Wound Care Conference’s: is a meeting that is designed to create a “team” spirit among the wound care teams at all GH clinics. The purpose is to share challenging wound care cases, and get feedback and ideas from each other.
These Meetings will happen Bi-Monthly. Sheila will attend on the meetings on the 2nd Wednesday of every month and Pat will attend the meeting on the 3rd Tuesday of the month. Pat and Sheila will be presenting a case in July.
Warm Transfer forms: Dr. Chapman and the other PCP’s have approved the form. Once the forms arrive at the clinic, each wound care team member will in-service the flow staff in their clusters.
CORE Work Flow
1. Drop In Records have been updated for the month of May. Drop In patients continue to climb and Wednesday’s still have the most drop in’s. Core team are still looking for ways to offload work on Wednesday
2. Wound care Records: This is a new tracking system that will be updated monthly. The data shows how many wound cares we see each month and what days of the week are the busiest. This new tracking system is critical in estimating our flow staff needs. So far this year the core has done “716” wound cares.
3. Wound care Data: not a new tracking system, but equally important to show core staff the progress we are making. This is a Coop wide tracking system. It entails
a. the length of time it takes to heal a wound.
b. How many active wounds we have
c. How many patients are getting healed with in the target area
d. How many ( year to date) current wound care patients we have and those that we have healed.
Burien is doing well in all categories. We have the 3rd highest amount of wound care patients throughout the coop. (Olympia and Northgate have the highest.)
Thursday, June 25, 2009
CORE MEETING MINUTES Tuesday 6/2/09
Agenda
1. Appointing guidelines
What’s new, impact on core- Due to the high volume of patients that we see in the core it has become more and more difficult to balance out the Wound cares and allergy appointments. In an attempt to correct this problem Cindy has been working and working on a new template and has finally come up with one that will work well in the core. Cindy deserves a big star!!! Even though the template looks different we still will be booking patients the same. (Well Cindy will)
Tid Bits
Drop In records: Core was extremely busy this month with drop in’s. we had 52 for the month of May. Sheila and P also had vacations which added to “busy” schedule. Some Questions and Idea’s for drop in’s was discussed:
1. Make a Sign that states: We are not an urgent care facility, and, this clinic operates by appointment only.
Will need Support from Becky, PCP’s and administration.
2. Go back to the way it used to be; Having Team RN’s evaluate and treat drop in’s. With Core assisting when Team RN’s are busy.
3.Communicate with CNS that all patients do not need to be seen the same day, and it would help if they communicated this to patient (“call clinic and make an appointment with your Doctor so that you are seen in the next 2-3 days.")
Warm Transfer
Form is now complete and has gone to Becky, Dr. Chapman and Jill who have all have given the “Go ahead”
1. Another thought for warm transfers was to get the core a cell phone
2. That way if someone (PCP’s, Flow Staff..Etc) needed something done for a patient they could call or text us. This would save time for everyone and increase communication.
3. The CP number would go on the daily schedule. Just like the “DOD” we could have “NOD” which would tell everyone who has the phone. Sheila would carry it unless she was out of the clinic.
1. Appointing guidelines
What’s new, impact on core- Due to the high volume of patients that we see in the core it has become more and more difficult to balance out the Wound cares and allergy appointments. In an attempt to correct this problem Cindy has been working and working on a new template and has finally come up with one that will work well in the core. Cindy deserves a big star!!! Even though the template looks different we still will be booking patients the same. (Well Cindy will)
Tid Bits
Drop In records: Core was extremely busy this month with drop in’s. we had 52 for the month of May. Sheila and P also had vacations which added to “busy” schedule. Some Questions and Idea’s for drop in’s was discussed:
1. Make a Sign that states: We are not an urgent care facility, and, this clinic operates by appointment only.
Will need Support from Becky, PCP’s and administration.
2. Go back to the way it used to be; Having Team RN’s evaluate and treat drop in’s. With Core assisting when Team RN’s are busy.
3.Communicate with CNS that all patients do not need to be seen the same day, and it would help if they communicated this to patient (“call clinic and make an appointment with your Doctor so that you are seen in the next 2-3 days.")
Warm Transfer
Form is now complete and has gone to Becky, Dr. Chapman and Jill who have all have given the “Go ahead”
1. Another thought for warm transfers was to get the core a cell phone
2. That way if someone (PCP’s, Flow Staff..Etc) needed something done for a patient they could call or text us. This would save time for everyone and increase communication.
3. The CP number would go on the daily schedule. Just like the “DOD” we could have “NOD” which would tell everyone who has the phone. Sheila would carry it unless she was out of the clinic.
North Cluster Makes its Own Gallup-style Poll
NORTH CLUSTERS GALLUP!
I would like to see the North Cluster continue to be the BEST cluster to work IN, and the BEST cluster to work WITH!
This self evaluation can serve as a feedback mechanism to raise our awareness on:
1) how do we as individuals feel about working with our team
(how are the team and its members working for you?)
2) how are we functioning as a team members (what are you doing for the
team and its members)
The questions are pulled from the Gallup survey we do once a year. The format of ranking each question 1 through 5 will be the same as well:
5= strongly agree/extremely satisfied
1= strongly disagree/extremely dissatisfied.
_____________________________________________________
In order to get your feedback on how you would like to see this, please answer the questions below with your preferences. You can leave this form in my inbox and I will compile the results and present at our next meeting.
______________________________________________________
1) FROM THE LIST BELOW PLEASE SELECT THE TOP FOUR QUESTIONS YOU WOULD LIKE TO BE ASKED, RANK THEM 1-4 (1=MOST IMPORTANT TO BE INCLUDED):
-There is someone at work who encourages my development.
-There is someone at work who seems to care about me as a person -In
the last seven days, I have received recognition or praise for doing good work.
-At work, I have the opportunity to do what I do best every day.
-I have the materials and equipment I need to do my work right.
-I know what is expected of me at work.
-I have had opportunities at work to learn and grow.
-How satisfied are you with the North Cluster as a work place.
2) HOW OFTEN WOULD YOU LIKE TO BE ASKED THESE QUESTIONS? (Circle ONE):
-once a day
-once a week
-once a month
-once every 3 months
3) PLEASE CIRCLE YOUR PREFERED FORMAT FOR ANSWERING THESE QUESTIONS (circle one)
-EMAIL (CONFIDENTIAL TO ALL EXCEPT RECIPIENT)
-FILL OUT ON CLUSTER BOARD (PARIALLY CONFIDENTIAL)
-WRITE ON PAPER AND PUT IN ENVELOPE (CONFIDENTIAL)
Thank you and feel free to write any free form comments as well! dd
I would like to see the North Cluster continue to be the BEST cluster to work IN, and the BEST cluster to work WITH!
This self evaluation can serve as a feedback mechanism to raise our awareness on:
1) how do we as individuals feel about working with our team
(how are the team and its members working for you?)
2) how are we functioning as a team members (what are you doing for the
team and its members)
The questions are pulled from the Gallup survey we do once a year. The format of ranking each question 1 through 5 will be the same as well:
5= strongly agree/extremely satisfied
1= strongly disagree/extremely dissatisfied.
_____________________________________________________
In order to get your feedback on how you would like to see this, please answer the questions below with your preferences. You can leave this form in my inbox and I will compile the results and present at our next meeting.
______________________________________________________
1) FROM THE LIST BELOW PLEASE SELECT THE TOP FOUR QUESTIONS YOU WOULD LIKE TO BE ASKED, RANK THEM 1-4 (1=MOST IMPORTANT TO BE INCLUDED):
-There is someone at work who encourages my development.
-There is someone at work who seems to care about me as a person -In
the last seven days, I have received recognition or praise for doing good work.
-At work, I have the opportunity to do what I do best every day.
-I have the materials and equipment I need to do my work right.
-I know what is expected of me at work.
-I have had opportunities at work to learn and grow.
-How satisfied are you with the North Cluster as a work place.
2) HOW OFTEN WOULD YOU LIKE TO BE ASKED THESE QUESTIONS? (Circle ONE):
-once a day
-once a week
-once a month
-once every 3 months
3) PLEASE CIRCLE YOUR PREFERED FORMAT FOR ANSWERING THESE QUESTIONS (circle one)
-EMAIL (CONFIDENTIAL TO ALL EXCEPT RECIPIENT)
-FILL OUT ON CLUSTER BOARD (PARIALLY CONFIDENTIAL)
-WRITE ON PAPER AND PUT IN ENVELOPE (CONFIDENTIAL)
Thank you and feel free to write any free form comments as well! dd
North Cluster Notes June 23, 2009
CLUSTER OBJECTIVES
Quality improvement
Team building
KUDOS
-Thanks from Lakisha to Ted for staying on time, has helped her!
-Thanks to all for covering Diane during my absence
- thanks to all for being flexible with all these changes that we are working on toward reaching medical home!
TEAM BUILDING
Lead MA role, Becky wanting contact person- Staff to talk amongst themselves and get back to team next week with:
1) who
2) if rotating position
Becky to let them know rough job description and pay adjustment.
What makes a good day:
1)predictability – Liz with MA schedule doing well
2) good/easy communication sign out to Star before leaving, can leave message on her voice mail or email her
3) timeliness of providers. Doing better!
QUALITY IMPROVEMENT PROJECTS
1) Outreach
Put on hold PAP/colon cancer outreach till details flushed out and MA’s have more time, focus/priority on figuring out access and chronic care
2) Medication reconciliation: adopt July 7th any
-sugestion to check snap shot for duplicates and erase
-try use of .revami as a dot phrase in nursing not where discrepancies can be noted (especially OTC/meds not listed)
-ask about inhalers/vitamins/eyedrops/otc meds as well
3) Cluster board: goal to simplify- agreed to 4 reports for now:
-‘huddle’ time(required by admin)
-chronic care use-(required by admin) providers agree to work on emailing cc of chart where used to save staff from double work Goal of 3/week by each provider
-cluster satisfaction(see attached form to help create)
-avs
Quality improvement
Team building
KUDOS
-Thanks from Lakisha to Ted for staying on time, has helped her!
-Thanks to all for covering Diane during my absence
- thanks to all for being flexible with all these changes that we are working on toward reaching medical home!
TEAM BUILDING
Lead MA role, Becky wanting contact person- Staff to talk amongst themselves and get back to team next week with:
1) who
2) if rotating position
Becky to let them know rough job description and pay adjustment.
What makes a good day:
1)predictability – Liz with MA schedule doing well
2) good/easy communication sign out to Star before leaving, can leave message on her voice mail or email her
3) timeliness of providers. Doing better!
QUALITY IMPROVEMENT PROJECTS
1) Outreach
Put on hold PAP/colon cancer outreach till details flushed out and MA’s have more time, focus/priority on figuring out access and chronic care
2) Medication reconciliation: adopt July 7th any
-sugestion to check snap shot for duplicates and erase
-try use of .revami as a dot phrase in nursing not where discrepancies can be noted (especially OTC/meds not listed)
-ask about inhalers/vitamins/eyedrops/otc meds as well
3) Cluster board: goal to simplify- agreed to 4 reports for now:
-‘huddle’ time(required by admin)
-chronic care use-(required by admin) providers agree to work on emailing cc of chart where used to save staff from double work Goal of 3/week by each provider
-cluster satisfaction(see attached form to help create)
-avs
West Cluster Meeting June 24, 2009
Present: Becky Dolan, Doug Knopp, Ashley Lindell, Sarah Philp, Kelly Walsh, Jason Mateo, Esma Delalic, Mark Christianson, Star Morales
Chronic Care dot phrases: How are they going? Doug found one which was very tedious and time consuming.
How is everyone doing? Comments from Jason, Doug, Star and Esma
Discussion about patients showing up late and throwing off the schedule. The current standard is for the person making the appointment is to ask all pts to show up 10 minutes early. Pts have been showing up 10-30 minutes late for their physicals. Ultimately the PCR’s should check with flow staff or the provider to see if they can be put into the schedule if the pts are 15 minutes late, and pts are told they may have to reschedule.
New HEDIS letter is ready!!!
Medical Home:
Lead MA/LPN- discuss in cluster and choose before next meeting. There is an extra $1.25 an hour more; Becky is developing a job description.
Do we want Shannon Jewell to be at more than 1 cluster meeting every other week?
Do we want Team RNs attending meeting every other week?
Cluster board- where to place? Should we place in view of patients; somewhere for staff only; should we make it portable so we can bring it to the meetings and change?
HEDIS- Becky brought a new graph for Hedis measures we have already been working on to better view our progress; these are available to put on our board if we wish.
Pilot Program surrounding pre-visit work; Sarah and Diane are looking ahead on the schedule to see if pts are appointed appropriately (calling to convert OV to PV, etc.) this week. Also working on chronic care smartphrases more regularly. Jason is using the fishing report to look 1 week ahead and calling patients. Becky will get him skills list for each provider.
Pap smear dot phrase for patients signed up for online services was presented by Kelly. She will revise and email the final to us for use.
Mark presented the Future FP Appointment Continuity of all Burien Patients Chart.
Chronic Care dot phrases: How are they going? Doug found one which was very tedious and time consuming.
How is everyone doing? Comments from Jason, Doug, Star and Esma
Discussion about patients showing up late and throwing off the schedule. The current standard is for the person making the appointment is to ask all pts to show up 10 minutes early. Pts have been showing up 10-30 minutes late for their physicals. Ultimately the PCR’s should check with flow staff or the provider to see if they can be put into the schedule if the pts are 15 minutes late, and pts are told they may have to reschedule.
New HEDIS letter is ready!!!
Medical Home:
Lead MA/LPN- discuss in cluster and choose before next meeting. There is an extra $1.25 an hour more; Becky is developing a job description.
Do we want Shannon Jewell to be at more than 1 cluster meeting every other week?
Do we want Team RNs attending meeting every other week?
Cluster board- where to place? Should we place in view of patients; somewhere for staff only; should we make it portable so we can bring it to the meetings and change?
HEDIS- Becky brought a new graph for Hedis measures we have already been working on to better view our progress; these are available to put on our board if we wish.
Pilot Program surrounding pre-visit work; Sarah and Diane are looking ahead on the schedule to see if pts are appointed appropriately (calling to convert OV to PV, etc.) this week. Also working on chronic care smartphrases more regularly. Jason is using the fishing report to look 1 week ahead and calling patients. Becky will get him skills list for each provider.
Pap smear dot phrase for patients signed up for online services was presented by Kelly. She will revise and email the final to us for use.
Mark presented the Future FP Appointment Continuity of all Burien Patients Chart.
Friday, June 19, 2009
Meeting Minutes from 6/17/09
WAY TO GO NORTH CLUSTER
We got through a LOT in a very short time. Thanks for everyone being on time, that was super helpful!
See red highlights for discussion decisions/topics addressed and new items from this meeting
TO DO FOR NEXT WEEK:
JASON: -will review how to do colon cancer screening outreach.
MA/LPN: Please come up with a plan for PAP outreach (calls/letters/email) and please plan on picking someone to present that to the team.
EVERYONE: pick one item you would like on cluster board , EMAIL TO ME THIS NEXT WEEK AND I WILL MAKE A LIST and we can agree on 4-6 measures to start with)
Thanks for all your participation!
You guys are the BEST!
Outreach
Outreach
Start doing more active outreach now with Caulda here to help with access
- PAP outreach: Ma/LPN to look into ways they would like to start doing this and report back to team next meeting
- Colon cancer outreach: Jason to present next meeting things to consider when doing outreach
Predictability
MA/LPN schedule available ahead of time, they will review for accuracy to help Cindy out
Liz will assign our cluster each day (Cindy will notify us if cluster staff being pulled out and for what reasons) QUALITY IMPROVEMENT PROJECTS
1) Medication reconciliation: any input from shadowing that would change protocolWe will visit this each week for June to tweak as needed and if ready vote to adopt as our standard protocol July 7th.
2) tier I board,
Where do we want it? Decided to hang on Lynn’s portable wall (work order placed)
What do we want on it? Discuss next visit, we ran out of time
-staff satisfaction/by day or week?( Diane working on format)
-avs
-virtual medicine
-fishing report
-fluorid- access-% chronic care with Tx plan-hedis
Friday, June 12, 2009
West Cluster Meeting Notes 6/3/09
Present: Kelly Walsh, Sarah Philp, Ashley Lindell, Becky Dolan, Shannon Jewell, Esma Delalic, Jason Mateo, Star Morales
Thanks to nursing staff for working HEDIS measures on cancer screening; Kelly is seeing patients who are aware of their need for colon screening.
Provider schedules are in the process of being approved for Fall. Amy will start in October.
Discussion of HEDIS letters; providers are getting inquiry about the wording for the colonoscopies; a copy of the letter is distributed to the providers. The letters are copied from what the East cluster mails out. The West providers will discuss and maybe revamp the wording or take out colonoscopy all together as this requires a referral and can be done if there is a positive hemoccult.
Back to the Medical Home list; Proactive Care
What are we doing already? Looking ahead on Hedis list a day or so before
How do we decide what to do next? Be more proactive; can we notify appointed patients before visits (to come in fasting or that they are in need of a pap)? Each nursing staff can be responsible for 1 provider weekly and can email MyGHC active patients ahead of time… Providers will discuss and get back to nursing staff.
There is no more shortage of the shingles vaccine. If a shingles vaccine is ordered, direct the patient to go to the Business office and check on their coverage and if they still desire to get the vaccine, go to the Core to register for the injection room.
Meeting closed at 1:40PM
Thanks to nursing staff for working HEDIS measures on cancer screening; Kelly is seeing patients who are aware of their need for colon screening.
Provider schedules are in the process of being approved for Fall. Amy will start in October.
Discussion of HEDIS letters; providers are getting inquiry about the wording for the colonoscopies; a copy of the letter is distributed to the providers. The letters are copied from what the East cluster mails out. The West providers will discuss and maybe revamp the wording or take out colonoscopy all together as this requires a referral and can be done if there is a positive hemoccult.
Back to the Medical Home list; Proactive Care
What are we doing already? Looking ahead on Hedis list a day or so before
How do we decide what to do next? Be more proactive; can we notify appointed patients before visits (to come in fasting or that they are in need of a pap)? Each nursing staff can be responsible for 1 provider weekly and can email MyGHC active patients ahead of time… Providers will discuss and get back to nursing staff.
There is no more shortage of the shingles vaccine. If a shingles vaccine is ordered, direct the patient to go to the Business office and check on their coverage and if they still desire to get the vaccine, go to the Core to register for the injection room.
Meeting closed at 1:40PM
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