Name of Group/meeting : Admission History Revision debriefing 1 for vuh and OB

/ Next Meeting: / Nov 17 730-830 11N conf Room
Date / Time / Location / Nov 16 2011 730-830 cvicu conf room
Chair: Karen Hughart / Facilitator
Recorder / Gwen Holder
Attending: / Lynn Conduit 10S/D, Joann Moore SSS, Martha White 9N/S, Blair Anderson OB, Chris Kennedy Inpt Med
Meeting Objectives: / Identify issues with implementation that need to be quickly addressed
Provider Forum for clarification and to identify issues

Topics

/ MINUTES
Summary / Decision / Next Steps
1) / Generally staff are very positive and saying “THANK YOU FOR TAKING AWAY THE FLUFF”
“I hope this is the last STAT immunization I have to give”
2)1 / Support
Largest number of admissions occurs after 5Pm. @ 1700 yesterday there were 50 pending.
What is best support model for SSS- should staff call help desk? Do we need more people present during change of shift? Worried that at shift change time the staff won’t do admit hx – that is not the case per group. / SSS gives phone # to units so they can call prn
SSS to round
Need SSS more 5pm and after / Gwen will look at SSS staffing and reporting mechanism – will see if all night shift people can work 5p-5a ( confirmed)
3) / Indicators
Admit Hx indicators placed on WB today but we are still in transition from paper process to all electronic so they will NOT be accurate.
Need to reinforce that with staff and leadership so they DO NOT FOCUS ON INDICATORS. There are also some tech issues that are being worked on with indicators that we could not do before admit hx when live in prod. /
  • Need to communicate that indicator not reliable at this point due to transition.
  • Indicators should be reminders not punitive
/
  • SSS to focus on this when making rounds
  • Gwen will email leadership to alert to this fact

4) / Transfers from Periop and Cath Lab
  • CCL will have all of the admit hx done in Whitt system except for immunizations- so immunizations is the only portion that inpt staff need to complete once pt arrives to floor after Cardiac Cath
  • Periop is using combination of VPIMS ( pt that had this done prior to implementation 11/15)and Admin Hx ins starpanel section 1. Important thing for post op units is to focus on is getting immunizations piece done in section 2.
  • Changes in the VPIMS system for periop to correspond to the admit hx changes will be implemented Dec 6th- so there will be several weeks of transition.
/ SSS/ Unit Leadership on Card cath and post units to communicate to staff
5) / ISSUES/COMMENTS
Open Draft: Many people needed help learning how to open a previous draft of the admit history so they edit and continue to add information.
Review Imported Data/ Save as draft : most staff are completing all 3 sections at one time. The “review imported data” box must be checked in all sections ( it is a mandatory field) but the save as draft only needs to be clicked in section 3.
Discussed having only 1 review imported data in section 3 .
Changes: SSS getting lots of suggestions for changes – some can be done quickly some are more long term or need more discussion. NO CHANGES WILL BE MADE THIS WEEK unless crucial.
OB would like to have the OB section moved to section 1.
Religious Preference and Clergy Visit- these are in 2 difference sections. Can they be combined? Rationale for this is that needed to know immediately if pt had religious preference that impacted txm – ie don’t want blood products – but don’t need to know immediately if pt wants clergy visit. When staff get more familiar with process and know they complete all 3 sections at once they will probably ask both questions together. But not appropriate to move since there are some areas/ situations where completing sections at different times is appropriate. / SSS communicate these points when making rounds
Karen will take suggestions back to work group to evaluate priority for changes
6) / Immunizations
This seems to be the most confusing/ complex issue with the changes. Chris K involved in work group that meets re: these issues weekly and will take back this feedback
OB: pt status changes from pregnant to non-pregnant so confusion re: best approach to assuring immunization screens are correct and vaccines appropriately given. Due to complexity of issue will have meeting off line
Card Surg pts- cardiac surgeons do not want their post op pts to get immunizations. Need to meet off line
Liver Transplant- the exclusion criteria reads” Admit for organ transplant” and there is concern that if pt is readmitted staff may not catch that this is a recent liver transplant and pt would get vaccine. Need clarification from Liver Tx re timeframe post op that pt should not have immunizations and then figure out workflow/tech changes.
Debunk Myths Need to clarify what the evidence shows re: immunizations there are a lot of myths floating around.
Consents :Consent form is NOT needed for immunizations. Portion on admit hx form that ask if pt would take covers that piece. VCH is different and will use consent.
Vaccine storage on unit: Not all units have capacity to store vaccines in accudose refrigerators so pharmacy will send up via tube. VIS should be with the vaccine. Nurse should only have to print VIS if need it in language other than English. / Mtg to be set up ( Karen to f/u):
OB
Card Surg
Chris to contact liver tx re” clarification of timeframe