November 2019
Deanette
Joe
,
RN
Regional Offices-KPOST
Kaiser Permanente, The Appointment and Advice Call Center
Oakland
,
CA
United States

 

 

 

A patient presented in the PACTS system as an "Unknown" origin of AAA. The patient originally went into the ED due to blood in the urine. The patient had a renal ultrasound and a large aneurysm identified. The nephrologist notified the patient of the findings and then referred the patient to the vascular surgery department. The patient was then seen in the vascular surgery department. The vascular surgeon recommended the patient have a CT scan to confirm the findings. After much convincing, the patient conceded and had the test. The new results (CT scan; 9.0cm AAA), which were populated in the PACTS system the next day. Deanette sent a staff message to the vascular doctor immediately. The vascular doctor had not replied to the message in a timely manner. Deanette was concerned and wanted the patient to be taken care of more immediately, due to the size of the aneurysm for fear the vascular doctor would not see the message before the weekend. At the request of Deanette, the manager contacted the Clinical Vascular Surgeon (responsible for KPOST) to inform him of the situation. The Clinical Vascular Surgeon was in surgery at the time. Moments later the vascular physician responsible for the patient read the note. The patient was eventually reached (8 pm Friday night) and was told to go to ED for an ICU admission with surgery scheduled for Saturday.
Patients who are in the AAA program are monitored. Patients are referred to the vascular surgery department when the size of the aneurysm is 4.0cm or larger. Often surgery is performed once the aneurysm reaches 5.0cm or greater. The nurses in the KPOST department review cases of patients who have been identified as having an aneurysm, in the Population and Condition Tracking System (PACTS). Thank you to Deanette who was not willing to let the patient go through the weekend without being contacted by the vascular surgery department.