient - please send PCR. The PCR is presently done off-site, but we
should be performing it on-site in a few weeks.
3. Contacts: Starting October 19th - no children <16 y/o will be allowed
to visit LPCH. This is a step being taken at multiple Childrens'
Hospitals around the state, but will obviously be a burden on some of
our families. The hospital is ramping up education on this, and you
will see signs around. I am not clear what kind of support we will have
for our families - but lets get social work involved to help our
overburdened parents as early as possible. Additionally, if parents are
sick, they cannot visit. This has been the cause of previous exposures.
There will be exceptions to this rule for gravely/terminally ill
children.
4. FLU SHOT: please get it!!! As you know, we have the yearly tri-valent
flu vaccine presently, and there are signs on the 1st floor as to where
to obtain the shot. We should have the H1N1 at the end of October/Early
November. This is essential in protecting not only you, but also your
patients.
For outpatients with flu-like illness: I am working to obtain back-to
school recommendations from the DPH on this - will have them for you
soon.
LPCH website with Flu updates, information for parents, prescription
information, etc:
https://intranet.lpch.org/departments/infectionControl/swine-flu/index.h
tml
Flu Mist Recommendations 10-7-09 FINAL
Message from Dr. Hammer (August 10, 2009):
For those of you with Continuity Clinic at LPCH or during your ACC rotations, you will find that the Child Psychiatry staff offer a valuable service to our primary care patients. They see patients referred from our clinic in their Thursday afternoon "Continuity Psych" clinic that occupies 1-2 rooms in the same module on the first floor at 730 Welch Road as our Primary Care Clinic.
Patients are scheduled into that clinic using the checkout form that we also use to schedule follow up visits for ACC and continuity. A referral form DOES NOT need to be completed for patients being seen in this clinic.
In order to communicate the reason for scheduling a patient into the Continuity Psych clinic, we ask that you complete a "general message" in LINKS and forward it to me. This past year, the messages were forwarded to a psych resident, but, this year, to help make the process more consistent, I ask that you send this message to me in LINKS (not by regular email). The message should be saved in the patient's record in LINKS. This will enable the child psychiatrist to access the information within the patient's Powerchart.
If you are unfamiliar with sending a "general message" within LINKS, please ask your attending or another member of the housestaff.
Message from Dr. Hammer (July 20, 2009):
For those of you who have continuity clinic and/or rotations in Acute Care, I'd like to remind you of a few things that can make your experience here more enjoyable. I welcome your comments and feedback.
1. The forms for WCC visits are under revision and will be replaced in the MD Workroom with updated versions within the next few weeks. Thanks go to Lori Rutman for adding Spanish phrases to the Development section of these forms for your assistance (not to replace use of the interpreter-by-phone).
2. Be sure to give your patients/parents the age-appropriate Parent Information Sheet that goes along with each WCC visit.
3. Please detach the BMI form from the WCC packet, complete it, and hand it to the attending when you present your WCC patients.
4. We have a supply of books from the Reach Out and Read Program. The Program recommends that you bring the book into the visit at the start of the visit, NOT at the conclusion of the visit, so that you can make use of the book during the visit. You can access the Reach Out and Read website for additional information. Use this URL: http://www.reachoutandread.org/
5. Please use the light system in the MD workrooms to notify our staff that you are ready to have your next patient roomed. In general, patients prefer to be roomed when their physician is ready to see them, rather than sitting in the room for an extended period of time waiting.
6. Speaking of WAITING, our staff work hard to keep patients informed when their physician is running late. Patients are kept waiting for a variety of reasons, but their satisfaction with the visit is greatly enhanced if the staff can give them an idea of how long their wait is likely to be. It is your responsibility to keep our MA's informed about how far behind you are and how soon you expect to see your next patient. If you need help making this assessment, ask one of us to help you. Ed, Julie, Liz, Sonia, and the other staff, will be much better prepared to help mitigate the discomfort of delays if they are better informed.
I hope that your new "year" is getting off to a good start.
Best wishes,
Larry Hammer