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     Agreed.  If an improved handoff system is necessary, they should come down to get the patient.  The senior resident may not know all the details of a particular case, the nurse escorting may not be the primary nurse, etc.
     That being said, in my experience, when I escort the patient up (due to my own concerns regarding patient stability), the PICU Attending and resident are often sleeping/otherwise involved in another patient's care.
     We do typically send a physician (resident or Attending) with any patient who we feel is at risk for deterioration, but do not routinely do this for more stable patients, I.e., trauma patient requiring frequent neuro checks.  These usually go with an ED nurse and a tech.
     Of course, good communication is key.

Niel
Rutgers--New Brunswick

Sent from my iPad

> On Aug 10, 2017, at 2:45 PM, Khan, Naghma <[log in to unmask]> wrote:
> 
> This is absurd.
> What makes absolute sense is that they come down to the ED with their multi-disciplinary team to pick up the patient.
> 
> 
> Naghma
> 
>> On Aug 10, 2017, at 2:10 PM, Michael S. Mitchell/Emergency Medicine <[log in to unmask]> wrote:
>> 
>> Good afternoon.
>> 
>> Our PICU physicians are asking that all PICU admissions from the ED have a bedside handoff in the PICU.  Basically, they want a senior resident/PEM fellow to escort the patient to the PICU (about 6-7 min away from the Peds ED) and then give a detailed hand-off (much like rounding) to a multi-disciplinary team in the PICU including RN, MD, and RT.
>> 
>> Their request is incredibly costly for the peds ED as our residents and fellows are usually not expendable.
>> 
>> Have other institutions tried this and found a way that it works?   We certainly see the benefit for that one single patient, but it comes at a cost of caring for the rest of the ED.
>> 
>> Thanks in advance for any advice you can offer.
>> 
>> Michael Mitchell, MD
>> Medical Director-Pediatric ED
>> 
>> 
>> 
>> Michael S. Mitchell, MD
>> Assistant Professor of Emergency Medicine
>> 
>> Section of Pediatric Emergency Medicine
>> 
>> Wake Forest University School of Medicine
>> 
>> Medical Center Boulevard
>> 
>> Winston-Salem, NC 27157
>> 
>> For more information, send mail to [log in to unmask] with the message: info PED-EM-L
>> The URL for the PED-EM-L Web Page is:
>>                http://listserv.brown.edu/ped-em-l.html
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For more information, send mail to [log in to unmask] with the message: info PED-EM-L
The URL for the PED-EM-L Web Page is:
                 http://listserv.brown.edu/ped-em-l.html