MRIs

MRI PRIORITIZATION
(for inpatients)

  • Every morning one person from each team (NICU fellow for NICU, senior residents for neurology genu/stroke/consult services) must update the Neurology- MRI Prioritization List (found under “Shared Patient Lists”)
    • This includes removing any MRIs that were completed or cancelled
  • Once added to the list, please edit the “ICU Other” category. You can do this by double clicking the “ICU Other” column and then navigating to the other tab at the bottom left
  • Please include the MRI priority level (table below) and a very brief description. After you type in the box you must click CLOSE for it to save. If you refresh the list – these comments will now appear. 
  • We will be in communication with the MRI supervisors at 8am and they will adjust their work-cue based on our priority list
    • If you don’t remember to add your patient, they will NOT get prioritized
    • If you don’t remove your patients, it will cause delays by slowing down the efficiency of this system


RAPID OUTPATIENT MRIs
(FOR GENERAL CONSULT PATIENTS ONLY)

  • Has officially launched!!
  • Reminder, this is for scheduling rapid (within 1 week) MRIs – for general consult patients
  • Resident Responsibilities
    • Staff case with the consult attending (or NYP-attending-on-call after hours)
    • Tell the ED team that you will be referring this patient for rapid outpatient MRI
      • The ED resident will place an order to patient navigation (I know they have been asking our residents to do this but they will be re-educated on their role in placing this)
    • Open an “Orders Only” encounter and place order for the MRI
      • Select “Future” for status, “1 week” as Expected Date
      • In the comments, please type .RAPIDMRI and include a brief description
    • Start an epic secure chat with Radiology administrators (Lourdes Contreras, Priscilla Vicioso and Melissa Irizarry), MRI supervisor (Tracey Duffy, Wendi Dominguez) Patient Navigator Supervisors (Luisa Santos, Gabriela Reda), and CUIMC ED Social Work and Care Manager Consult. Please also include the chief resident. FYI I am working on making a group in Epic so you don’t have to individually add all these names -but this is not available in Epic yet – hopefully soon!
      • Write that you are referring the patient for rapid outpatient MRI and ask the group to help schedule, confirm insurance status and ensure PCP follow-up (the individual teams will know which responsibility is theirs)
      • If this is during business hours, they should respond. Otherwise, they should respond when they return.
    • If the patient needs neuro follow-up, please separately send an in-basket message to Barbara Almeida & Liz Matthews
    • Add the patient to the “Shared Patient List” called “Rapid Access MRI”
  • MRI Results
    • Results should be mostly be interpreted by medicine NPs or PCPs in follow-up appointments, but critical results will be sent to the consult senior
    • If you receive a page/call regarding critical results while on service, forward them to the current neurohospitalist on the consult service
      • You are not responsible for responding or managing the results but just forwarding them to the hospitalist


RAPID MRIs
(FOR NON-CONSULT PATIENTS)

  • This can be used for clinic patients or patients on the GenNeu/stroke services – but the caveat is that there needs to be a plan on who will follow-up the results (either the discharging resident/attending, or primary outpatient neurologist if they have one)
  • Order the MRI
    • For clinic patients, just order like you normally would
    • For inpatients – open an “Orders Only” encounter and place order for the MRI, select “Future” for status
  • Start an epic secure chat with Radiology administrators (Lourdes Contreras, Priscilla Vicioso and Melissa Irizarry), explaining why you need it urgently and requesting a certain time frame


CHONY MRIs

Do not call techs, instead call the tech manager (M-F days): Tracy Duffy 646-942-1096



MRIs WITH ANESTHESIA

  • Email RADANESTHESIA@nyp.org with:
    • The diagnosis for why anesthesia is needed
    • Most recent H&P for the patient
    • A med list
    • An allergy list
    • Height & Weight
  • If you have issues, email Steve Miller (Co-director of Non-operating room anesthesia) at sm2536@cumc.columbia.edu