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Ambulatory Diagnostic and Treatment Unit ADTU Clinic Model Summary – Taubman Health Center ADTU Summary and Purpose: The clinic is established to diagnose and treat acute conditions or acute exacerbations of chronic conditions that may require extended time for appropriate diagnosis and treatment. To be referred to the ADTU, a patient must have an established relationship with a Taubman provider (must have been previously seen at Taubman Health center by provider referring patient to the ADTU) and a defined problem that is able to be diagnosed and treated in the ADTU in a period of 2 to 6 hours. The ADTU helps to ensure there is a coordinated plan for clinical and diagnostics services (including priority Lab tests and Radiology exams) to enhance patient access and convenience for a variety of complex patient conditions requiring care that extends beyond that provided in a typical clinic visit. Patient Referral and Hours of Operation: Patients must be referred to the ADTU clinic by their provider based on established protocols and patient conditions acceptable for testing/treatment in the ADTU. (See inclusion and exclusion criteria below) The ADTU will operate from 8:00am to 6:00pm Monday – Friday. Patient Discharged from the ADTU: Following discharge from the ADTU a summary of the patient’s visit will be directed to the referring provider. Care of the patient will then be resumed by the referring service. (The discharge summary will be completed at the end of the APP’s shift.) Planned Scope of Services: Stat Lab (CBCPD, basic panel) and Radiology (General Radiology, ultrasound, DVU as needed) Hydration and medications including infusion therapy (no blood transfusions) EKG, breathing treatments including oxygen Urinary catherization ADTU: Inclusion criteria for Patient Conditions GI/GU: Nausea, vomiting, diarrhea, constipation, abdominal pain, urinary retention, dysuria, flank pain Urology: hematuria; catheter obstruction – flushing; kidney stone Cardio/Pulmonary: increased shortness of breath, CHF , COPD/- or asthma flare, mild fluid retention, cough Musculoskeletal: Joint pain and/or swelling, rheumatologic disease flare Pain: known condition for migraine General conditions: fever, cellulitis, newly diagnosed or symptoms of DVT, dehydration, elevated blood sugar (without ketosis) community acquired pneumonia (non-immuno-compromised) Uncontrolled hypertension (notes- if chest pain or TIA- send to ED) Hyperkalemia w/o associated worsening kidney function (* EKG treatment) ADTU: Exclusion criteria for Patient Conditions Controlled substances dependence/addiction Respiratory isolation required: known or suspected TB, pertussis, disseminated shingles, measles, mumps, rubella Unstable airway/ Unstable hemodynamics Chronic dialysis Acute neurological deficits/status Suspected cardiac event, tachyarrhythmia CF patients w/ new respiratory symptoms/ Home ventilator Congestive Heart Failure/Chest pain Pain: Pain control, e.g. acute flare (for conditions other than those listed in the inclusion criteria) Ketosis Proposed Protocols for Patient Treatment Service Developing Protocol Protocols for Patient Treatment Pulmonary Asthma, COPD Exacerbations. Pneumonia, Persistent cough/Bronchospasms Hematuria, UTI, catheter irrigation, surgical wound evaluation, Abdominal Pain - suspected renal colic GI bleed (w/ stable hemoglobin), Diverticulitis, Nausea, Vomiting, Diarrhea, constipation Urology/Renal GI General Medicine or other Taubman Specialties Hyperglycemia, Hypertensive Urgency, Volume under-load/overload Cellulitis Dehydration, Incision & Drainage, (Gen Med/Infectious Disease) Dysuria, Rule-out UTI Deep Vein Thrombosis Transplant Pre-transplant patients Surgery/ Orthopaedics/ Otolaryngology/ Urology/Ostomy Neutropenic Fever ( w/ other symptoms/indicators) Neurology Headache without focal CNS changes, Sciatica, seizure med loading Nephrology Hyperkalemia Rheumatology Gastroenteritis Lupus flare Rheumatoid Arthritis flare Septic Joint G-Tube, Trach change, Wound debridement, Superficial Incision & Abscess Drainage Updated: December 10, 2015