Clinic Assistant Updates - Table of Contents

Clinic Assistant Updates - Table of Contents

Feb. 17th, 2015 – Clinical Updates and Reminders:

Acutely Ill Adults

Any Clinic Assistant that fails to appropriately flag these patients for staff may be dismissed from the Clinic Assistant program.

Feb. 9th, 2015 – Clinical Updates and Reminders:

Depression Screening

Huddling and Chart Prep

NextGen Trainings

Clinic Assistant Shifts

Volunteer Resources Webpage

Jan. 9th, 2015 – Clinical Updates and Reminders:

Next Gen Updates

PCMH – What is it and what can Clinic Assistants do to help?

Staying Healthy Assessments

Clinic Assistant Skills Update

Oct. 17th, 2014 – Clinical Updates & Reminders:

1.SUMMIT

2.Flu Shot Reminder

3.Ebola Screening

Oct. 2nd, 2014 – Clinical Updates & Reminders:

1.Tobacco Usage

2.Flu Shots

Sep. 23rd, 2014 – Clinical Updates & Reminders:

1.Next Gen Updates:

a.Tracking

b.Height and BMI

c.Tobacco and Allergies

2.Clinic Assistant Skills Update (LEADS):

Sep. 16th, 2014 – Clinical Reminder:

Sep. 2nd, 2014 – Clinical Reminder:

Aug. 11th, 2014 – Next-Gen Reminder:

Jul. 28th, 2014 – Next-Gen Reminder:

Jul. 23rd, 2014 – Clinical Reminder:

Jul. 17th, 2014 – Clinical Reminders:

1. Patient Labels:

2. Well Child Checks (WCC):

Apr. 25th, 2014 – Clinical Reminder:

Apr. 22nd, 2014 – Clinical Reminder:

Apr. 18th, 2014 – Volunteer Dress Code Reminder:

Mar. 11, 2014 – Clinical Reminder:

Mar. 5, 2014 – Clinical Reminders:

1.Homeless Patient Screening – Next-Gen Procedure

2.Follow Up on ER Visit or Hospitalization

3.NO BMI Plans

Feb. 12, 2014 – Clinical Reminder:

Feb. 17th, 2015 – Clinical Updates and Reminders:

Acutely Ill Adults

IMPORTANT CA REMINDER: Please be sure to stay in good communication with your buddy MA. During just this past Friday afternoon shift, we had TWO patients complain about chest pains and were not immediately flagged for staff.All the following circumstances (Designated as Acutely Ill Adults) should be flagged for staff immediately:

Complains of shortness of breath, wheezing or choking
Pulse Oximetry less than 92% on room air
Chest pain or pressure
Recent drug overdose, ingested poison or recent skin exposure with dangerous chemicals
Complains of severe headache starting in last 24 hours or new paralysis of any part of the body
Actively bleeding, vomiting blood, or recently passing bright red blood in stool
Has an abnormal blood pressure and or pulse:
Systolic BP greater than 200mm Hg or less than 80 mm Hg
Diastolic BP greater than 110mm Hg
Pulse greater than 120/min or less than 50/min
Blood glucose: Less than 70 or above 350
Hemoglobin is less than 8
Temperature is over 102˚F

Any Clinic Assistant that fails to appropriately flag these patients for staff may be dismissed from the Clinic Assistant program.

Feb. 9th, 2015 – Clinical Updates and Reminders:

Depression Screening

We are excited to announce that VFC will start implementing annual depression screenings for all patients ages 12 years old and up. We will also screen post-partum mothers of pediatric patients 0-3 months. We ask that all Clinic Assistants review the attached workflow and sample screener BEFORE your next shift in order to correctly screen and enter patient’s PHQ2 (and PHQ9 as needed) information into NextGen. Please check in with your MA buddies for more information. This process is live or is going live at all sites this month:

Site / Depression Screening Start Date
Levine / Wed. Feb 4th
Colen / Fri. Feb 6th
Simms / Wed. Feb 11th
*Rose / Wed. Feb 18th
*Training on Fri. Feb. 13th at 4:45pm

Huddling and Chart Prep

Please note that all Clinic Assistant volunteers are expected to proactively engage with a MA/Provider team during each shift. Clinic Assistants are encouraged to participate in the huddles at the beginning of each shift. If for some reason you miss the huddle, you still much check in with an MA and plan for your patients. It is helpful to review the Chart Prep Checklist for your team each day. If you find yourself with some downtime, please check in with other members of the Nursing Staff to see if anyone helps needs your help.

NextGen Trainings

We have two trainings scheduled for this month:

Friday, Feb. 20th (12pm-1pm) at Simms/Mann
Monday, Feb. 23rd (12pm-1pm) at 604 Rose

This is a great opportunity for all CAs, old and new, to brush up on the NG skills. Please sign up for an upcoming training through Volgistics. If you are a Lead Volunteer (or an experienced Level 2 / aspiring Lead Volunteer) please contact me regarding co-hosting this training. I would love to have your help!

Clinic Assistant Shifts

Room for a shift or two? We have a handful of shifts available at Simms, Rose, and Levine, with a high need for female CAs at Levine on Tuesdays (afternoons) and Wednesdays (morning and afternoon). Please contact me for more information regarding these available shifts if interested.

Volunteer Resources Webpage

Do you use the VFC Volunteer Resources Webpage?!? This is a great way for you to access all the past and present Clinic Assistant updates, review the current CA training materials, and even practice your Spanish language skills with free medical terminology AND audio! You can access the Volunteer Resources webpage at any time by logging into Volgistics or by simply saving this link to your favorites:

Jan. 9th, 2015 – Clinical Updates and Reminders:

Next Gen Updates

Homeless Patient Screening:Please be aware that the recent NextGen upgrade eliminated the Homeless Patient Template. In order to complete the required Homeless Patient Screening, please notate “Lack of Housing” as one of the Reasons for Visit.

The Front Desk will indicate “HP” in details whenever a patient identifies themselves as homeless.
Under HPI Detail for “Lack of Housing”,please enter where the patient is staying.
Ex: Street, Beach, Car, etc.
This information is important for our Homeless Grant.

Women’s Progress Notes: The Next-Gen upgrade has also affected the way in which we enter “Women’s Progress Notes”. In order to complete Women’s Progress Notes, please select “Preventative Exam” as one of the Reasons for Visit.

You will recognize that the Women’s Progress Note is now mapped to the preventative exam option.

PCMH – What is it and what can Clinic Assistants do to help?

* Click here to watch a short video about PCMH.

* Huddles: Thank you for huddling! Your effort has helped your teams improve work flow and even patient care. Please review the following reminders at the attached Huddle Expectation Sheet (which has been shared with all nursing staff and providers) as we continue the Huddles.

* Expectations for Clinic Assistants:Clinic Assistants are expected to and will be required to:

1. Assign yourself to a team at the beginning of your shift

2. Join the MA and provider huddle (preferable). Or debrief with the MA.

3. ALWAYSconsult with your MA and Provider to ensure all necessary steps are completed. If you pick up a chart that is meant for a different team, consult with the MA that is assigned to that patient

4. Check in with your MA throughout the session

* Chart Prep!Our MAs have done an amazing job prepping charts in the midst of our clinics’ busy flow. Please continue to prep even if you are not able to prep for your entire patient list.

* Meet!Chart prepping is only part of the huddle. Be sure to meet with each other and discuss face to face. Attached are more guidelines for huddling. Like huddles on the football field, it is important to take a “time out” for the team to discuss their game plan.

* Communicate throughout the session!Do you have tips on how PCPs, MAs, and CAs can communicate about patients during the session? If so, please let me know so that we can share your best practices.

* Give feedback!Don’t forget to tell your teammates when s/he does something great!And don’t be afraid to share your ideas on how your team can work better. Communication is vital for any team!

Staying Healthy Assessments

You will notice a pink piece of paper that reads “STAYING HEALTHY SCREENING” in the red sleeves. This is alerting us that Front Desk gave the patient a Staying Healthy Screening tool that is required by the patient’s insurance. The patient is to fill out screener and give to provider. Provider needs to review and sign. Unfortunately, many providers neglect to sign form and without provider signature, the form is invalid.

This little pink piece of paper is letting us know to encourage patients to fill out form and tell patients to hand it to provider for review and signature. If the patient has finished the form, feel free to insert into red sleeve so provider can review. Place in front of encounter for good visibility.

I attached a sample form for your review, but not that there are different forms for different age groups. The Adult form is attached. These forms are very important for patient’s insurance and we, as an agency, are required to fill them out.

Clinic Assistant Skills Update

Level 1 - Basic CA Skills:

Reminders-

Buddy with LEAD CA or Clinic Staff: All new Clinic Assistants should continue to work alongside a LEAD Clinic Assistant or MA, until receiving your designation as a Level 2 Clinic Assistant volunteer.

Next-Gen: New volunteers that have not yet completed their Level 1 Clinic Assistant Skills Checklist, should refrain from utilizing Next-Gen until they complete their “Basic Skills Checklist” or are otherwise instructed by a VFC Staff member. If you do enter information into Next-Gen, please be sure to always get your work checked by Staff!

Basic Skills Update: Please note that since Clinic Assistants will no longer be working with pediatric patients, we have removed pediatric skills from the Basic Skills Checklist.
New Clinic Assistants are no longer required to complete the following skills:
Height & Weight (Child)
Temperature (Axillary
Blood Pressure (Child)

Congratulations! You completed your Basic Skills Checklist: What’s Next?

Check your service hours in Volgistics!
In order to level up, Clinic Assistants will need to complete the skills checklist on the back of their green name tagand complete a minimum of 30 hours of service as a Clinic Assistant.
To check your service hours, log in to Volgistics and click the “My Service History” tab.
Alert Volunteer Services

Once you have completed your checklist and 30 hours, please notify the Volunteer Services Department in order to receive your Level 2 name badge.
Please email and attach a photo of your completed checklist.

Oct. 17th, 2014 – Clinical Updates & Reminders:

SUMMITReminder: If you are not familiar with how to screen patients for the SUMMIT program, please review our step-by-step SUMMIT guidelines, which are available online on our Volunteer Resourcespage. It is very important that you thoroughly understand the screening process for SUMMIT and what to do with a positive screen. The SUMMIT survey should be reviewed with patients at the beginning of every work-up.

When a patient has a positive screen, please refer that patient to the Nursing Staff for further assistance!This screening process allows medical providers to quickly identify patients with harmful levels of substance abuse, provide a brief intervention, and then refer patients to SUMMIT for further screening and treatment.

Flu Shot Reminder:It’s flu season, and VFC has started to offer flu shots to all patients! Please remember to ask every patient if they are interested in a flu shot as part of their work up.

If the patient is interested in receiving a flu shot, give them the Vaccine Information Sheet (VIS) and the Flu Vaccine Screening Checklist/Consent. Please alert Nursing Staff that the patient is interested in receiving a flu shot, and give the Nursing Staff the completed consent form.

If the patient declines, please note this in “HPI details”
Notate “Patient declines flu vaccine/shot. VIS given.” in the comments section
Your note helps the provider know that we screened the patient, and the provider can then update their clinical care guidelines.

Ebola Screening- I’m sure you have all heard what is going on in the news regarding Ebola. Although we feel we are not at high risk for Ebola here at VFC, we wanted to share with you what Ebola precautions and procedures the clinic currently has in place.

All front line staff (including the Nursing Staff) will be asking ANY patient that presents with fever if they’ve had recent travel (within the last month) out of the country.

What does this mean for Clinic Assistants?

Be sure to screen anyone with fever, by asking if they have travelled out of country in the last month.
If the patient responds “Yes”, the next question is “Did you travel to West Africa?”
If your patient states “Yes” that they have travelled to West Africa, STOP what you are doing and take patient immediately to a designated “Isolation Room” .
If the patient has travelled to West Africa, be sure to ask which country they travelled to. The West African countries where Ebola has been confirmed are Guinea, Liberia and Sierra Leone.
Once you have escorted the patient to the designated Isolation Room, please close the door and notify an RN or Medical Provider ASAP.

Signage will be placed on all ports of entry asking patients to disclose if they have recently travelled to West Africa and/or have fever.

Personal Protective Equipment (PPE) has been sent to all locations. This PPE kit includes gloves, gown, shoe covers, goggles and mask. Please make sure you know where the PPE is located. At Rose, the PPE kits are located in Room 15 and at the Triage area downstairs where we keep emergency supplies.

Clinical Leads at every site will identify “Isolation Rooms”. The goal is to minimize exposure to other patients and staff.
Rose: Alcove area on the 1st floor behind security and Room 15 on the 2nd floor
Simms: Triage Room on the 1st floor and Room 11 on 2nd Floor
Colen: Patient bathroom (potential isolation room)

Attached are instructions on how to don PPE and how to remove it.

In the event that a patient needs to be reported as an Ebola suspect- Contact Public Health Phone Line: (213)240-7941, After Hours: (213)974-1234.

Oct. 2nd, 2014 – Clinical Updates & Reminders:

Tobacco Usage-The Next-Gen upgrade did NOT transfer patients’ “Tobacco Usage” information completely.When entering patient information into Next-Gen, please always make sure that the patient’s Tobacco Usage information is up-to-date.

Always check to make sure both the “Smoking Status” boxand the “Tobacco Use” box are filled in.

“Smoking Status” and “Tobacco Use” fields are required in order for the clinic to meet Meaningful Use (MU) requirements.

Applies to all patients that are 13 years of age and over.

To update Tobacco Use Information, please click on “Tobacco Usage” on the right side of the screen

Complete “Tobacco Use Status”by selecting an option from the drop-down menu (see below)

Please note: For children 12 and under, you will need to answer the questions under “Passive Smoke”. Please ask if you are not sure how to update these fields.

Flu Shots:It’s flu season, and VFC has started to offer flu shots to all patients!

What does this mean for Clinic Assistants?
Always ask your patient if they are interested in receiving the flu vaccine.

If the patient is interested in receiving a flu shot, please alert Nursing Staff so that they can administer it.

If the patient declines, please note this in the “Comments” section of the Chief Complaint / Reason for Visit page
Notate “Patient declines flu vaccine/shot” in the comments section
Your note helps the provider know that we screened the patient, and the provider can then update their clinical care guidelines.

Sep. 23rd, 2014 – Clinical Updates & Reminders:

1.Next Gen Updates:

Tracking: We must now track patients when we start work up by selecting WITH NURSING and then track when we finish to WAITING FOR PROVIDER
This new system will help the Clinic better track the flow of patients and, eventually, improve our efficiency and ability to serve more patients
Height and BMI:Please use feet/inches or cm. Not total inches. It does not automatically calculate BMI.

ERRONENOUS entry:

CORRECT entry:

Tobacco and Allergies:Please update Tobacco usage and update allergies at every visit

This is how the templates should look like. Please see screen shots below. Please always feel free to ask nursing supervisors on staff and other medical assistants for help.

*Be sure to scroll all the way down to the Save & Close button*