Specialty inpatient adult medical units at Bendigo Health include Cardiology, Renal and Oncology. The General Medical Unit admits all other adult medical patients. Cardiology admit patients with clear cardiological problems but NSTEMI or CCF in a patient with comorbidities might be admitted by AMU by agreement. There is a fortnightly respiratory medicine outpatient clinic run by Dr Emma Broadfield (from ICU) and Dr Kate Carroll. Dr Robert Campagnaro has a fortnightly outpatient clinic for general and respiratory medicine. Access to these clinics is generally via the GP or referral from an inpatient admission. There is no inpatient respiratory medicine service.
All acute medical admissions are under the Acute Medical Unit except strokes who are admitted under the admitting physician of the day. The AMU reg (the admitting med reg) carries pager 550 and phone 6185 at all times.
Decision to admit rests with the Emergency Consultant on duty. If in doubt about admitting a case it is best to speak directly with the Physician on call. Likewise, doubt about need for telemetry or other special requirements is best clarified by a consultant to consultant discussion with the Physician on call.
Patients can be sent to the ward on interim treatment orders written by the ED Medical officer and signed off by the Emergency Consultant. Interim orders must be complete. The AMU registrar should be advised that this is being done. Alternatively the AMU reg may admit the patient in ED but this process must not delay access to an allocated ward bed for patients deemed to need admission.
Private medical patients can be discussed directly consultant to consultant with the on call physician and their instructions documented in the notes.
If the patient is to go to St John of God hospital the physician may choose to review them in ED before they go or the may meet them over there. In the latter case a referral letter and St John of God drug chart can serve for interim orders. These are stored in the fishbowl.
Private patients who are to be admitted to the public hospital are frequently admitted by the AMU registrar. In general they can be referred directly to the AMU reg who will speak with the private physician however there will be times when the ED senior will elect to speak directly to the physician responsible to get key decisions made early.
Interim orders may be used as for public patients.