CARE PARTNER/MEDICAL RECEPTIONIST

New Employee Orientation 2014

Getting Started:

Welcome

  • Introductions with explanation of CAPs role
  • Restrooms
  • Length of class is 4 hours with 1 break.
  • Explain handouts

Previous Experience Trainer: Get an idea of who your audience is

  • Who is new to Vanderbilt?
  • What’s your previous work experience?
  • Who is being cross trained as an MR?
  • Do you know medical terminology and abbreviations?

Your job as a Care Partner and/or a Medical Receptionist will vary based on your specific unit. Today you will learn about patient care applications as they related to your job.

For class today, everyone will be using a Training ID. Your permanent ID and systems access will be set up by your security manager (on most units, the AA). A checklist is provided for things that need to be done to complete your systems access and set up your Virtual Clinical Workstation.

StarPanel:

Trainer: Show Companion PPT slide 1and explain StarPanel is the electronic medical record and StarBrowser is the inpatient view of StarPanel designed for inpatient clinicians

Inpatient Whiteboard:

  1. Press Spacebar…sign-on
  2. Explain VCWS

Practice in StarPanel:

  1. Set up user preferences for frames. Explain users will need to do this once with their own ID and instructions are located on the Systems Access checklist.
  2. Click on Customize, then Preferences on the Black menu bar
  3. Scroll down and find Show numeric frame sub tabs. Click on no and it will change to yes. This only needs to be done once.
  4. Users can also Resizethe upper frame … drag or double click white spot
  5. Locatepatient’s name onPatient Listandfind patient on census list…may need to scroll or resize to locate
  6. Click MR# to load patient’s entire chart
  7. Click Pt List to view full census for unit
  8. Click ACTIONS to the right of your patient’s name
  9. Click CHANGE
  10. Select Medical Receptionist’s Menu

Actions Menu:

Trainer:Review most frequently used functions by MR from Actions menu

  1. Click AllDocuments – this contains a record of any document that pertains to a patient’s medical history at Vanderbilt University Medical Center.

Frame below census opens with all of the documents in the pt’s chart

  1. Type “Property” in the Title search field
  2. Press ENTER
  3. Click on one of the Property Records

Frame below AllDocuments opens with a scanned document of the property the pt had with them at admission.

  1. Click Appointments: If the pt has upcoming appointments, they will display here
  2. Click Consent Documents
  3. Open Surgical Consent document
  4. Scroll to view scanned in consent document. Many consents are now being collected electronically.
  5. ClickDemographic. Insurance and patient contact information displays in frame below
  6. Click e-Docs
  7. Type Downtime. 2nd document listed Downtime and Code Req
  8. Right of document, Click glasses to view. When HEO/Wiz, the order entry system goes down, this document used to order labs, blood products and other tests.
  9. Click ED Docs. List of all documents done while pt was in ED
  10. Click OPC
  11. Overview of Patient Care
  12. Printed by MR for nurses prior to shift change
  13. Nurses use to give and receive report… Handover tool
  14. Pt information from orders, test results, nursing & MD

Point out the following as learners locate

Situation:

Team Team Page can be done from here

Patient Contact Information… phone # nurse collected

Synopsis: Residents note if what brought patient to the hospital

Alerts: Allergies, Isolation, Fall,

Advance Directive: end of life document

Background:past medical/surgical history

Assessment: Nursing documentation

Recommendations: Orders from HEO Wiz

  1. Print OPC for nurses prior to shift change
  2. Click Actions
  3. Click OPC
  4. Note Print button - DO NOT click
  1. Note Next Patient till entire census prints
  1. Print CarePartner Snapshot prior to shift change…same steps as OPC
  2. Click Actions Menu
  3. Click CP Snapshot
  4. Note Print button and Next Patient - DO NOT click
  5. Print Charge Nurse Snapshot prior to shift change
  6. Click Print. One document prints with all patients listed

MR Dashboard:

  1. The MR dashboard is located under the Dashboards list in the black menu bar of StarPanel. Click Ancillary dashboards to expand the list and select MR-Ancillary.

  1. Show class how to Drag and drop MR Ancillary in the Favorites list for easy access.
  2. MR’s should be set up to use their MR-Ancillary dashboard by clicking “show this dashboard after login” at the bottom of the dashboard. Then setup their Inptwb to show in favorites and select their floor – but do not set it up in preferences to show on sign on. It won’t work if they have selected “show this dashboard after login”. CP’s crosstrained to MR should use whichever is their primary role to determine which to set up.
  3. Demonstrate how to drag and drop Inpatient Whiteboard census in Favorites. This will allow them to easily toggle between MR Ancillary and Inpatient Whiteboard.
  4. Show the dashboard by clicking on MR Ancillary
  5. Click on Change Panel
  6. Trainer selects 5N(this will take you into the live region).
  7. Have students select the unit they will be working on. Show them how to select multiple units.
  1. Click OK
  2. Point out the indicators. Currently there are indicators for RT, EKG and Discharge Appointments.
  3. The dashboard is a view of the unit census with columns to show:
  4. Pt. demographic information ( including security codes)
  5. Ancillary Orders – initially just RT and EKG
  6. RT – green is a routine order and red is for STAT. From the MR Dashboard, click on the order indicator. Review the order and click “Acknowledge orders” to acknowledge you have seen the order. A hollow box indicates the order has been acknowledged. By acknowledging, you are showing you saw the order and it is the electronic equivalent of picking the paper requisition up off of the printer. An automatic page is sent to RT for STAT orders.
  7. EKG –the indicator colors are the same as RT’s but the process for notifying EKG will be specific for each unit. There is no automatic notification for EKG orders.
  8. In the notes column, click in the bland space to make notes for MR or Charge RN. For example, this is a way to track Consents, pt specific data from shift to shift and contact precautions, etc.
  9. The Discharge Appointment indicator provides notification of any follow0-up appointments made since admission. If the indicator is white, no appointments have been scheduled andfollow up is needed with the patient’s RN.

TRAINER: Refer to handout on MR Dashboard and explain it is on the SSS website.

HEO/Wiz:

Show the objectives on Companion PPT slide 2.

  1. Double click on Green Wizard to open HEO/ Wiz Training region

Confidential Status

  • N= pt requested no info be given out
  • G= general info such as room number can be given out
  • U = unknown
  • NS = No info and Security Risk , i.e, Victim of violent crime

Other Things from Census View

  • Search for patient. Type Ztest
  • Printouts button
  • Refresh(refreshes the census after a Medipac transfer/discharge)

Printouts Button:

  1. Practice printing a patient list from Printouts button – Don’t print
  2. Practice printingWiz labels- Don’t print

Diet List is printed (for Adult Units) prior to the arrival of the food cart in Adult Hospital.Print Diet list from Actions menu in StarPanel

Pre-Orders Playback:

Trainer: What did the purple P indicate to the left of a pt’s name?

Preorders are entered by a provider and stored prior to the patient being placed in a Medipac bed. A purple “p” alerts medical receptionist to activate the orders. Orders can be played back from either HEO/Wiz or StarPanel.

  1. Double click on your same patient
  2. Click Manage PreOrder(list of preorders with today as playback date will be displayed)
  3. Verify the correct preorder set is selected

Trainer: Do NOT Attempt to playback Unsigned orders-check with Charge Nurse for date to playback.

  1. Click Playback. Preorders load

5. Scroll to bottom and click next. The orders will load & flash across the screen

6. Click Next. The preorders report will be displayed. This document is also sent to StarPanel and if Wiz were down during the time you needed to playback the orders you could access this document in StarPanel, print it and use for downtime orders.

7. Scroll to bottom of the View/ Playback orders screen

8. Click Playback Orders

9. Click Yes to “Are You Sure?” HEOcloses once orders are played back. POS and Reqs print

  1. Click REFRESH - Purple P goes away

Some units get more preorders than others. Dialysis orders are only played back by Dialysis Staff

Reprint Requisition:

  1. Click on Patient’s name
  2. Select Reprint Req…Reqs can be printed for yesterday, today, tomorrow
  3. Reprint “cbc/plt/diff in 0500 – prints to closest printer on unit

Why would you reprint a req? Lost, damaged, need early

Processing Orders:

Trainer: When orders are entered directly by a provider or nurse or playback by the MR, a hard copy of the orders print on the inpt units.

HANDOUTS: POS and REQs …. Review laminated sheet

Computerized Physician Orders pages 1 and 2

►Generally print to Medical Receptionist’s printer when orders entered in HEO/WIZ and the MR’s either distribute them to the bedside or keep them at a central location. You will learn what your unit does from your preceptor.

RN’s will acknowledge orders online

Patient information and MD who authorized order at top

Each order has a number

STAT orders display bold … see page 2

Start & stop times (right side of page)

Open-ended orders (continuous) display start time. Remain until deleted or pt discharged – see #10 NHO

One-time orders - see #13 culture urine bacteria

Timed orders – See #23 (pg 2) Morphine. 72 hrs stops

Far right column provides a place for MRs to note when dept called, etc

When orders are processed and verified, MR & RN initials are required during a downtime

Computerized POS is not a permanent chart document

Shredded after replaced

Requisitions: Lab pg 3

►Reqs print on unit if procedure or test done on unit. The MR either distributes the req to the bedside or places it in a central location. You will learn what your unit does from your preceptor.

►Other Reqs print in performing department, i.e. Radiology, Nutrition Svc.

►Lab Reqs are bar coded:

2 barcode above double line are patient information

Barcodes below line defines tests

Lab scans Req when specimen is received

►Multiple tests print on same Req if tests can be run in same dept (CBC and PCV)

►Full signature, VUNet ID, dates & time from person collecting specimen.

►Text in center section gives directions on how to collect specimen, color of tube

►If test ordered STAT, MR calls the performing department, except for Labs.

►Batch Reqs print after midnight if the test is to be done after MN, ie, next day’s labs

Medipac:

Trainer: Show Objectives in PPT slide 3

Trainer: Whiteboard unit’s census is managed in 3 ways via the Medipac system:

  1. Admitting department admits a new patient into Medipac
  2. Unit staff discharge patients in Medipac when they leave VUMC
  3. Unit staff transfers patients in Medipac to a different location

When a change is made in the Medipac system, the census is changed in StarPanel and in other applications. Maintaining an accurate unit census is one of the most important aspects of the Medical Receptionist’s job.

Trainer: Find your patient on the patient list, use MR training ID TRAIURV, nurse___ so your screen matches the students.

Review Patient Listfrom laminated packet

  • Snapshot of current census at the time it is printed
  • Headers across top: unit, bed, pt’s name, age, sex, admission status (all here are inpts (IA), MR#, Case #, date admitted and Attending
  • At the Beginning of shift, print a Patient List.
  • Will Use this list to practice transfer and discharge
  • Case # = Account # - always use this account #, not blue card

Trainer: Show Medipac Keyboard Tips and Pavillions in PPTslides 4, 5

What unit is your patient on? 7N(or census for the room training is being held)

What Pavilion is 7N in? Heart and Vascular institute – pavilion 4

  1. Click Go to Desktop… 2nd icon from black bar
  2. Double click Medipac Icon

Medipac & StarBrowser display lower tool bar

  1. Click Medipac…rsf from lower tool bar to view the application
  2. Tab to MEDP3M
  3. Type A at the white square
  4. Press ENTER. Patient management menu displays

Change Pavilions: Transfer to PAV 4

Trainer: Turn over your training card and practice transferring a patient from 7N to the unit and bed listed on the card (MCE5 Cardiac Short Stay MCE or 5S)

What Pavilion displays? Pavilion 1

  1. Tab to PAV
  2. Shift /tab..practice going back one space
  3. Tab back to PAV
  4. Type 4
  5. Press Enter… Note Message “Pavilion change accepted”.

If the pavilion had not been changed, would the patient be available for transfer? NO

  1. Tab to Nurse unit Transfer (NXFE)
  2. type A & press Enter
  3. Press TAB key until the white box stops to the right of the Account #
  4. Type the number zero
  5. Locate your pt’s case # on the laminated sheet
  6. Following the zero, Type the 12 digit case #
  7. Press Enter

Trainer:

Always confirm that the name in the top left corner matches the name on the Patient List.

Transfer Date and time defaults to current time. If the patient leaves the unit earlier, be sure to Type over date and time, shown in red, to reflect actual time left.

F8 turns page forward

F7 goes back a page

Pause/Break goes back to the home screen

Tab goes forward

Shift Tab goes backward

If you see the stick man, press Esc

  1. Tab to PAV. The patient is transferred within Pavso no Pavilion change is needed
  2. Tab to LOC
  3. delete red text
  4. Type ??
  5. PressEnter
  6. Review the list of locations patient can be transferred to
  7. Turn your patient card over and see what unit your patient is being transferred to and find it on the list and type in the appropriate line number
  8. Press ENTER

Trainer: A list of available beds display, have students assign their patient to bed on the back of their patient card. No two people should select the same bed.

  1. Locate line number and bed on the Patient List
  2. Type LINE # …be careful to select correct bed for your pt
  3. Press Enter
  4. Confirm Medipac bed matches what’s on the Patient List
  5. Note Message …Transfer complete

Transfer Back to Home Unit:

Trainer: When the patient returned to the unit from surgery or other areas, the MR should transfer the patient immediately to their unit’s census.

  1. Tab to Account #
  2. Type zero
  3. Type the12 digit account number
  4. Press Enter
  5. Tab to LOC
  6. Delete Red text
  7. Type ??
  8. Select 7N… the pt’s home unit
  9. Type line number for theoriginal bed, based on the pt list
  10. Press Enter. Transfer complete displays at bottom left screen

Additional Transfer Information:

  • Transfer Notice will print
  • When transferring to the OR, CCL or other procedure areas,select any available bed.
  • When transferring to unit,select actual room pt is going in to

Discharge for IA:

Trainer: Practice discharging your SAME patient. All patients should be back on 5N

  1. Press Pause/Break to get out of transfer function
  2. Tab to NDSC “Nurse Unit Discharge”
  3. type A
  4. Press Enter
  5. Tab to Account #
  6. Type zero
  7. Type account #
  8. Press Enter
  9. Type overdate /time if not time patient leaves unit
  10. Tab to disposition code
  11. Type E
  12. Press Enter
  13. Press Enter again after message-Warning, ptinhouse on this day
  14. message at bottom left

Additional Discharge Information:

What admissions types are discharged, IA or OT? IA…on Patient list

Use Patient List for account number, not the blue card

Never perform the medipac discharge or transfer function until the patient physically leaves the unit

  • Transfer complete displays at bottom left screen
  • Admitting department must cancel all discharges… i.e., patient is leaving unit but collapses at elevators and MD decides not to discharge

Is there urgency in getting a discharge cancelled if pt didn’t leave? Yes, orders are lost in 4 hours and no new orders can be entered until patient is back in Medipac.

What happens if disposition code 7 is selected instead of E? Pt will not have MR # to schedule clinic visits/hospital readmits.

If you correctly typed in the acct #, but get message “Pt not in this Pavilion”, what’s the problem? Change pavilion

Departure for OT: Trainer Demo Only

Nurse Unit Departure is similar to Discharge (NDSC) except Departure is for Outpatients (OT). Watch the screen to observe how a Departure is done

  1. Press Pause/Break to return to Patient Management menu
  2. Confirm PAV 1 Displays
  3. Select NDPT, Nurse Unit Departure
  4. Type this case #: 000503212-0298 - ZTRAINSSS10SD, ANDRE
  5. Departure time should match time patient physically leaves the unit
  6. Disposition – E
  7. Press Enter… departure complete
    Instruct learners to close out Medipac
  8. Press Pause/Break and F3 until back to signon screen
  9. X out of Medipac so that Desktop displays

Break 15 Min (during break, trainer’s need to cancel discharges from Medipac)