MEDICAL RECEPTIONIST

New Employee Orientation 2015

Getting Started: 5 min

Welcome: Trainer show slide #1

  • Introductions with explanation of CAPs role
  • Restrooms
  • Length of class is 4 hours with 1 break.
  • Explain handouts –
  • Class Handouts
  1. Computerized POS (laminated on ring clip)
  2. Computerized Requisition (laminated on ring clip)
  3. Patient list
  • Unit handout (paper copies to take and use in class and on unit)
  • MR HANDOUT #1: Notes page. If users learn best by taking notes, this page was made for them!
  • MR HANDOUT #2: One Time Set Ups use immediately on the unit
  • MR HANDOUT #3: Systems Access Checklist Refer users to partner with their Security Manager to get racfid issued and setup. Will prevent access to Medipac if not issued.
  • 3 blank lab requisitions for practice activity
  • MR additional activities handouts

Trainer:Your job as 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:(30 min)

Driver: Show slide #2OBJECTIVES

and explain StarPanel is the full electronic medical record. StarBrowser is the inpatient view of StarPanel designed for inpatient clinicians and quick link includes icons down the left side of the screen.

Inpatient Whiteboard:

Trainer:

  1. Until you sign on you have a nonsecure view of the patient list, and indicators for orders, labs, etc.
  2. Nurses ONLY acknowledge orders here.

Sign on:

Trainer/Driver:

  1. Press Spacebar…sign-on**Unclick Virtual to sign in
  2. VCWS vs non virtual
  3. Explain VCWS:
  4. Tap in or Sign on to virtual and open all your applications.
  5. Don’t close applications, use Red X to sign off or tap out.
  6. As you move from one computer to another you will go right into where you left off.
  7. Always check patient name in new room to avoid documenting on wrong patient! You will only do it once!

StarPanel practice:

Trainer:

  1. HANDOUT #2: Refer user to one-time setups for inpatient whiteboard & frame sub tabs
  2. Navigating in StarPanel: Numbered tabs at top =Frame number, or resize a frame by double click in a white spot or drag lines between up and down

Driver:

  1. Click inpatient census in black bar
  2. Locate patient’s name on Patient List and find patient on census list…may need to scroll or resize to locate
  3. Click MR# to load patient’s entire chart
  4. Click Pt List to view full census for unit
  5. Click ACTIONS to the right of your patient’s name
  6. Click CHANGE
  7. Select Medical Receptionist’s Menu

Actions Menu:

Trainer: Review most frequently used functions by MR from Actions menu. Instruct how to change the view to Medical Receptionist view by using the change button and choosing the appropriate actions menu view. Remind to click on Actions from the patient list in top frame.

Driver:

  1. Click AllDocuments (will open in frame 2) – Trainer: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
  1. Property documents opens in a new popup window. Review the scanned document of the property the pt had with them at admission.
  2. Click on the red X at the top R to close the popup
  3. Click frame 1 tab to return to patient list
  4. Click Actions menu next to your patient’s name
  5. Click e-Docs (will open in frame 2)
  6. Opens in a new popup window
  7. Click Downtime tab. 2nd document listed Downtime and Code Req (bottom of list)
  8. Trainer:Explain broken up into Acute Care, Specialty, and ICU areas. When HEO/Wiz, the order entry system goes down, this document used to order labs, blood products and other tests.
  9. Click on the red X at the top R to close the popup
  10. Click on Actions menu next to your patient’s name
  11. Click OPC (will open in frame 2)
  12. Overview of Patient Care
  13. Printed by MR for nurses prior to shift change
  14. Nurses use to give and receive report… Handover tool
  15. Pt information from orders, test results, nursing & MD

Trainer:Point out the following as learners locate on OPC

Situation:

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

Explain OPC are printed for nurses prior to shift change

  1. Click Actions
  2. Click OPC
  3. Note Print button - DO NOT click
  1. Click frame 1 tab
  2. Point out Care partner and Charge nurse snapshot
  3. Explain CarePartner Snapshot printed prior to shift change…same steps as OPC
  4. Explain Charge Nurse Snapshot printed prior to shift change
  5. One document prints with all patients listed
  6. Click IVT Request Form. (learner will just watch as you will show live patients)

Trainer: MR, CP or RN completes this form to request IVT services. It displays on their dashboard so they are not interrupted by calls and pages. See Handout #2 for instructions on setting up the IVT dashboard in your favorites.

Point out the following as learners locate on Actions Menu (no need to go to them)

 Appointments: If the pt has upcoming appointments, they will display here

 Consent Documents: Some consents will be handwritten and scanned but many are electronically collected now.

Demographics: Insurance and patient contact information displays in frame below

MR Dashboard:(15 min)

Trainer: MR Dashboard is what you should see when you first sign on to the computer as an MR. It was designed for MR’s to promote efficiency and facilitate notification of orders once requisitions no longer print– see HANDOUT #2: One Time Set ups handout for instructions to set this up on your own ID.

Go through the dashboard and have users watch since these are live patients.

  1. The MR dashboard is located under the Dashboards list in the black menu bar of StarPanel.

  1. On your own ID you will save the Inpatient Whiteboard and the MR ancillary Dashboard to your favorites as you see here so you can easily toggle back and forth if change roles
  2. MR dashboard – use as MR
  3. Inpatient WB – use as CP

Driver:

  1. Show the dashboard by clicking on MR Ancillary
  2. Check the unit census –
  3. Click on Change Panel if you need to change
  4. Trainer selects ___(census of training room) (this will take you into the live region).
  5. Show them how to select single and multiple units.
  6. Click OK
  7. The dashboard is a view of the unit census with columns to show:
  8. Pt. MRN, age, location and including security codes
  9. Action button (OPC is here)
  10. Team Pager – Click to text the provider (x out -don’t click send)
  11. Orders - shows new orders, red for STAT orders, P for Preorders you need to playback at appropriate time (more on this later)
  12. Ancillary Orders – initially just RT and EKG
  13. 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. STAT orders are called to the RT team. Routine orders will be seen by RT on their dashboard.
  14. 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.
  15. Indicators. Currently there are indicators for Orders/preorders, RT orders, EKG orders, code status, Discharge Appointments and Discharge orders.
  16. In the notes column, click in the blank 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.
  17. Discharge Appointment indicator provides notification of any follow-up appointments made since admission. If the indicator is white, no appointments have been scheduled and follow up is needed with the patient’s RN.
  18. D/C indicator shows if there has been an order placed to discharge the patient.

HEO/Wiz:(30 min)

Driver:show HEO/Wiz video (3 min)

Driver:show slide #3OBJECTIVES

Driver:

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

Trainer:

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:

Trainer:

Printouts button used for printing most important list of day…The patient list used for tracking patient movements throughout the shift.

Driver:

Click on Printouts, demonstrate printing a patient list from Printouts button – Don’t print

Diet List is printed (for Adult Units) prior to the arrival of the food cart in Adult Hospital.

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.

Driver:

  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.

Driver:

  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?” HEO closes 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:

Driver:

  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

Trainer: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.

CLASS HANDOUTS (laminated): have class get out the packet to use for this section

Computerized Physician Orders

► Print to Medical Receptionist’s critical printer when orders entered in HEO/WIZ and the MR’s either distribute them per unit protocol.

RN’s will acknowledge orders online

Patient information and MD who authorized order is at top - show on handout # 1

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

Computerized POS is not a permanent chart document

Shredded after replaced – see unit protocol for details

Requisitions: Lab (class handout #2)

►Reqs print on unit if procedure or test done on unit. The MR distributes the reqs per unit protocol. You will learn what your unit does from your preceptor.

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

►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 RT or EKG 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

Break Time (10min)

Medipac:(45 min)

Driver:show Medipac video (7 minutes)

Driver:show slide #4OBJECTIVES

Refer toMR HANDOUT#4Acronyms and Medipac tips

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

Driver:Show slide #5 (Medipac keyboard tips) and #6 (Pavilions)

Trainer:

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

Driver:

  1. Click Go to Desktop… 2nd icon from black bar
  2. Double click Medipac Icon
  3. Medipac & StarBrowser display lower tool bar
  4. Click Medipac…rsf from lower tool bar to view the application
  5. Tab to MEDP3M
  6. Type A at the white square
  7. Press ENTER. Patient management menu displays

Transfers:

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

What Pavilion displays? Pavilion 1

Trainer: If you need to transfer a patient to a different pavilion or from a different pavilion you will have to change the pavilion.

Driver:

  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. Type a zero (leading zero). 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. Never transfer or discharge till you see the patient actually leaving the floor!

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

Driver:

  1. The patient is transferred within Pav so no Pavilion change is needed
  2. Tab to LOC
  3. Type ??
  4. Press Enter
  5. Review the list of locations patient can be transferred to
  6. 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
  7. 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.

Driver:

  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.

Driver:

  1. Tab to Account #
  2. Type zero
  3. Type the 12 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 the original bed, based on the patient list
  10. Press Enter. Transfer complete displays at bottom left screen

Trainer: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 patient is going in to

Discharge for IA: