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All Hands Meeting

All Hands Meeting . September 24, 2009. Agenda. Welcome new employees: Cristin Flu vaccine: Jasmine Phlebotomy form: Cristin Online radiology request forms: Cristin Visit Planner (Yellow Sheet): New Provider Section Depression Screening and Suicide protocol: Andrew and Cristin

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All Hands Meeting

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  1. All Hands Meeting September 24, 2009

  2. Agenda • Welcome new employees: Cristin • Flu vaccine: Jasmine • Phlebotomy form: Cristin • Online radiology request forms: Cristin • Visit Planner (Yellow Sheet): New Provider Section • Depression Screening and Suicide protocol: Andrew and Cristin • QI teams: Kim

  3. Staffing Updates

  4. Welcome • Jasmine Levy, RN • Arlene Chung, MD • Erin Vanscoyoc, MD • Yvonne Williams • Jennifer Williams • Care Assistants • Cole Andrew (pain) • Jenny Chou (diabetes) • Natalie Phillips (diabetes)

  5. Flu vaccine

  6. Flu vaccines • H1N1 vaccine: expected in October • Seasonal influenza • In progress

  7. Influenza

  8. Flu vaccine templates

  9. New Phlebotomy Form

  10. NewLabForm(front)

  11. NewAncillaryForm(back)

  12. Online Radiology Requests

  13. ABN Form

  14. Online Radiology

  15. Diabetes Visit Planner: New Provider Section Andrew Sampson, MD

  16. New Provider Section • Roll out planned for Monday 9/28 • Current changes were made with provider input • Goal is to increase current usage (3/09 – 8/09): • % signed off foot exams (high risk) = 18% - 75% • % assessment of contraceptive status when indicated = 20% – 38% • Continuity intern (B Vincent) to evaluate provider usage of new planner, including new depression prompt • New Information: • Labs • Meds • Depression Prompt

  17. New Provider Section: Labs Relevant labs are provided

  18. New Provider Section: Meds • Utilization of key meds are listed based on information from the WebCIS medlist and the diabetes registry • Provider is prompted if patient is not on key med and patient is indicated

  19. New Provider Section: New Depression Prompt Prompts provider to assess depression follow-up if patient screened positive for depression that day or at last visit Will replace foot prompt for appropriate patients Promote PCP/CA communication to ensure depression follow-up

  20. Depression Improvement Work • Along with the new provider depression prompt, other efforts to improve depression screening, treatment and follow up are: • Standardized communication of results by CAs to providers • Revise current algorithm for treatment and follow-up with input from LCSW with mental health experience (Diane Dolan-Soto) • Develop scripts for CAs to make consistent, directed phone call follow-up • Develop depression education handout for CA to review with patients who screen positive

  21. Procedure for Suicidal Patients Cristin Colford, MD

  22. Procedure for Suicidal Patients • Voluntary • Involuntary • Emergency

  23. Voluntary • Provider and patient determine together that they should be evaluated. Provider determines patient is safe and can go to Crisis Clinic/ED on own, accompanied by family member or accompanied by nurse • If patient determines en route that they do not wish to pursuit evaluation, then escort would allow patient to go.

  24. Involuntary • Provider and patient determine that patient should be evaluated and provider does not feel patient is safe if they were to not seek care. • Fill out forms, notarized by clinic staff, faxed to magistrate, call Public Safety. • Once magistrate returns (by fax) custody order, then Public Safety will escort patient to ED. • There is a second line (on back) where provider can sign that says you do not want to be included in future commitment hearings

  25. Emergency Custody Order • Special form to fill out • If patient is unstable and you cannot wait for magistrate to return the custody order, signing this form enables Public Safety to immediately take custody and transport patient to ED.

  26. QI Projects

  27. Current Team Projects • Team 1 • Radiology form approval • Staff Directory • Standardization of nurse lab kits • Misdirected mail issues • Discarding old lab sheets and forms • Team 2 • Late clinic – Late patients and the impact they have on Late nurse staff and Front desk staff • Team 3 • No shows – tools and scripts, case management • Standardizing brochures in the clinic • Retinal Camera – check in/check out/flow • Team 4 • Patient flow and signage • ABN paper form code correction and ensuring codes are filled in by MDs • Customer service training

  28. Team Metrics • Data collected on Attendance, Participation, Tasks Complete, Agenda for Meeting, PDSAs in process

  29. Meeting Location Changes

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