Michigan Medicine



Ambulatory Diagnostic and Treatment UnitADTU Clinic Model Summary – Taubman Health CenterADTU 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 oxygenUrinary catherizationADTU: Inclusion criteria for Patient ConditionsGI/GU: Nausea, vomiting, diarrhea, constipation, abdominal pain, urinary retention, dysuria, flank painUrology: hematuria; catheter obstruction – flushing; kidney stoneCardio/Pulmonary: increased shortness of breath, CHF , COPD/- or asthma flare, mild fluid retention, coughMusculoskeletal: Joint pain and/or swelling, rheumatologic disease flarePain: known condition for migraineGeneral 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 ConditionsControlled substances dependence/addictionRespiratory? isolation required: known or suspected TB, pertussis, disseminated shingles, measles, mumps, rubellaUnstable airway/ Unstable hemodynamicsChronic dialysisAcute neurological deficits/statusSuspected cardiac event, tachyarrhythmiaCF patients w/ new respiratory symptoms/ Home ventilatorCongestive Heart Failure/Chest painPain: Pain control, e.g. acute flare (for conditions other than those listed in the inclusion criteria)Ketosis Proposed Protocols for Patient TreatmentService Developing ProtocolProtocols for Patient TreatmentPulmonaryAsthma, COPD Exacerbations. Pneumonia, Persistent cough/BronchospasmsUrology/RenalHematuria, UTI, catheter irrigation, surgical wound evaluation,Abdominal Pain - suspected renal colic GIGI bleed (w/ stable hemoglobin), Diverticulitis, Nausea, Vomiting, Diarrhea, constipation General Medicine or other Taubman SpecialtiesHyperglycemia, Hypertensive Urgency, Volume under-load/overloadCellulitis Dehydration, Incision & Drainage, (Gen Med/Infectious Disease)Dysuria, Rule-out UTIDeep Vein ThrombosisTransplantPre-transplant patientsNeutropenic Fever ( w/ other symptoms/indicators)Surgery/ Orthopaedics/ Otolaryngology/ Urology/OstomyG-Tube, Trach change, Wound debridement, Superficial Incision & Abscess DrainageNeurologyHeadache without focal CNS changes, Sciatica, seizure med loadingNephrologyHyperkalemiaRheumatologyGastroenteritisLupus flareRheumatoid Arthritis flareSeptic Joint Updated: December 10, 2015 ................
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