Transcript physician_orientation_may18_2016_test3

Floyd Medical
Center
Medical Staff
Orientation
Information and Resources
Your orientation to Floyd Medical Center includes meetings with designated
resource people, facility tours and written resource materials. The resource
people and your assigned orientation facilitator are available to answer any
questions you may have.
You will be introduced to staff members and will become familiar with areas of
the facility where you will be providing care and services. Clinical managers,
clinical supervisors and staff of each area are available to assist you as you
become familiar with Floyd.
At the end of the online portion of your orientation, you will be asked to verify that
you have reviewed the materials provided.
Organizational Overview
Organizational Overview
Our Mission is to:
> provide the communities we serve with a comprehensive and technologically advanced
health care system committed to the delivery of care that is characterized by continually
improving quality, accessibility, affordability and personal dignity.
Our Vision is to:
> be the regional health care provider of choice
> deliver patient- and family-centered care that is compassionate, sensitive and respectful
of each individual’s needs.
Our Values
Our Patients are:
> our highest priority
> provided high-quality, state-of-the-art health care
> given respect and dignity
> treated equally
> provided education and information for themselves and their families
Organizational Overview
Our Values
Our Employees are:
> our most valuable asset
> offered an environment that attracts and retains highly qualified personnel
> encouraged and supported to reach their maximum potential through education
> recognized for a job well done
> provided an environment of open communication, participation in planning and respect
for each employee’s contribution to our mission
Our Medical Staff Members are:
> our valued customers as well as partners in health care
> provided an environment that attracts and maintains high caliber physicians
> involved in the direction of the hospital community
Organizational Overview
Service Standards/Patient Satisfaction
All customers, while in the care of the Floyd Medical Center health system, will be treated
with dignity and respect throughout all stages of their life and death regardless of their
mental status. In all our words and actions, we strive to do unto others as we would have
them do unto us and our families. We use the term “customer” in the broadest sense to
include patients, families, visitors, members of the community, physicians, vendors and,
certainly, co-workers.
Administrative Contacts
Phone: 706.509.6900
Kurt Stuenkel, FACHE, President and Chief Executive Officer (CEO)
Joseph Biuso, M.D., FACP, Executive Vice President and Chief Medical Officer (CMO)
Sonny Rigas, Executive Vice President and Chief Operating Officer (COO)
Sheila Bennett, RN, DNP, Senior Vice President and Chief of Patient Services
Glenda Thomas, CPS, CPCS, Medical Staff Coordinator
Organizational Overview
Medical Staff Bylaws
Bylaws are available by request from Administration at 706.509.6915.
Medical Services
A list of services provided by Floyd Medical Center is available on Floyd.org.
Corporate Compliance
To assist our organization and physicians with ensuring that licensing, accrediting,
regulatory and legal requirements are met on an ongoing basis, we have a Corporate
Compliance Plan. Physicians are encouraged to express their concerns and opinions on
any issue regarding potential violations of laws, regulations, ethics, policies and/or
procedures.
Any questions or concerns regarding compliance at Floyd Medical Center or any of its
affiliates should be reported to the Accreditation Compliance Coordinator at 706.509.5197
or any member of the Corporate Compliance Committee. The compliance Hotline number
is 706.509.5120. Calls to the Hotline are not traced or taped. Persons who call the Hotline
may remain anonymous, and confidentiality is maintained to the limit of the law.
While practicing at Floyd Medical Center, providers will follow all HIPAA guidelines for
privacy of patient information. Information on Floyd Medical Center’s Corporate
Compliance Program is available by request from the Accreditation Compliance
Coordinator at 706.509.5197.
Corporate Compliance
Our organization’s responsibilities include:
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Documentation of care provided
Charging only for necessary services provided
Delivering care designed to meet the patient’s needs
Any employee, physician or other individual who provides care, treatment or services and
who has concerns about the safety or quality of care provided in the organization may
report these concerns to The Joint Commission.
Corporate Compliance
Review a copy of our Standards of Business Conduct.
By consistently demonstrating service standards behaviors, each employee helps fulfill the
mission, vision and values of the Floyd Medical Center health system. By incorporating the
service standards into performance expectations, we reinforce the importance of these
behaviors and clearly communicate that they are expected to be practiced by all
employees while at work.
Contacts
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Compliance Hotline, 706.509.5120
Accreditation Compliance Coordinator, 706.509.5197
Corporate Compliance Officer, 706.509.3283
Best Practices for Reducing
LOS and Direct Costs of Care
“These key points help provide effective patient care.” − Dr. Joseph Biuso
1. Communicate with prior-treating physicians about patients’ prior history and testing.
Senior citizens only very rarely have a new chronic condition or new incidental finding.
2. Use consultations judiciously. Every consultation should contain a specific question for
the consultant that justifies the need for the consultation.
3. Communicate with consultants frequently to make sure patients are moved efficiently
through the continuum of care and that pre-existing issues not related to the acute
admission are not unnecessarily reevaluated.
4. Do not ask consultants for permission to discharge. Notify consultants of the plan to
discharge. Ask for any recommendations for post-hospital care. They will let you know if
they disagree.
5. Round early in the day and attend to discharges as a priority.
Best Practices for Reducing
LOS and Direct Costs of Care
Continued…
6. If a patient has a pending result that will likely be negative (e.g. nuclear part of a
negative stress test), do the discharge instructions and dictation pending the results.
When the nurse calls and it is negative, as it will be 90 percent of the time, give the
final discharge order, and if necessary, dictate a two-line discharge summary
addendum.
7. Revisit patients who become ready for discharge later in the day, if necessary.
8. Start discharge planning on admission. Take a careful social history on admission to
identify barriers to discharge.
9. Practice evidence-based care to avoid unnecessary variation that leads to increased
expense, length of stay (LOS), complications and worse clinical quality.
10. Respect pre-existing clinical relationships. A prior consultant can take care of a patient
more efficiently with a more detailed knowledge of the history.
11. Checking the clinical notes area of net access on every admission will facilitate
compliance with many of the listed practices.
Environment of Care
Emergency Codes
In the event of an emergency, dial 123 within the hospital. This call will go directly to the
Operator and will override all other calls being made to the switchboard.
For Floyd departments and practices in outlying areas, call 911. Then notify the Safety
Officer (706.509.6946; 706.509.5197) or Risk Manager (706.509.5745) regarding the
incident.
Fire Response: RACE
Rescue − Any persons in immediate danger. If you are going to open a closed door, feel
the surface first. If it is warm or hot, do not open it. Stay calm, and remember to stay low to
the ground to avoid the smoke and heat.
Alarm − Don’t hesitate to sound the alarm. Alert everyone via the alarm or other
emergency communication. This may be pulling the fire alarm or calling 911 if you are in an
office located off the main campus.
Confine − The fire. Close doors and windows. Stuff towels under doors to keep smoke
out.
Extinguish/Evacuate − If the fire is small, you may be able to extinguish it. If the fire
cannot be extinguished, be prepared to evacuate the patients. Never put yourself or others
in danger by attempting to extinguish a fire you cannot control.
Using a Fire Extinguisher: PASS
Pull the pin.
Aim the nozzle at the base of the fire.
Squeeze the handles together.
Sweep from side to side motions.
Infection Prevention/Bloodborne
Pathogens/Hand Hygiene
The National Patient Safety Goals (NPSG) identifies infection prevention elements in place
at Floyd Medical Center. A written plan for these elements is available from The Joint
Commission.
Floyd has specific guidelines regarding infection prevention and hand hygiene.
The Infection Prevention department can be reached at 706.509.5740. This team is a
resource for infection prevention issues and physician health requirements.
Hazardous Materials
Please be aware of any products you work with that may be hazardous.
Emergency information is included on product labels.
Hard copies of safety data sheets (SDS) are available throughout the hospital. These are
also available on our intranet (GreenLink), accessible through any Floyd computer.
Emergency Preparedness
If called, report to the Emergency Care Center (ECC) and assist.
The process for credentialing non-Floyd Medical Staff providers during a disaster is
available in Policy EC-04-009.
The Medical Staff participates in internal and external disasters affecting the hospital to
ensure continuous and safe delivery of health care services.
Review the following information and familiarize yourself with it prior to a disaster occurring.
If you have any questions, contact Dr. Joseph Biuso at 706.509.6900 or Kenna Baker,
Safety Officer, at 706.509.6946.
Emergency Preparedness
PROCEDURE
1.The Executive Vice President/CMO and/or Medical Staff President are notified by the
Incident Commander or their designee to activate the call roster of the Medical Staff.
2.The CMO in conjunction with the Medical Staff Officer, notifies the Medical Staff as
follows:
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Medical Staff President/Medical Staff President Elect
Department Chairs
Medical Directors
Alphabetically calls the Medical Staff
3.The CMO, Medical Staff President or designee will assume the responsibilities of Medical
Staff Director for the Emergency Operations Center upon notification from the Incident
Commander.
Emergency Preparedness
4. The Chief Medical Officer, Medical Staff President or designee reports directly to Labor
Pool Area/Doctor’s Lounge.
5. The CMO, Chief of Staff or designee works in conjunction with the Incident
Commander, Operations Chief and the Medical Staff President to assign Medical Staff
members to areas of need.
6. The Medical Staff leadership/members are oriented to the Disaster Plans, and any
changes to these plans via new member/new chair orientation and the Medical
Executive Committee. In addition, Medical Staff leadership members are encouraged
to participate in the Homeland Security Presidential Directive 5 requirement by taking
the National Incident Management System (NIMS) online courses IS-100.HCb, IS200.HCa, IS-700.a, and IC-800.b available from FEMA Emergency Management
Institute.
Emergency Preparedness
The goal of this communication is to determine what each medical specialty has to bring to
the table in the event that a disaster occurs in the City of Rome/Floyd County or outlying
areas to allow the best possible utilization of our physicians. This will allow the Incident
Commander and/or his/her agents to decide where physicians should report when they first
arrive based on where needs exist.
Disaster Management
Physician Responsibilities
Department of Surgery
Disaster Management
Physician Responsibilities
Department of Anesthesia
Should be assigned to the ECC or Surgery for airway management, analgesia (nerve
block), surgical anesthesia
Behavioral Health
Should be assigned to ECC or Inpatient Unit to assist with pre-existing and acute
psychiatric issues
Department of Emergency Medicine
Triage patients (use tag system).
Acute resuscitation (ABCs).
Stabilize patients for admission, discharge or Surgery.
Sign out patients to admitting/treating physician.
Incident command will receive frequent reports from ECC to allow timely assignment and
dispatch of necessary specialists and expeditious transfer to Surgery, ICU or floor with
necessary information.
Disaster Management
Physician Responsibilities
Department of Laboratory Medicine
Stand by for deluge of blood work and blood bank specimens, tissue samples (especially if
plague/epidemic). If necessary, request assistance of outside labs, from other hospitals
and facilities.
Department of Family Practice
Assist with disposition of walking wounded and admission to floor for support.
Request help from outside facilities for transfer of stable, pre-existing patients out from our
floors if we need space, offer to accept patients from other pre-existing inpatients from
other facilities if they are in need.
Department of Pediatrics
Assist with resuscitation and stabilization of pediatric patients and transfer to inpatient unit
or more appropriate facility, when stable.
Department of Radiology
Read films stat. If requested, track down treating physician with report.
Disaster Management
Physician Responsibilities
Department of Medicine
Cardiology
Assist Internal Medicine. Be available in ECC/ICU/Telemedicine for management of
cardiac problems, echos, etc.
Gastroenterology
Assist Internal Medicine. Evaluate and treat GI bleeders (scopes).
Oncology
Assist Internal Medicine. If plague, assist with lab medicine workup. Be prepared for
immediate plasmaphoresis in toxic exposure cases.
Disaster Management
Physician Responsibilities
Hospitalists
Assist with disposition of walking wounded and admission to floor for support.
Request help from outside facilities for transfer of stable, pre-existing patients out from our
floors if we need space. Offer to accept pre-existing inpatients from other facilities if they
are in need.
Infectious Disease
If plague/bioterrorism, work with lab medicine to find causative agent. If not, assist Internal
Medicine.
Internal Medicine
Assist with disposition of walking wounded and admission to floor for support.
Request help from outside facilities for transfer of stable, pre-existing patients out from our
floors if we need space. Offer to accept pre-existing inpatients from other facilities if they
are in need.
Disaster Management
Physician Responsibilities
Nephrology
Assist Internal Medicine with acute/chronic renal patients; be available for acute dialysis in
toxic exposure.
Neurology
Diagnose/treat idiopathic illnesses. Assist Internal Medicine.
Pulmonary
Should be assigned to the ECC or Critical Care area for critical care management, vent
management, bronchoscopy.
The Disaster/Mass Casualty Response Plan is available in Policy EC-04-003.
Risk Management
Unusual Occurrences
Floyd has an automated system for reporting and follow-up of unusual occurrences. Alert
unit nursing staff of any occurrence, and they will initiate the required incident reporting. If
you have questions about incidents, reporting or follow up, please contact the Risk
Manager at 706.509.5745.
Our Employee, Patient, Visitor Incident Reporting Using Online rL Solutions Policy is Policy
AD-03-005.
Risk Management
Floyd’s Risk Manager is available to assist physicians with legal questions, identifying
individuals able to give consents, end-of-life issues, potential suit situations or events that
legal counsel may need to be made aware of. Contact the Risk Manager at 706.509.5745
(office).
Risk Management
Sentinel Events
A sentinel event is an unexpected occurrence involving death or serious physical or
psychological injury, or the risk thereof, occurring at or associated with services provided
by Floyd.
Floyd is committed to improving the quality of patient care. The occurrence of a sentinel
event (as defined herein) or "near miss" may identify an opportunity for improvement. Floyd
will, thus, seek to identify and respond appropriately to all sentinel events/near misses
occurring at or associated with services provided by Floyd. In response to an identified
sentinel event or near miss, Floyd will conduct a timely, thorough and credible root cause
analysis and will develop, implement and monitor the effectiveness of an appropriate plan
of action, which is designed to reduce the risk of the occurrence of similar events in the
future.
Our Sentinel Events Guidelines are available in Policy AD-01-060.
Secure Access Areas
Access to some areas of the facility is restricted to authorized badge holders. For
occasional access, use the intercoms adjacent to the locked doors. If you will be seeing
patients in these areas regularly, the clinical manager for the area will request ID badge
access for you. Once activated, swipe your Floyd-issued ID through the scanner adjacent
to the locked doors.
Secure Areas:
• Inpatient Surgery
• Emergency Care Center (ECC)
• Labor and Delivery/Postpartum/Nurseries
• Pediatrics
• ICU
• Doctors Dining Room
• Doctors Lounge (keypad access)
• Medical Records (keypad access)
You will be given a numeric code during orientation for areas with keypad access.
Customer-Focused Patient Care
Customer-Focused Patient
Care
Quality
Floyd is committed to providing care that follows evidenced based standards. The following are major
inpatient populations that we are currently monitoring:
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Stroke (AHA/ASA Get with the Guidelines)
Venous Thromboembolism (CMS)
Total Hip and Knee Replacement (Marshall Steele)
Hip Fracture (Marshall Steele)
General and Vascular Surgery (NSQIP)
Spine Surgery (TJC)
Perinatal Care (CMS)
Neonatal Intensive Care (VON)
Blood Utilization (Blood Assurance)
Type 2 Diabetes (TJC/ADA)
Inpatient Psychiatric Patients at Floyd Behavioral Health (CMS)
Palliative Care (TJC)
(Sponsoring organizations are listed in parentheses.)
For more information, contact the Director of Quality Management at 706.509.5196.
Customer-Focused Patient
Care
Pain Management
Pain is population specific, varying with factors such as age, cultural diversity and cognitive
impairments. All providers should be knowledgeable about how to assess and manage
pain in their patients. Clinical staff can provide details on the pain management scales
used at Floyd.
The Pain Assessment/Management Policy is PCS-01-005.
Customer-Focused Patient
Care
Restraints
Physicians who solely order restraints must be aware of and have read the appropriate
policy (PCS-03-006). Physicians who apply restraints must show competency in the
application of the restraint.
Abuse and Neglect
Floyd’s abused and neglected victim assessment and reporting policy (PCS-01-006) was
developed to assist with identifying those patient characteristics that are indicative of
having been abused or neglected. The policy provides a protocol for patient identification
and assessment, describes characteristic findings and signs of high-risk situations. It also
defines the procedures for reporting abuse and neglect.
Customer-Focused Patient
Care
Cultural Sensitivity and Diversity
Floyd’s patient population reflects diversity in race, ethnic origin, religion and age.
Providers should treat each patient as an individual, identifying any special needs related
to culture, and meeting those needs in a sensitive manner. Floyd staff members are trained
not to treat the patient as they, the staff, would want to be treated but instead to use
communication skills to find out how the patient prefers to be treated. We recommend:
when in doubt, ask.
Language services and support are available for patient care. Interpreters are available
onsite and on call for Spanish speaking patients. Telephone interpretation is available for
multiple languages and/or when interpreters are not available. NexTalk telecommunication
equipment is available for communication with hearing impaired patients.
The Floyd Chaplain is available as a resource for managing religious and spiritual concerns
with patients. The Chaplain can be reached at 706.509.5199.
Customer-Focused Patient
Care
Patient Rights/Ethical Issues
Floyd has an Ethics Committee available for consultations. Consultations may be
requested by physicians, staff, patients or their families. The Ethics Committee reviews
pertinent information and may make recommendations to providers. The ethics consult
process (PCS-04-008) can be activated by contacting the Chaplain at 706.509.5199.
Patient Satisfaction
Floyd’s goal is to be the health care provider of choice for our region. To help achieve that,
we continually seek feedback from patients and use their experiences to improve service
where needed and to recognize those cited when service is exemplary. Patients may
respond to questions about the care received from their physician. You can receive details
about your satisfaction ratings by contacting the Service Excellence Coordinator at
706.509.5195.
Customer-Focused Patient
Care
Pharmacy Services
Details about Floyd’s formulary and policies and procedures related to medications are
available on GreenLink, Floyd’s intranet, which is accessible only through a Floyd
computer. The Pharmacy is open for inpatient orders 24/7.
Clinical pharmacists are available to serve as a resource to providers and to provide Total
Parenteral Nutrition (TPN) services, aminoglycoside and vancomycin dosing, renal dosage
adjustments, and anticoagulation dosing and monitoring.
Call 706.509.5910 for assistance with pharmacy-related services.
Confidentiality/HIPAA
Review Floyd's Notice of HIPAA Privacy Practices.
Customer-Focused Patient
Care
Health Information
Medical Records will provide a personal dictation number and instructions for dictating.
Floyd complies with the Repeat/verify verbal order requirement, GA Rules/Regs for
Hospitals 111-8-40-18 (Policy PCS-06-007).
Floyd’s electronic medical record (EMR) software, Cerner, is used to provide you with
access to patient information, reports and results. You will be trained in the use of portal
and related secured access requirements by a member of the Clinical Informatics staff.
Anticoagulation Education for
Providers
The National Patient Safety Goals require that we provide education regarding
anticoagulant therapy to prescribers, staff, residents and families (Policy PCS-06-051). The
education should include the following elements:
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Importance of follow-up monitoring
Compliance
Drug-food interactions
Potential for adverse drug reactions and interactions
Floyd meets this requirement by providing excerpts from the ACCP Guidelines.
Special Services
Special Services
Parking
The main Doctors Parking Lot is located on Turner McCall Blvd. in front of the 330
Physicians Center. Use your Floyd ID badge at the gate for access. Limited and restricted
physician parking is also available at the main entrance to the Emergency Care Center
(ECC) for physicians coming in on call.
Dining
A private Doctors Dining Room is located adjacent to the cafeteria. Access is by Floyd ID
badge. A complimentary buffet lunch is provided Monday – Friday from 11:15 a.m. – 1:30
p.m. You may get additional items from the cafeteria serving line or stations. Please let the
cashier know that you are a member of the Medical Staff.
Special Services
Courtesy Discount Policy
Floyd Medical Center offers a courtesy discount for health care in accordance with specific
terms, conditions and exceptions as outlined in our Professional Courtesy Discount policy.
A copy of this policy can be requested from Administration.
Policies and Summaries
Policies
Patient Safety
Rapid Response Team – Policy PCS-14-001
Universal Protocol for Prevention of Wrong Site Surgery – Policy PCS-03-003
Standard and Transmission Based Precautions – Policy EC-06-001
Pharmacy
Dosage Adjustment for Renal Insufficiency – Policy PCS-06-030
IV to PO Interchange by a Pharmacist – Policy PCS-06-032
IV Potassium Guidelines – PCS-07-002
Range of Orders for Medications – PCS-06-008
Therapeutic Interchange – PCS-06-027
Resources
Resources
Floyd Telephone Directory
This is a list of phone numbers to clinical and non-clinical departments.
Annual Report
Annual reports for the Floyd health care system are available on FloydStraightforward.org.
Verification
Verification
To verify your review of the Medical Staff Orientation for Floyd Medical Center, complete
this short form.
Once you complete the verification form, a member of our Medical Staff Credentialing
Team will be in touch within one to two business days.
If you have questions, contact our Medical Staff Credentialing Team at 706.509.6915 or
email us at [email protected].