Facility standardized triage and clinical pathways must be developed in order to provide consistent patient care. There should be educational modules employed to train call center staff, providers and support staff. All call center staff should receive consistent training regarding appropriate triaging and follow-up for all patients, especially those with urgent/emergent concerns. Additionally, there should be clear pathways established to direct patients with urgent/emergent needs to the Emergency Department or appropriate specialist for same day care. These pathways should be warm hand-offs between departments ensuring issues are addressed promptly and that care coordination is seamless. When defining standardized triage pathways, facilities
Thathamkulam led the initiative to revise and wrote Telecare’s Computer Downtime Policy (Memorandum 118-Tele-015). He has further contributed to minimizing costs to the Houston MEDVAMC, as he has developed documentation protocols to ensure quality documentation for SI/HI callers who called from the After Hour off Site Call Centers. He served as a preceptor to new RN staff, he emphasized the importance of RNs including the Financial Disclaimer in all symptom calls received to help control cost due to negligence by failure to inform Veterans in regards to the disclaimer and failure to address the disclaimer in documentation. As a chair person in one of the Performance Improvement projects for Abandonment Rate Committee, he identified that the Telecare unit was experiencing a high rate (36.7%) of caller abandonment according to 2014 abandonment rate data. This was a problem that had been occurring for the last few years. In collaboration with Pharmacy team, IT team and mental health team, he decided to cut short the documentation policy for Telecare nurses, who are receiving symptom calls including suicidal calls. One suicidal call usually takes approximately 30 minutes to one hour, that back up other patients’ calls in the queue. It automatically resulted in increasing the abandonment rate for the incoming calls. He initiated and created a committee to resolve this issue. The committee meets on a monthly basis to evaluate the situation, and he initiated a plan of action that recommended management to hire additional staff and alert to revisit the documentation policy in order to reduce the current abandonment rates. Mr. Thathamkulams’ vast experiences in Mental Health, he was managed to convinced the Telecare management team and suicidal prevention team by eliminating some of the unnecessary suicidal protocol, which helped to reduced the call handling time to 25minitus per each suicidal call. He also monitored about calling procedures of staff to make sure that
Once the mandate was given to area hospitals not to divert MH patients, each hospital had to figure out how to deal with MH patients in their own organization. This entailed a safe environment for the MH patient, safety for the staff, and the ability to “board” MH patients in the ED. “Boarding” patients in ED’s became necessary because of the lack of inpatient MH beds in the State of Washington.
The purposes of a handoff report are mainly to convey essential patient care information, plan and organize treatment, debrief, enhance teamwork and provide education. Handoff is a complex issue as it happens at a variety of instances and stages of patient care in different settings. Moreover, it involves several clinicians with diverse skill-sets, education, experience, expertise and priorities (Berger, Sten & Stockwell,
Karen is a post visit register nurse (PVRN) at Cincinnati Children’s Medical Center (CCMC). She has been an employee at CCMC for nine years but has only had this position for about four years. PVRN’s are responsible for following up on any positive culture results to make sure the patient is on an appropriate treatment plan. If they are not receiving the correct treatment, the PVRN must contact the doctor to get orders for the necessary medications and educate the family of the updated treatment plan. PVRNs also make follow up calls to patients who have been seen in the Emergency Department (ED) within the last 24 hours. During these calls, they make sure the discharge plan has been implemented and any follow up care is arranged.
Maintaining an open mind and learning what one can in terms of national and facility-specific standards will help equip one to perform his or her duties as expected. Above all, the overall care of the patient – mental, physical, financial and spiritual - is paramount.
Provision of high-quality care at the right time, in the right place and delivered by the right persons is of vital importance in reducing pressure on hospital services. Rapid and efficient discharge of patients from acute hospital beds to the next level of care plays a vital part in ensuring capacity is available for patients needing to access acute care beds. Equally important is the need to ensure that the transition for patients from acute hospital to community care is safe, well coordinated, and well communicated.
The standards issued herein may be utilized as the indication of the standard of care, with the knowledge that the application of the rules is context dependent. The standards are determined to change with the dynamics of the nursing profession as new models of professional practice are developed and affirmed by the nursing education and the society. In addition, specific requirements and clinical circumstances may also affect the application of the criteria at a given time; e.g., during an emergency and natural disaster or in the war. The standards are directed to formal, periodic review and revision.
Purpose: Current evidence based research demonstrates that the utilization of defined sepsis care guidelines, provide time sensitive treatment protocols that help guide nurses through effective early initiatives in reducing patient mortality. Since time of treatment for sepsis is outlined as being most effective if delivered in the first six hours following diagnosis, it is imperative to treat patients as soon as they arrive in the hospital for treatment. Emergency departments (ED) are the most common initial route of care that patients take for hospitalization of sepsis type infections. Currently many hospitals do not have a defined treatment protocol that initiates this needed treatment to start in the ED. Sepsis bundles offer ED nurses the guidelines that are needed to help care for such patients.
...nt an organizational chart. This allows all personnel to understand what their roles are at time of incident, and whom you communicate sensitive information too. If no direction or communication is given, providing facilities run the risk of victims trying to enter their doors seeking care, which can over exhaust resources and oversaturate hospitals. Therefore, a hospital triage is implemented to assess if patient condition has worsened or remained stable, if there is a need for decontamination process, or if a person seeking assistance is a family member looking for victim. Having these procedures ensures that patients inside the hospital prior to incident are protected for potential harmful exposure to contamination agents and other measures. In addition, hospital and providing facilities are a source of information for victims, the media, and family members.
Existing research has demonstrated that patients, families, and health care providers perceive many advantages to a multispecialty clinic approach for multisystemic disorders. First, in a review of multispecialty clinic operations, Makary (2011) explains that a principal benefit of a multispecialty clinic is their intrinsic ability to diagnose critical problems early on in the disease process. These clinics also have the potential to intervene before further disease progression. Here, patient safety is improved when all treatment options are discussed among multispecialty team members, rather than depending on accurate and expeditious transmissions of medical communication between separate clinicians. In this way, multidisciplinary teams intend to make a complex health care system safer and more navigable for the patient (Makary, 2011).
A ward handover is a continuous and effective process to circulating essential information about a patient which is necessary to ensure the promotion of safe patient care. Ward handovers require effective communication to ensure correct clinical care delivery to all patients. This takes the form of both verbal and non-verbal communication and requires valuable leadership skills. Following a specific communication model or framework can result in a successful handover and therefore, continuity of care for each individual patient, overall ensuring high quality patient care. Ward handovers are essentially used to improve communication through the sharing of patient information between professionals, improve patient safety by certifying reliable care and improving quality and productivity, this will help reduce inaccuracies in information sharing and the quality of patient care. There is also a growing recognition within ward handovers that enhanced training to ensure effective handovers are crucial in maintaining high standards of clinical care. To ensure that an effective handover takes place all healthcare areas must have a handover policy and compliance to this policy must be ensured.
51). The discussed ED is having difficulties with long wait times in their facility. Both staff and patients are affected by this health care issue. Possible solutions that can be proposed are hiring more nurses or designating a discharge nurse for each shift. These suggested outcomes may need to be discussed with staff members and the hospitals administration before it can be implemented. Until changes can be made staff should continue to provide excellent discharge information and provide the best care possible for all patients, no matter the wait time. Staff should always remember that safe care is quality
Non-comprehensive and non-uniform patient handovers stand as a current concern within the department. Inadequate handovers may lead to delays in care and communication errors. Additionally, poor communication and poor teamwork in relation to handovers pose a threat to patient safety. The proposed intervention is to implement the utilization of a paper, SBAR formatted, standardized template with patient information on it that can be passed on from nurse to nurse at shift change. The template will be updated throughout the patient’s stay at the facility and will help provide a comprehensive view of the patient. This SBAR formatted template will provide the framework for the verbal report given during patient handovers on medical-surgical units of a Midwestern, rural hospital. The review of the literature supports the implementation of this intervention, by noting error reduction with the employment of a template. The results of a study by Triplett and Schuveiller (2011) suggested that over half of the nurses surveyed had discovered errors during the patient handover process with the addition of the template. According to Johnson, Jefferies, and Nicholls, (2012) not only did the employment of a template complement verbal handover, but it also provided a tool to allow for easy access to comprehensive information on any given patient in the units. Overall, the
Although I had been feeling overwhelmed by a busy work atmosphere, I enjoyed being part of the Palmerston North CAFS team. One of key areas of learning during my placement at CAFS was to gain a basic understanding of the initial assessment process, from allocating referrals to clinicians to having MDT decisions of whether or not referrals meet service criteria. Once referrals have been received, the duty triage clinicians allocate each referral to other clinicians for initial assessment and arrange appointments. Most clients I saw at their initial assessments were referred by their General Practitioners (GPs) or their schools, and one of crisis referrals were sent through Child, Youth, and Family (CYF).
As a healthcare professional, effective communication is arguably the most important trait to have next to patient care. The ability to communicate efficiently can make or break you as a respected healthcare professional, but even more importantly it can alter the patient’s treatments and the fluid transition from pre hospital to hospital care. Patient advocacy is one of the major keys in communication for a pre hospital caretaker in particular. We as pre hospital personnel need to paint a clear picture of our patient’ condition in order to accurately treat our patients and forewarn the receiving hospital of what they are about to have at their doorstep. In the words of a 10 year mobile intensive care nurse, “the most important aspect of radio contact by the paramedic is the ability to accurately describe what the priority