There are different ways to create a timeline that organizes important information about a client's life. Below is one example of an ACT client timeline. If your team uses a different method or template, print both tools off and compare them. Pull a client file and look at the forms included. What information does a timeline highlight?

If your team does not use a timeline, look at the forms in the client file and identify the forms that most resemble a timeline. Where are the gaps in information collection? Using the client file as a source, fill out this timeline.

You will use your completed timeline from this assignment for further assignments coming up in the module.

Example Client Timeline

Client Name:

Timeline Date / Admission
Or Discharge Date / Institution or Provider / Presenting
Problem or Legal Status / Diagnosis,
symptoms,
significant
events (suicide
attempts,
threats, violent
acts, self-
neglect) / Medication / Services Rendered / Living situation, dates, address or type, reason for leaving, Activities of Daily Living (ADL)(Personal hygiene, household
activities, housecleaning,
cooking, grocery shopping, laundry, and financial source and money management) / Employment or education
(Dates held, employer
position, type reason
for leaving, other
educational activities) / Other
(Alcohol or
drug use
treatment, family
relationships
medical other:
specify)

ACT 4 TREATMENT PLAN
CURRENT / CLIENT:
LAST DATE REVIEWED BY TEAM:
Legend: Black = Team Management Plan, Blue = Client-Centered Plan
DSM DIAGNOSES:
AXIS I
AXIS II
AXIS III
AXIS IV
AXIS V / STRENGTHS:
GOAL CATEGORIES: Psychiatric, Substance Use , Physical Health, Housing, Social Skills and Personal Development, Activities of Daily Living, Education and Employment, Family and Relationships, Legal, Other
DATE:
CATEGORY:
DESCRIPTION:
SMART GOAL AND PLAN: / RESULTS:
DATE:
CATEGORY:
DESCRIPTION:
SMART GOAL AND PLAN: / RESULTS:
DATE:
CATEGORY:
DESCRIPTION:
SMART GOAL AND PLAN: / RESULTS:
DATE:
CATEGORY:
DESCRIPTION:
SMART GOAL AND PLAN: / RESULTS:
DATE:
CATEGORY:
DESCRIPTION:
SMART GOAL AND PLAN: / RESULTS:
DATE:
CATEGORY:
DESCRIPTION:
SMART GOAL AND PLAN: / RESULTS:
DATE:
CATEGORY:
DESCRIPTION:
SMART GOAL AND PLAN: / RESULTS:
DATE:
CATEGORY:
DESCRIPTION:
SMART GOAL AND PLAN: / RESULTS:
DATE:
CATEGORY:
DESCRIPTION:
SMART GOAL AND PLAN: / RESULTS:

Different teams use different kinds of systems to create Daily Team schedules. How similar is your scheduling process to the one described here? How is your scheduling process effective? What are the challenges? Discuss with a co-worker.

Several BC ACT teams are now almost completely paperless. Vancouver ACT teams use Outlook calendar for the daily schedule, an alert board and safety plan. Read about this system below. How might it be helpful in your work?

Implementing ZONING/Traffic Light System for Vancouver ACT team

What is Zoning in patient care ?

Zoning/Traffic light system is primarily a system to manage the case work and target the resources effectively in clinical care setting.

What does the colour coding mean ?

RED

Clients at high risk/Crisis

Need frequent/ intensive input, monitoring & follow up

Eg: daily visits

AMBER

Unwell but do not present as high risk

Eg: may require increased input/ monitoring to manage/ reduce the risks or to attain stability

GREEN

Stable

Need routine visits

Input as per the care plan

Blue

Outside routine care

Eg: In Hospital/ Facility/Treatment centre/Prison etc

Background & evidence

Ryrie et al 1997- Discussed about Traffic light/ Zoning system

It can enhance operational management and ensure clinical knowledge and expertise is consistently shared and organized.

Green & Hipkiss 2001- Zoning intervention integrates with care planning & promotes safety and continuity of care.

Gamble et al 2007 - Daily to plan the clinical activity and categorize the resources and how different patient priorities can be met. Zoning helps in managing the risk effectively.

Key principles

  • Important to be proactive
  • Commitment
  • Adhering to set criteria and importance of time management
  • Promote safety and continuity of care
  • Resource management

Implementation

1. Assigning every client on the white board in to the zoning profile based on the above criteria

2. Zoning is reviewed daily using a white board (with client information), paris notification and by active participation of staff by round robin approach with all the staff sharing their observations or assessments of the client zoning profile and rapidly appraise the priorities.

3. Done every day as part of morning meeting. Staff to proactively change the zoning profile as required on the board by end of the day and send notification via paris for all amber blue and red clients. This can be discussed in the morning meeting by round robin approach and if there is no available to share that information the notification from the paris could be used for appraising the available information.

4. To notify only for clients in amber, red and blue zone or for changes in clients from green to any other colour.

5. To discuss in the morning the risks, intervention or any other action plans including the resource allocation.

6. Once a week to review the all the clients independent of their zoning profile.

References

  1. Implementing zoning across mental health care trust- a lived experience (Gamble C et al 2006)
  2. Zoning – A system of managing case work and targeting resource in CMHT’s – Journal of mental health. 65, 515-523. (Ryrie et al 1997)
  3. Lambeth early onset zoning criteria – South London & Maudsley NHS trust, Green C & Hipkiss M (2001)