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Before Care Episode

Page history last edited by PBworks 14 years, 8 months ago
1. Before Care Episode          
Participants/Workflow step Goals General CDS Strategies Specific CDS Considerations Given Paper/Digital Tools Outcomes/Lessons Learned/Pearls Owners/Stakeholders Metrics
Preparation            
  Define TERMS clearly - Those that will be used to identify VTE patients, processes (patient registraion process), stakeholders, methods, and tools The definitions will be valuable to the development of CDS solutions as well as the education process during implementation Paper: Information intake forms, etc,
 Digital: Build an organized database for these definitions so that it can be easily queried during solution building and used as the basis for education		 Early definition of terminology that may be confusing will save time and effort in the long run C-level, IT, Physicians, nurses, pharmacist, clerks, patients…inpatient and outpatient realm Definitions
  Assess current Inventory of tools, processes, and human resources for CDS implementation for VTE prophylaxis     Need to know what you have, before you do a wish list   Inventory list and relationships / their owners
  Understand current process - often, armed with enthusiasm, this step is missed or done ad hoc.  We recommend that some amount of time is devoted on this action alone.  MAP out current processes (current state) that involve VTE prophylaxis, however imperfect.  Note where error opportunities may exisit in the process.  What CDS exist currently Risk factors: diabetes, heart disease, preventative practices, labs, screen results Is there a current electronic registry of patients?  How about for VTE patients (consistent with the above definition)?  If so, how will the registry need to be modified?  How will we get the data? Need to know what you have, before you do a wish list C-level, IT, Physicians, nurses, pharmacist, clerks, patients…inpatient and outpatient realm Future map and its dependencies
  Construct future process - In the context of available inventory, re-engineer current process to reduce error opportunities, waste, and inject CDS and safety nets where appropriate CDS and new workflow should be complimentary, not adversarial.  CDS add value to the patient and stakeholders (i.e., users) Lay out plans to either modify or create the necessary CDS tools and workflow changes Provides the project compass C-level, IT, Physicians, nurses, pharmacist, clerks, patients…inpatient and outpatient realm Organizational metrics such as VTE prophulaxis rate, compliance, data management metrics, data integrity audits
Action            
Organization Identify all patients with pertinent clinical conditions or eligible for preventive interventions Provide necessary technological and workflow infrastructure to support the "future process"; Communication tree utilizing e-mail/automatic phone message/letter generation/mass mailing Tools ought to bridge the inpatient and outpatient experience.  Both patient care domains are dependent on each other for the data needed to optimize VTE prophylaxis     organizational metrics such as VTE prophylaxis rate, compliance, data management metrics, data integrity audits
 
 
            Patient satisfaction, VTE prophylaxis, health metrics, LOS, complication rates, focus groups
 
 
 
 
             
 
 
Healthcare Provider Level Trained on the CDS tools and understand value to patient and themselves; before this encounter, past healthcare providers should have entered relevant information into the various related data sources (i.e., HER) CDS prompts healthcare providers for necessary information that would help assess patient risk Training modules, have relevant information systems in place and easy to use so that pre-encounter information is accurate and reliable.     User satisfaction, action time, effects survey, focus groups
             
Participants/Workflow step Goals General CDS Strategies Specific CDS Considerations Given Paper/Digital Tools Outcomes/Lessons Learned/Pearls Owners/Stakeholders Metrics
Patient Understand condition(s) • Provide reference information and guidance regarding conditions, treatment plan, medications, symptoms, health maintenance, etc.        Patient satisfaction, VTE prophylaxis, health metrics, LOS, complication rates, focus groups
Adhere to plan; meds, follow-up, basic monitoring;

Respond appropriately to new findings (e.g., symptoms, trends in self-monitored disease parameters - includes using appropriate care venue to address changes)

Make use of self-assessment and self-management tools

Know when to seek professional services		 • Personal health record and related documentation tools to track disease parameters/health risks

• Reminders for meds/appointments/tests/etc.

• Self-assessment and training tools

• Access to clinical test results

• Consider online patient portal, communicating with clinician’s office for refills, appointments, questions, etc.
   
   
   
Communicate questions/concerns effectively with provider  
  • Patient can access and interact with treatment plans
             
 
 
                 
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   

 

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