General Internal Medicine Clinic At Risk Caller Response Outline

1. General Internal Medicine Clinic At Risk Caller Response Outline • Triage Nurse will locate identified back up staff • (Lead Nurse will confirm daily availability of back up staff) • Overhead page first 2 names 2x. After 2 min page next 2 names, 2x. • Message: “Names, call Triage Nurse at ext ###.” • Call received by Clinic or Communication Center Staff • Staff person who gets call stayson line with caller • Inform another staff person that of at risk caller • Page Triage Nurse online at WebXchange at http://directory/webdirectory/INTERNAL MEDICINE NURSE PAGER#: 919-216-0954 • Include reason for page, your name and location e.g. AT RISK CALLER, Maria’s desk, Trailer 47, need help • Get information. Let caller know you’re glad they called. • Back up staff • Work with staff who took call to engage and assess caller • Collect caller information: name, date of birth, street address and plan; name and address of intended victim(s) and plan if caller is threatening to harm others • Let caller know you’re glad they called for help. • Determine and respond to risk: • If notat immediate risk, advise patient to go to nearest ER. Also givenational suicide hotline #s (800) 784-2433 or (800) 273-8255. • If at risk, inform caller you want to insure their safety and you are calling 911 to get them help. Complete Involuntary Commitment Form (refer to Risk Response Outline) • If others are at risk call 911 and make effort to warn intended victims • Document in WebCIS clinic or phone note and finalize before leaving clinic!! • While waiting for assistance writecaller’s information: • Caller’s name (first and last) and date of birth • Caller’s phone # if not on caller ID • Caller’s address where they are now • Caller’s plan? (how, what, when). • Means? “Do you have what you need to carry out plan?” • Intent? “Is there anything that would stop you from hurting yourself (or someone else)?” • If plan involves hurting someone else get: name and address of potential victim (duty to report) Rev 7/6/11 D. R. Dolan-Soto, LCSW

2. General Internal Medicine Clinic At Risk Caller Response Outline Back Up Staff to consult or assist with at risk callers in order of listing and in clinic availability. Jasmine Levy – 216-2043 Diane Dolan-Soto – 216-2679 Carrie Palmer – 216-8181 Kristen Amann – 216-1591 Amy Weil – 216-6925 Betsy Shilliday – 216-5723 Cristin Colford – 216-9547 Resident Clinic Preceptor – GIM West Wing Resident Room • Triage Nurse (Lead Nurse will confirm daily availability of back up staff) • Overhead page first 2 available staff names two times in succession. For example: “Jasmine or Diane call the Triage Nurse at ext 111”. Repeat “Jasmine or Diane call the Triage Nurse at ext 111” • If no response in 2 minutes, page the next two available back up staff • If no response inform Resident Clinic Preceptor