“Scott helped me today and did a review on a patient. Shortly after he sent the review to Aetna, I noticed that there was a d/c order on the patient. I did a quick look in Epic to see what the patient’s problem was and what meds they were on.
The patient came in with a documented DVT, on Xarelto by their PCP, but c/o SOB, a Chest CT showed small, bilateral pulmonary emboli and the patient was admitted to telemetry. I called Scott, without reading his review, to see if he thought that may be this patient should be converted to observation since Xarelto really does not meet inpatient Interqual criteria and that the patient was being discharged today. He informed me that he did not know of the discharge but was concerned because this patient had a 50 beat run on nonsustained VT!
Something wasn’t right so I called the doctor on call and asked her about the VT. The RN had called this to the inpatient team at 0300 but the info was not passed onto to the doctor. I checked with the monitor tech who pulled the copy of the VT for Dr Novacic to review. She called the original attending physician who viewed the rhythm strip from his office. It really was VT, the d/c order is cancelled and the original attending physician is currently seeing the patient.
This was a great save on Scott’s behalf and could have potentially saved the patient’s life.I didn’t know how to document this since Scott is not a hospital employee but one must give credit when credit is due. “ ~ Jan C, RN – Utilization Management Coordinator