Ward Council Meeting – March 17, 2017

Attendees: Dana, Laurie, Monica, James, Deepti, Peggy, Charlie, Justin M., Sergio, Mary, Lenny, Jake, Isaac, Miriam, Jenny, Tony, Balin, Eileen, Justin R., Seth, (4 residents)

  1. Back Fill – Mary/Jake/Charlie
  2. Still collecting data to determineif feasible to do a proposal for Back Fill.
  1. Bounce Back – Deepti
  2. Question of shortening or eliminating bounces for Gold because never the same providers, we don’t maintain continuity.
  3. Should we have a bounce back policy for all teams, shorten it for all teams, or eliminate it?
  4. We don’t have many bounces, have a low readmission rate.
  5. Originally came up with bounce back policy when residents and attendings were on the same team for a while, that is no longer the case, there is no continuity.
  6. There is no requirement for a bounce back policy.
  7. Don’t have any data on it. Can see how many bounce backs have weekly to see if it would affect anything.
  8. Can use the bounce back to see what could be done differently with discharge.
  9. Discuss with new chief residents when have a policy for bounce backs.
  10. Some bounces make sense, some don’t. Try to come up with number of days that would be most appropriate and useful. Go for something shorter—1 or 2 weeks. Can be consistent and say 1 week on any team.
  11. Action Item – next meeting in April will focus on the Bounce policy and see if want to revise it. Dana will come up with a proposal to shorten the Bounce policy. See if can come up with data on how many bounces. Will talk about it.
  1. Triage Sheets – Dana
  2. Have been revised. Initial trial getting 7% of them completed. (Getting all the information, every one had some information but only 7% completed)
  3. Have revised it and made it much easier to complete.
  4. Can be completed by medical record, time patient was presented by ED, time patient was evaluated by resident—just checking one box.
  5. Would like to develop a policy that first or second PALs is admitted by our Cross Cover rather than being admitted by the ED night float.
  6. If we can show that the PALs patients are taking away, can assign that to one of the Cross Cover people.
  7. If we pay them more or how we would do that would need to be figured out
  8. Hoping to get at least 3 weeks of data from triage sheets to show something.
  1. Question by Deepti
  2. Cerner will be down on Sunday for 5 hours and she is on day call; what do you do, anyone have experience with that?
  3. Do everything by paper; wait until comes back online to do documentation.
  4. Or can put in word document or dictate.
  1. Following of patients - Lenny
  2. Patients admitted by Silver in the morning and the responsibility of communication with the nurses, Powerchart to go over with day call team.
  3. Idea of day call team being in charge of patients or Gold team.
  4. Hard to follow, ER nurses found frustrating.
  5. Recommendation to have one consistent thing.
  6. Tech issue nationwide. Would be nice to have a way to let everyone know what providers are responsible for a patient on a given day.
  7. Silver has a lot to do already with admitting, consultations, triaging, seeing patients in the afternoon.
  1. Tony brought up that Keith mentioned the new OCD policy was becoming effective in April.
  2. James emailed everyone to know why they were ineligible.
  3. Keith emailed those that needed remediation.
  4. Told the soonest remediation courses available would be May or June.
  5. Will take several months to finish.
  1. Jenny – concern about text paging to nurses
  2. Just forwarded memo to Kendall that she saw from Greg Aguilar.
  3. Memo from new telecom representative, Greg Aguilar, that AMiON is not secure and no one should be text paging through it.
  4. Do only numeric phone paging.
  5. He believes that AMiON is not secure. The old fashion way of paging is recommended.