Download Proposed Protocols for Patient Treatment

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
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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