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
should ensure that both the referring service and the consulting services are involved in the development of the pathway. Facilities should also utilize triage algorithm data to align resources to provide clinically indicated care. Facility triage examples are outlined below in the resource section. When implementing an extender strategy, additional resources are needed. In order to successfully implement this solution: hiring, filling vacancies or restructuring specialty care support staffing model is required. Additionally, many of the functions that are performed by care coordinators do not receive workload credit due to the lack of codable documentation for care coordination activities. When implementing this model, it is critical that extenders are working at the top of their license in order to fully optimize this recommendation. Sites implementing this solution should measure the benefits not just in the extenders workload but their benefits to the whole system. Union collaboration is advised when restructuring current support staffing models.
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
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.
With the emergence of urgent care clinics, consumers now have another option when it comes time to receiving medical treatment. Often an illness arises during times when a person’s doctor is not available, such as at night or on weekends. This is when urgent care clinics can help.
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.
“Patient Navigators are trained, culturally sensitive health care workers who provide support and guidance throughout the cancer care continuum” (What are patient navigators? 2009). The healthcare system, which includes hospitals, clinics and insurance claims, can be hard to navigate for many patients. This is where patient navigators come in and help direct patients so that their experience in the hospital is made easier. According to the Center to Reduce Cancer Health Disparities, the activities conducted by patient navigators include:
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.
...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.
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.
I would argue that at the very least, there needs to be some form of triage implemented. The way the Endangered Species Act is currently allocating funds is mediocre at best and has many flaws. There is no denying there are limited resources so that makes efficient use of them even more important. Each of the systems of triage outlined in this paper have valid points and problematic components. Elements of each system could be combined into a nicely working plan that recovers the greatest number of species on a limited budget.
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.
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).
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
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