Lots of great problem solving at today's meeting.
EXTERNAL RX: include phone/fax no. where to place folder?
- Red folder to be placed on provider’s desk on right hand side to be matched up with hard copy of prescription so they can go back to the pharmacy together.
3 YR. WCC: eyes/ear.
- Concluded that for 3yo wcc-no eyes/ears-a lot of work and often fruitless
Red Alerts; solutions?
- Create and use PA openings to handle overflow during the day
Routine immunizations for pregnant patients:
- No routine (live) immunizations, but ifluenza vaccine is indicated. Also see Penatal Care Guidelines on InContext.
Evaluate processes:
- Fish, red/green alerts, pre-visit prep
- For Future Agenda: check to see if above system is working or not (one month)
Limit rate of new actions:
- Limit rate of new actions-such as above
- So no one feels intimidated or stupid
Rap Sheets: should be put in pharmacy slot in AM ASAP?
-Rap sheet to be placed into BO slot for Faxing-was done by Anna-system not working; Becky will discuss w/ Mark to continue process-BO to do faxing
Lab requests that pt’s name, # be on FOBT card:
- will put pt’s name/initials, and CSN on stool cards when sending out or placed stickers on when pt is being seen
Refrigerator temp. readings no longer being done:
- Continue to keep refrigerator temp. eye solution needs be in refrigerator
Pregnant patients again:
- week’s of gestation needs to be noted on nursing note
- generic list of preps/guides-Cheryl has copies if one needs a copy
Thursday, July 23, 2009
Tuesday, July 21, 2009
North Cluster meeting minutes 7/21/09
1) if everyone could write their days out on the calandar that would be great.
2) August 30th will be our potluck (Jason can make that day afterall!) I will send a formal invite soon.
3) Provider, please try to do 3 chronic care plans a week.
4) Previsit prep:
Green sheet on board to show this:
Support staff: review our HEDIS deficits like we have been doing during outreach times and write on green form
MD's: review missing HEDIS and reconcile if 'not due' and address if due (like we have been doing)
Support staff: do diabetic foot exams on all diabetics every 6 months, have them all take shoes and socks off for MD exam as well
Support staff:
Ask about MY GROUP HEALTH STATUS and see if we can get more patients signed up.
We will check and see how this is working next week.
Thanks to all of you for your hard work!
Saturday, July 18, 2009
Cross-covering protocol
My sister asked for this cross-coverage protocol, which was developed by Sarah Philp last Fall and posted to the blog in December. We've got several new providers since then, so it's worth sharing again.
Enjoy!
Enjoy!
North Cluster Develops a Medication Reconciliation Protocol
Cheers to the team up North for creating standard work we can all use to promote patient safety and get the medication list right every time!
Medication Reconciliation Protocol for North Cluster:
(DRAFT)
MA/RN/LPN Responsibilities:
1. INQUIRE
- ask the patient if they have a list and/or the pill bottles with them and reconcile their data with medication on epic
-ask about inhaled medications/OTC/herbals and PRN meds as well.
2. UPDATE
If a patient states they are taking a medication that is not listed on active meds, look in the historical meds and mark as taking and notify MD/PA on Yellow form/or PN of discrepancy.
3. DELETE
Discontinue all duplicate medications and completed courses.
4. VERIFY
verify with patient that AVS has been updated with RX changes and list has been correctly reconciled
MD/PA responsibilities:
1) REVIEW
review the med list for accuracy reviewing indications with patient and checking for understanding
2) UPDATE
-if any changes to medications made at that visit, ensure this has been reflected on medication list
(if not picking up new RX, rewrite and use 'update and file' tab)
-try to put indications on all RX to help patient understanding
-consider maximizing refills
3) VERIFY
if you are giving AVS, confirm with patient that RX list has been updated and changes reflected and confirm their understanding of the various indications
Medication Reconciliation Protocol for North Cluster:
(DRAFT)
MA/RN/LPN Responsibilities:
1. INQUIRE
- ask the patient if they have a list and/or the pill bottles with them and reconcile their data with medication on epic
-ask about inhaled medications/OTC/herbals and PRN meds as well.
2. UPDATE
If a patient states they are taking a medication that is not listed on active meds, look in the historical meds and mark as taking and notify MD/PA on Yellow form/or PN of discrepancy.
3. DELETE
Discontinue all duplicate medications and completed courses.
4. VERIFY
verify with patient that AVS has been updated with RX changes and list has been correctly reconciled
MD/PA responsibilities:
1) REVIEW
review the med list for accuracy reviewing indications with patient and checking for understanding
2) UPDATE
-if any changes to medications made at that visit, ensure this has been reflected on medication list
(if not picking up new RX, rewrite and use 'update and file' tab)
-try to put indications on all RX to help patient understanding
-consider maximizing refills
3) VERIFY
if you are giving AVS, confirm with patient that RX list has been updated and changes reflected and confirm their understanding of the various indications
Wednesday, July 15, 2009
CORE MEETING MINUTES Tuesday 7/7/09
7:30 Immunizations
Staff agreed that during the “back to school crunch” we will need extra help. Immunization letters were sent out to parents encouraging them to bring their children in early .
– even with this letter, we still get the bulk of kids between end of July and up until the first week of September
Last year immunization sites were put in the clusters (as well as the core) and all the LPN’s working that day would give the immunizations along with us, unless they were busy.
Core Staff feel that this wound be a good thing to have again this year.
The state has made many changes in the distribution of immunizations. For now, the flow staff will not order immunizations but can check the consent form and hand out the VIS.
We still need all cluster staff to know that patient stickers need to go on the back and from of the stickers. Every day it seems like we are getting new guidelines for immunizations which makes it pretty confusing. Bobbie has volunteered to help simplify the process.
8:00 CORE Work Flow
Drop In Records- the number of monthly drop in’s for june increased from 52 to 53. These are the highest since tracking the drop ins began.
The data shows that Wednesdays continue be the busiest with the most drop in’s.
Core work flow (continued)
Wound care Records- The number of Wound cares that were done last month dropped from 146 to 125. Some of the reasons for this were because we were able to heal and discharge a lot of our patients. And this is the quiet before the storm.
Wound care has patterns of high volume and low volume.. an example would be: May- high number of new patients – why? Because the nice weather is coming and more people are outdoors
June drops off because people have gotten used to the weather, not as many injuries and school is still in.
We should see a rise in July as summer is in full bloom, kids are out of school… etc
Wound Care Days of the week The high volume days have changed. Since may. Last month our busiest month was tied with Wednesdays and Fridays. This would not of been so bad, but because Wednesday is our busiest day for drop in’s , the work load felt impossible to co. Our lightest wound care day was Thursday.
The goal for June was to even out the wound care days so that Thursday picked up and Wednesday’s dropped off.
This goal was met. We evened out the wound care so that all days are about the same.
8:15 Nurse of the day cell phone- CORE staff have proposed that they get a cell phone that the Doctors or flow staff could use when trying to get a hold of the CORE staff. This would increase communication between the core and the clusters. The Cell phone number would be put on the daily schedule. The CORE RN would carry the cell phone and hand it off to another staff member when leaving the premise. We were not able to finish this discussion due to time constraints. Will be put on the agenda next meeting
Staff agreed that during the “back to school crunch” we will need extra help. Immunization letters were sent out to parents encouraging them to bring their children in early .
– even with this letter, we still get the bulk of kids between end of July and up until the first week of September
Last year immunization sites were put in the clusters (as well as the core) and all the LPN’s working that day would give the immunizations along with us, unless they were busy.
Core Staff feel that this wound be a good thing to have again this year.
The state has made many changes in the distribution of immunizations. For now, the flow staff will not order immunizations but can check the consent form and hand out the VIS.
We still need all cluster staff to know that patient stickers need to go on the back and from of the stickers. Every day it seems like we are getting new guidelines for immunizations which makes it pretty confusing. Bobbie has volunteered to help simplify the process.
8:00 CORE Work Flow
Drop In Records- the number of monthly drop in’s for june increased from 52 to 53. These are the highest since tracking the drop ins began.
The data shows that Wednesdays continue be the busiest with the most drop in’s.
Core work flow (continued)
Wound care Records- The number of Wound cares that were done last month dropped from 146 to 125. Some of the reasons for this were because we were able to heal and discharge a lot of our patients. And this is the quiet before the storm.
Wound care has patterns of high volume and low volume.. an example would be: May- high number of new patients – why? Because the nice weather is coming and more people are outdoors
June drops off because people have gotten used to the weather, not as many injuries and school is still in.
We should see a rise in July as summer is in full bloom, kids are out of school… etc
Wound Care Days of the week The high volume days have changed. Since may. Last month our busiest month was tied with Wednesdays and Fridays. This would not of been so bad, but because Wednesday is our busiest day for drop in’s , the work load felt impossible to co. Our lightest wound care day was Thursday.
The goal for June was to even out the wound care days so that Thursday picked up and Wednesday’s dropped off.
This goal was met. We evened out the wound care so that all days are about the same.
8:15 Nurse of the day cell phone- CORE staff have proposed that they get a cell phone that the Doctors or flow staff could use when trying to get a hold of the CORE staff. This would increase communication between the core and the clusters. The Cell phone number would be put on the daily schedule. The CORE RN would carry the cell phone and hand it off to another staff member when leaving the premise. We were not able to finish this discussion due to time constraints. Will be put on the agenda next meeting
Tuesday, July 14, 2009
Referral contact menu
Cheryl asked me recently to post my referral contact drop-down menu to the blog. So here it is. You can create your own dot phrase in Epic with these steps:
- In Epic, open Tools --> SmartTool Editors --> My SmartPhrases
- Click Accept
- Click Add
- Make up a SmartPhrase Name (like ReferralTelephone)
- In the SmartPhrase Text box, type this {:16687}
And that's it. When you use the SmartPhrase, you'll see a drop-down menu of contact phone numbers patients can call to schedule appointments. These numbers are only for Central Campus, though. I don't know of one for other campuses.
Saturday, July 11, 2009
East Cluster Notes, July 8, 2009
Agreements from the East Cluster this week.
Our cluster board is developing nicely. We feel great about having eliminated or edited the information that didn't mean anything to us because the language was inaccessible, the print was tiny, the data or goals weren't clear, or the information simply didn't have anything to do with our daily work.
We like the "How Was Your Day" sheet, modeled on the pediatric pain scale, and have made the "suggestion envelope" into sticky notes to post on the board. This takes the invisible (notes hidden in an envelope) and makes them visible for all to see and discuss. A hard day for one of us might lead to a comment about what was hard, a suggestion for improvement, and a rapid change that eliminates the cause of the bad day. That's the power of writing on the board.
We also have our daily Fishing Reports on the board, but are not yet addressing these in an organized way to improve our access.
We will continue to use this "How Was Your Day" approach to bring up what's good and what's not, to solve what we can right now, and to discuss in our weekly meetings things that need a little more time.
Until next week, this is East, signing off.
Our cluster board is developing nicely. We feel great about having eliminated or edited the information that didn't mean anything to us because the language was inaccessible, the print was tiny, the data or goals weren't clear, or the information simply didn't have anything to do with our daily work.
We like the "How Was Your Day" sheet, modeled on the pediatric pain scale, and have made the "suggestion envelope" into sticky notes to post on the board. This takes the invisible (notes hidden in an envelope) and makes them visible for all to see and discuss. A hard day for one of us might lead to a comment about what was hard, a suggestion for improvement, and a rapid change that eliminates the cause of the bad day. That's the power of writing on the board.
We also have our daily Fishing Reports on the board, but are not yet addressing these in an organized way to improve our access.
We will continue to use this "How Was Your Day" approach to bring up what's good and what's not, to solve what we can right now, and to discuss in our weekly meetings things that need a little more time.
Until next week, this is East, signing off.
Owning the Medical Home, Burien Style
I shared Burien's work on a couple of projects this week at the South Mini-Forum, and thought I would write a bit about it as well.
Through this process of launching the Medical Home at Group Health, Burienites (BRNites?) have sought effective ways to implement the creative piloting work our sister clinics and Primary Care Leadership Team. Excellent processes create solid standard work. Because of this, we enjoy the work, and we have excelled.
I think one of the reasons we've been able to sustain our enthusiasm is that we've explored ways to own the work and make the individual campaigns our own. Simply "receiving" the campaigns as orders in notebooks risks creating a culture of apathy (BRNouts!), staff who ace the checklists but don't feel energized by the effort.
So, how do we take very good ideas and faithfully put them to work at Burien while maintaining our sense of uniqueness, our sense that Burien is unique? It isn't easy! Or fast. Or linear. But owning the work is powerful, and worth the effort.
An example.
We're in the midst of launching the Prepared Visit effort. Goals: capitalize on opportunities to close care gaps, improve outcomes, and unburden our patients and ourselves.
When I look at the work from the perspective of various stakeholders, it's a winner all around: it looks pulls us out of the "tyrrany of the urgent," and helps us plan thoughtful care for our patients. But it is more work for our flowstaff, who are already heavily burdened with the daily demands of rooming patients, eliciting their concerns, reconciling their medications, making endless calls, handling provider requests, and moving information though our system. This doesn't begin to describe the amazing load of work our nursing staff accomplishes, and it is done with such efficiency and grace that it is largely invisible to me.
The idea of loading another task, and no small task, onto our flowstaff seemed like a guaranteed loser if handled poorly. More work? With what time? It seemed sure to feel bad all around if the work was introduced to flowstaff by boss-types who don't do the job and can't relate--really--to what another task means.
So we floated the Prepared Visit idea to a few of our excellent flowstaff, medical assistants with experience, smarts, and credibility among their peers. We asked these opinion leaders for their help: try out the work of preparing for visits before we launched clinic-wide, and share their experience. My medical assistant, Cheryl Rogers, took on the project with enthusiasm. I showed her a checklist five minutes before the end of a workday, and by the time she left she had already prepped one patient for the following day. Her response to the concept was enthusiastic: it was work, but it was worth it. She could see the payoff: preparation would improve patient care and lessen the burden of low-yield outreach letters and calls, work that consumes hours of her precious time every week.
The result. Cheryl and I have done more unscheduled pap smears in the last week than we scheduled in the last six months. And well-child checks. And colon cancer screens. Tetanus shots. Mammograms. Blood tests. Unbelievable, and very satisfying. And our patients like it--surprise. I've started running the checklist on my own with patients who send email.
By the time we had our launch event last week, everybody already knew about the project. They had watched their respected peers dive into the work and talk about it. And though we don't officially launch the project until next week, all of our flowstaff are already doing pre-visit checklists for our patients.
If you ask me, that's a successful launch. We're doing standard work (that we didn't have to create de novo), and we own the work because we presented it in a respectful way, engaging opinion leaders and allowing them to drive the process.
We are very fortunate at Burien to have a engaged, capable, and creative staff who crave meaningful work that matters to patients. Harness that spirit--rather than squash it--and we'll continue to lead the way in creating a model of what Primary Care really should be.
Crossposted at ghmedicalhome.org
Through this process of launching the Medical Home at Group Health, Burienites (BRNites?) have sought effective ways to implement the creative piloting work our sister clinics and Primary Care Leadership Team. Excellent processes create solid standard work. Because of this, we enjoy the work, and we have excelled.
I think one of the reasons we've been able to sustain our enthusiasm is that we've explored ways to own the work and make the individual campaigns our own. Simply "receiving" the campaigns as orders in notebooks risks creating a culture of apathy (BRNouts!), staff who ace the checklists but don't feel energized by the effort.
So, how do we take very good ideas and faithfully put them to work at Burien while maintaining our sense of uniqueness, our sense that Burien is unique? It isn't easy! Or fast. Or linear. But owning the work is powerful, and worth the effort.
An example.
We're in the midst of launching the Prepared Visit effort. Goals: capitalize on opportunities to close care gaps, improve outcomes, and unburden our patients and ourselves.
When I look at the work from the perspective of various stakeholders, it's a winner all around: it looks pulls us out of the "tyrrany of the urgent," and helps us plan thoughtful care for our patients. But it is more work for our flowstaff, who are already heavily burdened with the daily demands of rooming patients, eliciting their concerns, reconciling their medications, making endless calls, handling provider requests, and moving information though our system. This doesn't begin to describe the amazing load of work our nursing staff accomplishes, and it is done with such efficiency and grace that it is largely invisible to me.
The idea of loading another task, and no small task, onto our flowstaff seemed like a guaranteed loser if handled poorly. More work? With what time? It seemed sure to feel bad all around if the work was introduced to flowstaff by boss-types who don't do the job and can't relate--really--to what another task means.
So we floated the Prepared Visit idea to a few of our excellent flowstaff, medical assistants with experience, smarts, and credibility among their peers. We asked these opinion leaders for their help: try out the work of preparing for visits before we launched clinic-wide, and share their experience. My medical assistant, Cheryl Rogers, took on the project with enthusiasm. I showed her a checklist five minutes before the end of a workday, and by the time she left she had already prepped one patient for the following day. Her response to the concept was enthusiastic: it was work, but it was worth it. She could see the payoff: preparation would improve patient care and lessen the burden of low-yield outreach letters and calls, work that consumes hours of her precious time every week.
The result. Cheryl and I have done more unscheduled pap smears in the last week than we scheduled in the last six months. And well-child checks. And colon cancer screens. Tetanus shots. Mammograms. Blood tests. Unbelievable, and very satisfying. And our patients like it--surprise. I've started running the checklist on my own with patients who send email.
By the time we had our launch event last week, everybody already knew about the project. They had watched their respected peers dive into the work and talk about it. And though we don't officially launch the project until next week, all of our flowstaff are already doing pre-visit checklists for our patients.
If you ask me, that's a successful launch. We're doing standard work (that we didn't have to create de novo), and we own the work because we presented it in a respectful way, engaging opinion leaders and allowing them to drive the process.
We are very fortunate at Burien to have a engaged, capable, and creative staff who crave meaningful work that matters to patients. Harness that spirit--rather than squash it--and we'll continue to lead the way in creating a model of what Primary Care really should be.
Crossposted at ghmedicalhome.org
Wednesday, July 8, 2009
North Cluster Minutes July 7, 2009
Thank you all for a GREAT meeting, we are covering a LOT and very efficiently!
Please see final medication reconciliation document. If I do not hear back on modifications, we will formally adopt and share with Clinic. GREAT WORK ON THIS, it has really made a different in our work and our patient care!
Items to do:
1) Please place your gallup survey in our envelope and we will give it a try. I would also encourage you all to look at East clusters "how was your day" feedback and I will check in next meeting if you would like to do that as well.
2) We will try our North Cluster Huddles:
With Flow staff meeting before each session to clarify who is here/what assignments look like/problem shoot etc.
Flow staff will update as needed their provider with the pass off of the first patient.
We will touch base next week to see how that is working.
3) try to do today's work today
Convert exam to WCC if due, add a PAP if due etc.
Lakisha and Ted being a trial for the Pre visit prep and will let us know how that is going. We will incorporate all of cluster in this next week.
4) Providers don't forget the CCM plans
5) Potluck dates.
Don't forget to give me feedback on dates you would prefer. List 1st, second and 3rd choice. Also if there are dates you absolutely can not make please let me know and we will try and avoid those.
Dates are:
July 19
July 26
August 2
August 9
August 16(actually this one we may be out of town, so may need to remove this option, sorry!)
August 30
They are all Sundays, time around 3-6PM, kids/partners welcome!
Thanks for being such a great team!
Diane
Thursday, July 2, 2009
East Cluster Meeting, July 1, 2009
East Cluster had another great meeting on Wednesday morning.
We began by rounding at our cluster board. We like very much the "How Was Your Day?" daily survey, which gives each cluster member the chance to rate their day, 0-5 (five is a great day). An envelope tacked to the board gives us a chance to explain in words why we chose that number. We're not sure yet how to respond to what we put in the envelope: should we talk daily to address those things or wait until our cluster meeting each week? We agreed that if somebody's day was a one (ugh!), we should not wait up to a week to improve that?
Any thoughts on that?
Another thing about the cluster boards. A lot of the stuff up there (charts and text) doesn't pass Cheryl's very wise "plain English" test, which says that anyone walking by the board should be able to figure out quickly and easily what the information up there is trying to say. There shouldn't be jargon, tiny print, or charts that require a PhD in statistics to interpret. So we marked up our board with suggestions for improving.
But we didn't agree on who owns the job of updating the board.
We moved from the board to the roundtable and heard from Shannon (Pharmacy) and Sherrie (RN) about their roles in Chronic Disease Management. Here's a summary:
Shannon can help our patients who take medications for chronic diseases get to their treatment goals if we ask her help. She has protocols to adjust doses for diabetes and high blood pressure medications, and will call or see patients in clinic to follow blood sugars, blood pressures, lab tests, help with motivation, personal barriers to self-care, and any questions our patients have about their medications. She doesn't have a big case load now, and would love to see more of our patients!
Remember that she also has a separate blood pressure program for patients without complicated disease whose blood pressure is uncontrolled.
Sherrie and Christine, our RNs also take on patients with chronic diseases, including diabetes, asthma, COPD, heart failure, and coronary artery disease. They have two kinds of services to offer:
Phew.
We wrapped up by learning from Frank that extensive testing of the air in the East Cluster showed that it's pretty good. Nothing dangerous in it. There's more mold outside than in the building.
Great meeting!
We began by rounding at our cluster board. We like very much the "How Was Your Day?" daily survey, which gives each cluster member the chance to rate their day, 0-5 (five is a great day). An envelope tacked to the board gives us a chance to explain in words why we chose that number. We're not sure yet how to respond to what we put in the envelope: should we talk daily to address those things or wait until our cluster meeting each week? We agreed that if somebody's day was a one (ugh!), we should not wait up to a week to improve that?
Any thoughts on that?
Another thing about the cluster boards. A lot of the stuff up there (charts and text) doesn't pass Cheryl's very wise "plain English" test, which says that anyone walking by the board should be able to figure out quickly and easily what the information up there is trying to say. There shouldn't be jargon, tiny print, or charts that require a PhD in statistics to interpret. So we marked up our board with suggestions for improving.
But we didn't agree on who owns the job of updating the board.
We moved from the board to the roundtable and heard from Shannon (Pharmacy) and Sherrie (RN) about their roles in Chronic Disease Management. Here's a summary:
Shannon can help our patients who take medications for chronic diseases get to their treatment goals if we ask her help. She has protocols to adjust doses for diabetes and high blood pressure medications, and will call or see patients in clinic to follow blood sugars, blood pressures, lab tests, help with motivation, personal barriers to self-care, and any questions our patients have about their medications. She doesn't have a big case load now, and would love to see more of our patients!
Remember that she also has a separate blood pressure program for patients without complicated disease whose blood pressure is uncontrolled.
Sherrie and Christine, our RNs also take on patients with chronic diseases, including diabetes, asthma, COPD, heart failure, and coronary artery disease. They have two kinds of services to offer:
- A three month chronic disease management program that involves several face to face sessions and a lot of telephone and email follow up. This focuses on many aspects of helping patients live well with chronic diseases and is best suited to newly diagnosed patients or those having a hard time controlling their disease.
- A "treat-to-target" program that focuses on specific goals identified by providers. An example would be adjusting insulin dosing until the patient has met a target blood sugar goal.
Phew.
We wrapped up by learning from Frank that extensive testing of the air in the East Cluster showed that it's pretty good. Nothing dangerous in it. There's more mold outside than in the building.
Great meeting!
Wednesday, July 1, 2009
West Cluster Meeting Notes 7/1/09
Present: Kelly Walsh, Sarah Philp, Shannon Jewell, Sherrie Elmer, Jason Mateo, Star Morales, Ashley Lindell, Doug Knopp
Outreach; brief discussion on who is working on what this week…each of the flow staff is getting about ½ day every 1-2 weeks.
Cluster Social Gathering? Okay for a Friday in August? Email Kelly with dates that will not work for us.
Welcome, Shannon! Shannon discussed how she puts in medication refills and lab orders and documents in chart if she contacts patient. She states there is not so much Chronic Care Outreach being referred to her by the West Cluster yet. (See handout under Clinical Pharmacist Expectations).
Welcome Sherrie! Chronic Disease management; Sherrie explained how patients referred to RN’s work. These are patients referred for narrowed diagnoses (see handout under Family Practice RN expectations) and are followed for up to three months. When finished, these patients are warm transferred back to providers.
Voting for Flow Staff lead: Esma, Star and Jason all interested. We still need to decide whether this will be a rotating position (about every 6 months) or permanent position. Becky was working on developing a job description but we do not have it yet. It is hard to vote on this when we do not have a clear picture of what the job entails. Some people did not want to vote until we have the job description. Star brought up it would be helpful for the cluster to have each person's resume to review to help in decision making process. Each person interested will email the cluster their resume with an introductory paragraph of why they are interested in the position and then we can vote at the next meeting if the job description is provided.
Hedis- Flow staff pretty much caught up on Cancer screenings. Will add diabetes; Shannon states by the time the patient name is on the list, Pharmacy has already sent them two letters; so a phone call may work better. HTN- Wellesley already has a letter which we can send to patients asking them to come to the RN class. Star will contact him to get this and email to West Cluster before the next meeting. There are also two separate blood pressure goals for patients; diabetic and plain hypertensive.
Ashley brought her pre-visit dot phrase for labs; she will add no gum, gargling or mints to it and send to each of us.
Flow staff left at 1:40.
Outreach; brief discussion on who is working on what this week…each of the flow staff is getting about ½ day every 1-2 weeks.
Cluster Social Gathering? Okay for a Friday in August? Email Kelly with dates that will not work for us.
Welcome, Shannon! Shannon discussed how she puts in medication refills and lab orders and documents in chart if she contacts patient. She states there is not so much Chronic Care Outreach being referred to her by the West Cluster yet. (See handout under Clinical Pharmacist Expectations).
Welcome Sherrie! Chronic Disease management; Sherrie explained how patients referred to RN’s work. These are patients referred for narrowed diagnoses (see handout under Family Practice RN expectations) and are followed for up to three months. When finished, these patients are warm transferred back to providers.
Voting for Flow Staff lead: Esma, Star and Jason all interested. We still need to decide whether this will be a rotating position (about every 6 months) or permanent position. Becky was working on developing a job description but we do not have it yet. It is hard to vote on this when we do not have a clear picture of what the job entails. Some people did not want to vote until we have the job description. Star brought up it would be helpful for the cluster to have each person's resume to review to help in decision making process. Each person interested will email the cluster their resume with an introductory paragraph of why they are interested in the position and then we can vote at the next meeting if the job description is provided.
Hedis- Flow staff pretty much caught up on Cancer screenings. Will add diabetes; Shannon states by the time the patient name is on the list, Pharmacy has already sent them two letters; so a phone call may work better. HTN- Wellesley already has a letter which we can send to patients asking them to come to the RN class. Star will contact him to get this and email to West Cluster before the next meeting. There are also two separate blood pressure goals for patients; diabetic and plain hypertensive.
Ashley brought her pre-visit dot phrase for labs; she will add no gum, gargling or mints to it and send to each of us.
Flow staff left at 1:40.
Subscribe to:
Posts (Atom)