5.2.9 - Patient Emergency Protocol

Oklahoma City Clinics

During Clinic Sessions:

1.  The patient contacts either the Communication Center or the PSC and reports their dental concern.
2.  The dental concern is recorded in the contact notes of the patient’s electronic health record.
3.  The assigned student’s schedule is reviewed for open appointments.
4.  If the student is unavailable due to a rotation, the scheduler looks for another student in the same class and group practice who has an opening.
5.  If that is unsuccessful, the scheduler moves to the schedule of an adjacent group practice for an available student with whom to schedule the patient.
6.  If someone other than the assigned student sees the patient, an amail should be sent to the assigned student informing him/her of what transpired with the patient.

After Hours:

1.  The patient calls the main phone number 405-271-7744 and is given a number to call for the AEGD on-call resident.
2.  Upon receipt of being contacted, the resident contacts the patient to determine the nature of the dental concern and obtains the patient’s name, DOB, and assigned student’s name.
3.  The resident provides feedback to the patient regarding the dental concern and may determine that it is appropriate to call in a prescription for the patient.
4.  The resident amails the Director of Patient Relations, the Director of AEGD, and the student provider and records the following information in the patient EHR to report the management of the patient including:

• Patient instructions/information
• Follow-up care indicated
• Details of any prescriptions called in, including
  • Drug name
  • Dosage
  • Quantity
  • Pharmacy information including name, location, and phone number where the prescription was sent.

The student provider of the patient provides necessary follow-up.

During Academic Break:

1. The patient calls the Communications Center and reports their dental concern.
2. The Communications Center determines the urgency of the need by either referring the patient to AEGD to schedule an urgent appointment or scheduling the patient with the assigned student in the first available appointment session when the student returns. The Communications Center staff enters a contact note recording the patient’s dental concern.
3. If the choice is to schedule with AEGD, a referral is completed by Communications Center staff and forwarded to AEGD for scheduling.
4. The treating resident sends an amail to the assigned student, the Director of AEGD, and the Director of Patient Relations informing them of what transpired with the patient. 

Tulsa Clinic

During Clinic Session: Follow the same protocol as the OUHSC campus with the exception that the patient calls the Tulsa Clinic directly.

After Hours: 

1. The patient of record calls the Tulsa clinic and is directed to call AEGD for the on-call resident.
2. The resident triages the call and determines if the patient needs to be seen in the Tulsa Clinic. 
3. The resident contacts the on-call dentist regarding the emergency. 

During Academic Break: 

1. The patient of record calls the Tulsa clinic and the PSC or dental assistant will manage the emergency.  
2. The PSC or dental assistant will contact the Tulsa on-call dentist and an available dental student if the patient needs to be seen.  
3. The PSC or dental assistant will schedule the patient in the designated emergency chairs by utilizing axiUm.  
4. It is ideal that the patient be treated in the Tulsa clinic, but if no one is available, the patient will be directed to the AEGD clinic at the COD for care. 
5. If the patient needs to be seen at the COD, the treating resident will send an amail to the AEGD Director, the Tulsa Clinic Director, the assigned dental student, and the Director of Patient Relations informing them of what transpired with the patient.

1. The Communication Center will assign this patient to an available fourth-year student with an opening in their schedule.
2. After the emergency has been taken care of, the patient is scheduled for the appropriate completion of treatment.
3. Once the emergency treatment has been completed, the patient has the option to be screened for comprehensive care with the completion of the online Prospective Patient Form.

During Clinic Sessions

• The same protocol for the adult patient is followed with the exception that the student is responsible for contacting the parent to determine the nature and urgency of the emergency.  We consider this to be part of the teaching/learning experience -- discovering what is and what is not a true dental emergency. 
• If the situation is such that the patient needs to be seen before the assigned student can see the patient, then said patient will be scheduled either into the Pedo restorative rotation clinic or with another student. 
• If circumstances dictate, a prescription may be sent in.
• If the urgency/emergency can be managed without an immediate visit, the patient will be scheduled/added to the assigned student’s appointment list.  

After Hours

• The Pedo faculty should be contacted regarding how to address the particular patient's situation. 

During Academic Break

1. The patient’s parent or guardian contacts the Pedo PSC or PCM. They will determine the urgency of the need after consulting with the Pedo faculty. 
2. A referral is completed by Pedo PSC or PCM staff and forwarded to AEGD (or GPR program director if the patient is covered by SoonerCare).
   • If the referral is to the GPR program director, the Pedo PSC or PCM calls the GPR scheduler, ext. 14750, to alert that a referral has been sent through axiUm. 
3. The program, to which the patient was referred, will call the parent or guardian to schedule the patient.  
4. After treatment, the treating resident will send an amail to the AEGD Director or GPR Director (depending on which clinic treated the patient), the assigned dental student and the Director of Patient Relations informing them of what transpired with the patient.