Transcript Focused visits - Jacobi Medical Center

Jacobi
Ambulatory Care Service
There’s no I in team: Clinic (practice)
improvements based on resident
feedback!
CONTINUITY!!!
• TEAM Follow up (applies to all)
• Special Sessions (PGY3’s)
• PLANNED VISITS (PGY2 and
PGY3’s)
Jacobi
Ambulatory Care Service
My patient needs a quick follow-up…but I
am starting night float!
Jacobi
Ambulatory Care Service
Team follow-up sessions
• Do you have a patient with a form that needs
to be completed soon? A patient who needs a
quick B/P check? A patient who needs sooner
follow-up to review lab results?
• If you have no available appointments, use the
Team Follow-up session.
• Each team will have 2 sessions/month that
can be booked only with that team’s follow-up
patients—patients who need a quick, focused
visit.
Jacobi
Ambulatory Care Service
Level of Care for team follow-up
• Document exactly what needs to be done with
your patient.
• The team resident does only what you
indicated—not a comprehensive visit, but
rather a focused visit.
• For Z-outs, this will likely be a level 3 visit
• Send a short email to the referring colleague, if
indicated. For example—”Mr. Lee’s
B/P=134/70; he is tolerating dyazide well.”
Jacobi
Ambulatory Care Service
I’m a PGY-3 and I don’t have enough clinic
slots to see my patients…what can I do?
Jacobi
Ambulatory Care Service
PGY-3 Special Sessions
• Each PGY-3 will have one session/month that
only he/she can book patients into. This will
make it possible for you to follow your own
patients.
• There will be 6 slots initially, increasing to
seven in Jan 2012.
• This dedicated follow-up session should
obviate the need to overbook.
Jacobi
Ambulatory Care Service
This patient needs more than 15
minutes…how can I take better care of
her?
Jacobi
Ambulatory Care Service
The Planned Visit
• You’ll see two patients in the session and you’ll
choose them yourself
• Good choices might be patients with poorly
controlled chronic conditions, poor compliance
with medications, psychiatric disease, frequent
ED flyers, etc…
• These will not be in the booking schedule!
• Let the front desk Associates and your PCA’s
you are expecting patients!
Jacobi
Ambulatory Care Service
Important Tidbits of Info
Booking will be a three step process (not
planned visits):
First, check AMION for the dates and times of
these special sessions
Tell the patient when to come back
Send an email on Outlook to: APCS ACM with
the patient’s MR number and telephone
number.
Jacobi
Ambulatory Care Service
Can you view future booking?
• Sure! Ask any PCA or clerical person to show
you the availability of these special sessions. It
takes a few minutes, so try to pick a time when
the staff isn’t busy. They are willing and able to
help you.
Jacobi
Ambulatory Care Service
Caveats….
• You can see other/additional patients if your
Special Sessions, Team Follow ups or
Planned visits are not booked and confirmed
or are NO-SHOW
• Planned visits should be confirmed by you!!!
• Make a note in “other contact”
• Booking Associates will check your panel the
night before to identify any
unused/unconfirmed/open slots that can be
used for refills or overflow….
Jacobi
Ambulatory Care Service
Pitfalls/Troubleshooting
•
•
•
•
No special sessions in the schedule…
Special sessions are already booked…
Special sessions are incorrectly booked…
Nobody seems to know what you are talking
about…
• Let a manager know what is going on!
Jacobi
Ambulatory Care Service
Clinic Basics
Jacobi
Ambulatory Care Service
• Walk in closes for lunch at 12:15. Tell the DT and the
PCA if any charts are still on your door.
• If you are on call you are expected to see no more
than three patients (two for PGY-1’s) and to finish by
3:00.
• In regular clinic PGY-1’s should see four patients;
PGY-2’s six; PGY-3’s seven.
• If a patient is more than 30 minutes late please
discuss this with a DT. (Asking the patient to reschedule is an option.)
Jacobi
Ambulatory Care Service
• In the morning, clinic starts at 8:30 and ends at
12:15. In the afternoon, it starts at 1:15 and
ends at 4:30ish.
• Please sign in.
• Let the DTs know if you start falling behind.
They are here to help.
• If you see a DT unavailable, please do not
hesitate to say: “Hi—I need to present a case!”
Jacobi
Ambulatory Care Service
Jacobi
Ambulatory Care Service