BEST PRACTICES DWAM FY INITIALIZATION

Document Sample
BEST PRACTICES DWAM FY INITIALIZATION Powered By Docstoc
					WAM: Ambulatory Procedure Visit (APV)
      Enhancements Training



                    Updated 03 Sep 2004

                   Clinical, PAS/MCP, and
                          A&D Staff


                       VTC Session I
              Course Agenda

This course has the following components:
 • Overview
 • APV Order Entry Enhancements
 • Entering APR Orders
 • Ambulatory Procedure Profiles (APPs)
 • MAPV Option Enhancements and Entering MOS for
   APV Patients
 • Entering MOS for Pre Admission and Observation
   Patients
 • Updated APV Reporting
 • File and Table Requirements.


                                                    2
Overview




   APV Enhancements
                APV Software Deployment

• CHCS WAM: APV Enhancements software
  deployment planned for September/October 2004.
• An “off-switch” for APVs” on the CHCS II application
  will be deployed at the same time.
• The ‘off-switch” will be in place until CHCS II
  modifications are made.




                                     New
                                   Software!




                                                         4
                Prior to the APV…
 Patient
arrives for
    an                                               PAS/MCP
Outpatient                                              staff
   Visit                                            schedule the
   (B***                                                APV
 MEPRS
  Code)                                APV
                   Need       Yes                     Booking
                                     Request/
                for Surgery                           Request
                                      Order
                 as APV?                               sent
 Workload                            Initiated
counted as
Clinic Visit
                                     Supporting
                                       Ancillary
  Ancillary                             Orders
   Orders                            (RAD, LAB
(RAD, LAB                             and PHR)
 and PHR)                           linked to the
attributed to                            APV
 clinic visit
                                                                   5
                                      The APV Process



                  Start of APV Episode
                                                     APV Procedure Performed

                  APV            Pre-Op                                                      Patient has to
                                                                      Patient moves to
 Outpatient    Surgery is       Teaching                                                     stay overnight
                                                 Patient arrives       another location
Visit where    booked, as       occurs for                                                    on Ward. The
                                                  for APV. This       for recovery from
decision for   well as Pre-    APV. This is                                                      MOS are
                                                 is recorded in          APV. This is
 surgery is         Op         recorded in                                                     recorded in
                                                     Pre-Op              recorded in
   made         Teaching         Pre-Op                                                         Extended
                                                    Location.              Recovery
                  appt.         Teaching                                                     Recovery Ward
                                                                           Location.
                                Location.                                                       location.



       APV Data Entry                  Non-         MOS
                        MOS entered                                 Count                     MOS entered
                                       count                                      MOS
                         for Pre-Op              entered for       visit for
                                       clinic                                  entered for    for Extended
                          Teaching                 Pre-Op            APV
                                        visit                                   Recovery        Recovery
                          Location.               Location.
                                      optional                                  Location        Location




                                                                                                        6
APV Order Entry Enhancements




             APV Enhancements
        ORE<–>PAS APV Tracking


             APR Order         APR Order
                             creates MAPV
                                 entry



                             Booking either
                              links to an
                                order or
                              creates an
                                 order



MAPV Entry               APV Appt


                                              8
                  ORE<–>PAS Linking

WALK-IN SEARCH CRITERIA
Patient: DABBS,DENISE                    FMP/SSN: 20/359-08-
4943
Clinic: SDS DENTAL - NI/N-IN DI            ATC Category:
Clinic Phone:                      Appt Type: ACUTE APPT
Provider: WELSH,LYNN                      Duration:
Detail Codes:                      Srv Type:
Time Range: 1427 to 1427                 Days of Week:
Dates: 24 Mar 2004 to 24 Mar 2004
*** The Patient has an APR order for this APU.
   Do you want to link this appointment to the APR order? Yes//




                                                                  9
              Tips for PAS and PAD Clerks

1. You can enter multiple APV appointments at any
   time.
2. You can enter an admission even if the patient
   has an open APV appointment.
3. You can document MOS for now and in the past.
   You cannot enter future times.
4. System will prompt you to link orders when
   booking.




                                                    10
Entering APR Orders




         APV Enhancements
                  Order Entry Changes
• Upon software installation a conversion will run
  to:
   – Remove old APV paging and
   – Move orders to the outpatient page.
   – Emergency Disposition (EDA) action will be
     disabled at the ACTION prompt on the
     Patient Order List (POL).
• MAPV option is available at the ACTION prompt
  and has been added to Nursing Main menu.




                                                     12
                               Ambulatory Procedure Request
                               (APR)
  APR Order Screen Enhancements:

JOHNSON,TERI                        20/000-00-0000                      APR ORDER
AMBULATORY PROCEDURE REQUEST                                            040220-00145
-----------------------------------------------------------------------------------------
Requested APU Location: General Surgery (i.e. APV Clinic)
*Procedure Location: (Optional field) APP Default for the MTF Division
APU Physician: (Optional field)
Requested APV Date/Time: (Required field)
APV Procedure: (Required field)
(This is a 78 character free text field. Enter the APV Procedure name)
 Appointment Comment: (Optional field)
(This is a word processing field; the length of the text is unlimited. Enter any
     appropriate comments regarding the APV procedure in this field.)

----------------------------------------------------------------------------------------
File/exit Abort Edit
File changes and exit.

                                                                                            13
                    Linking Orders to the APR
• The filing of an APR will no longer create an APV page to
  the left of the Outpatient page on the POL.
• All orders will reside on Outpt pg.
• After filing the order, the system will prompt the user:


  Would you like to associate new orders with this APR? Yes//
  Select ORDER TYPE:




                                                                14
                                   ORE > PAO option
JOHNSON,TERI                    Age:26 20/000-00-0000                               OUTPAT POL
  1 APR APPT.FOR: ORTHOPEDICS APU on 01 Sep 2004
       {BRONCH}
         ~Pend.Appointment~ . . . . . . . . . . . . SCHMID 1SEP@0937
------------------------------------------------------------------------------------------------------
   1 RX VALIUM--PO 10MG TAB~T1 TAB AM OF SURGERY
          RF0 #2 DS2 on 01 Sep 2004@0937 (Not
          Dispensed) . . . . . . . . . . . . . . . . . . . . . SCHMID 1SEP@0937
   2 LAB *PREOP* HEMOGRAM & DIFF~SEND PATIENT TO LAB
         ~BLOOD~LAV on 01 Sep 2004@0937 . .SCHMID 1SEP@0937
  3 RAD CHEST, AP~Portable~DIAGNOSTIC RADIOLOGY -
          NI~AMB on 01 Sep 2004 {CHRONIC COUGH}
           ~Pend.Appointment~ . . . . . . . . . . . .              SCHMID 1SEP@0937
-----------------------------------------------------------------------------------------------------
Print Search Help eXit
Print all orders associated with this APR order.


                                                                                                    15
                                 ORE > MAPV option

--------------------------------------------------------------------------------
JOHNSON,TERI                          AGE:26Y 20/000-00-0000                     MAPV Enter/Edit
--------------------------------------------------------------------------------
Date/Time    APU/Location             Status  MEPRS            Tracking#           Order#
01Sep04@1000 ORTHO                    PENDING BEA5             200409010001        040901-00003




--------------------------------------------------------------------------------
Edit New Pre-admit Status pRint Help eXit
Edit the selected procedures, pre-admission or observation event




                                                                                            16
                                          ORE > Link orders to APV
Scheduled Appointments for JOHNSON,TERRI

Press <Return> to choose pre-selected appointment or use the SELECT key
to de-select appointment or select an alternate appointment.

Linking of orders provides workload credit to the clinic associated with
the appointment.
  Date/Time           Clinic/Div        HCP                  MEPRS/DMIS Type                  Status Reason
--------------------------------------------------------------------------------------------------------------
  Appointments with SCHMIDT,DONNA:
 * 01Sep@1000 OAPU/N-IN SCHMIDT,D BEA5/0124                                       ACUT PENDING BRONCH

 Other Appointments:
--------------------------------------------------------------------------------------------------------------
Search Help eXit
Leave picklist and return to order entry session.


                                                                                                                 17
                 Tips on Entering APR
                 Orders
1. Recommend entering the APR order first and any
   associated ancillary orders afterwards so that they are
   linked to the APR.
2. Use PAO at the action prompt on the Patient Order
   List (POL) in Order entry (ORE) to see the APR orders
   and all linked orders.
3. Use MAPV at the action prompt to see the APR and
   Pre-Admit entries.




                                                         18
Ambulatory Procedure Profiles (APPs)




                 APV Enhancements
                  Ambulatory Procedure
                  Profiles
What are Ambulatory Procedure Profiles (APPs)??
• An APP will define operational flow in use by the MTF
  for APV’s and provides standard default locations to
  save time documenting MOS in the MAPV option.
• Each separate combination of locations that describes
  a patient flow through the outpatient surgical process
  would result in a different profile.
• A single APP can support multiple APV clinics.




                                                       20
                             Setting up your APP(s)

Menu Path: CA → PAS → Managed Care → CDSK →
VAP→ AAPP (Ambulatory Procedure Profile
Enter/Edit).

 -----------------------------------------------------------------------------------------
 APP: APV FOR DIV A                                    APP Enter/Edit Screen
 -----------------------------------------------------------------------------------------
 Pre-Op Teaching Location: APV TEACHING LOCATION

 Post-Op Recovery Location: CENTRAL APV RECOVERY

 Extended Recovery Location: COST POOL WARD

 Inactive:



                                                                                             21
                                     How APPs Are Used

JOHNSON,TERI               20/000-00-0000                                           MAPV enter/edit
Tracking number: 2003-00989876                                    Order number: 030624-00145
--------------------------------------------------------------------------------------
Pre-Op Teaching Location(s):
  CENTRAL SCREENING
Pre-op Location:
   GENERAL SURGERY
Post-op Recovery Location(s):
 OUTPATIENT SURGERY
Extended Recovery Location(s):
   WARD 4B
--------------------------------------------------------------------------------------
preScreen Pre-op pOst-op exTended pRint Help eXit
Enter/edit Pre-Op Teaching information




                                                                                                      22
MAPV Option Enhancements and Entering
        MOS for APV Patients




                  APV Enhancements
                  MAPV option re-designed
• Allow the capture and reporting of Minutes of
  Service (MOS) not previously captured:
   – Time spent on APV pre-surgical teaching
   – Time spent on Pre-Admission (for future
     inpatient surgery) teaching
   – Time monitoring Observation patients
   – Time APV Patients spend recovering on Wards.
• MOS for multiple location types can be entered.
• Multiple start/stop times can be entered




                                                    24
                   MAPV option re-designed

•   APR orders can be created.
•   CPT codes can be added with ADM updates.
•   Walk-in appt can be entered.
•   Pre Op teaching MOS entry also creates appt, if
    location defined.
•   Allows appt status update (E.g., KEPT, CANCEL).
•   Pre-Admit/Observation MOS documented.
•   Provides capability to print the APV record.
•   MAPV available from Nursing Main Menu and from
    the ORE Action prompt.




                                                      25
                               MAPV Enhancements


   -----------------------------------------------------------------------------------------------
           Ambulatory Procedure Visit - Minutes of Service Enter/Edit
   -----------------------------------------------------------------------------------------------

Select (P)atient Name, (L)ocation, (O)rder, (T)racking Number, or (Q)uit: P

Enter PATIENT NAME: JOHNSON, TERI




                                                                                                     26
                               MAPV Enhancements
 • Use the select key to choose the desired
   appointment.

JOHNSON,TERI AGE:26y 20/000-00-0000                                  MAPV enter/edit
------------------------------------------------------------------------------------------------
  Date          APU/Location              Status MEPRS Tracking# Order#

* 24Feb04     GENERAL SURGERY PENDING BBA5                        200400989876 040220-00145
  27Apr03     ORTHOPEDIC APU  KEPT    BEA5                        200300875487 030427-00025
  01Jan03     APS APU CLINIC  CANCEL BAA5                          200300132234 030101-00024
  22Dec02     TEACHING CLINIC         ABAA                        200200045455


Select ‘*’ an APU/Location to Edit.
-------------------------------------------------------------------------------------------------
Edit         New         Pre-admit          Status       pRint       Help        eXit
Edit the selected procedures, pre-admission or observation event



                                                                                                    27
                               Pre-Op Teaching MOS for
                               APVs
JOHNSON,TERI AGE: 26Y 20/000-00-0000                                   MAPV Enter/Edit
Tracking number: 200400989876                         Order number: 040220-00145
--------------------------------------------------------------------------------
Requested APU Location: GENERAL SURGERY
Procedure Location: MAIN OR
APU Physician: SAWYER,DEANNA
APV Date/Time: 21 Jul 2004@1234
APV Procedure:
I&D, abscess right arm
Appointment Comment:
Mr. Johnson is a well developed 26 y/o male who presented today with a
2cm abscess of the anterior aspect of his right forearm.
Pre ADM CPT codes:

 00750 ANESTHESIA FOR HERNIA REPAIRS IN UPPER ABDOMEN
------------------------------------------------------------------------------------------------
Mos Cpt Print Help eXit
Enter/edit Nursing Minutes of Service
                                                                                                   28
                                 Pre-Op Teaching MOS for
                                 APVs


JOHNSON,TERI               20/000-00-0000                                           MAPV enter/edit
Tracking number: 2003-00989876                                    Order number: 030624-00145
--------------------------------------------------------------------------------------
Pre-Op Teaching Location(s):
  CENTRAL SCREENING
Pre-op Location:
   GENERAL SURGERY                                                                 Locations
Post-op Recovery Location(s):                                                     default from
 OUTPATIENT SURGERY                                                                 the APP
Extended Recovery Location(s):
   WARD 4B
--------------------------------------------------------------------------------------
preScreen Pre-op pOst-op exTended pRint Help eXit
Enter/edit Pre-Op Teaching information



                                                                                                      29
                           Pre-Op Teaching MOS for
                           APVs



JOHNSON,TERI                         20/000-00-0000                           MAPV enter/edit
Tracking number: 2003-0098987                               Order number: 030624-00145
--------------------------------------------------------------------------------------
Pre-Op Teaching Location: Central Screening – NNMC                                   DGAA

Intervention
Start Time               Stop Time         MOS (View only)
T@1530                   T@1600            30
T@1700                   T@1730            30




                                                                                            30
                            Pre-Op Teaching Appts for
                            APVs


JOHNSON,TERI 20/000-00-0000                                 MAPV enter/edit
Tracking number: 2003-00989876                              Order number: 030624-00145
--------------------------------------------------------------------------------------
Pre-Op Teaching Location: Central Screening                                          DGAA
Intervention
Start Time                 Stop Time           MOS (View only)
T@1530                     T@1600              30

Enter Pre-Op Teaching PROVIDER: MAURICE,JERRY                           038-50-7421
       OK? Y
Creating new appointment...
Walk-in appointment created successfully



                                                                                            31
                             Patient Arrival for the APV



JOHNSON,TERI 20/000-00-0000                                                   MAPV enter/edit
Tracking number: 2003-00989876                              Order number: 030624-00145
--------------------------------------------------------------------------------------
Pre-Op Teaching Location(s):
  CENTRAL SCREENING
Pre-op Location:
  GENERAL SURGERY
Post-op Recovery Location(s):
  OUTPATIENT SURGERY
Extended Recovery Location(s):
  WARD 4B
--------------------------------------------------------------------------------------
preScreen Pre-op pOst-op exTended pRint Help eXit
Enter/edit Pre-Op Nursing information



                                                                                            32
                         Patient Arrival for the APV
JOHNSON,TERI                   20/000-00-0000                      MAPV enter/edit
Tracking number: 2003-0098987 Order number: 030624-00145
--------------------------------------------------------------------------------------
Pre-op Location: GENERAL SURGERY - NNMC BBA5

Appt                Arrival        Appointment
Status              Time           Time
KEPT                T@0530         T@0730

Intervention
Start Time          Stop Time           MOS
T@0615              T@0715              60

Date/time Patient Departed the Facility:




                                                                                         33
                Ways to Mark an APV Appt
                KEPT
•   EOD (End-of-Day Processing/Editing)
•   IPC (Individual Patient Check-In)
•   MCD (Multiple Check-In by Default)
•   USV (Unscheduled Visits)
     – Allows you to ‘Walk-In’ an APV
     – Creates APR Order and MAPV entry in
       background.
• MAPV (APV Minutes of Service Enter/Edit)
   – Enter Arrival time or Status.
• ORE (Clinical Order Entry) - If a Provider selects an
  APV appt on the Date that it is scheduled, and enters
  Order Entry, the system will automatically change the
  status of the appt to KEPT.
                                                          34
                APV Appt status

•   If APV appointment status is PENDING, you can
    mark the appointment through the MAPV option as
    KEPT, WALK-IN, SICK-CALL, CANCEL, NO-
    SHOW, or LWOBS.
•   If the APV appointment status is KEPT, WALK-IN,
    SICK-CALL (all of which equate to KEPT), you may
    only mark the appointment as CANCEL, LWOBS,
    or NO-SHOW through the MAPV. These APRs
    cannot be rescheduled.




                                                       35
                                Post-PACU MOS for APVs



JOHNSON,TERI               20/000-00-0000                                      MAPV enter/edit
Tracking number: 2003-00989876                                          Order number: 030624-00145
--------------------------------------------------------------------------------------
Pre-Op Teaching Location(s):
  CENTRAL SCREENING
Pre-op Location:
  GENERAL SURGERY
Post-op Recovery Location(s):
  OUTPATIENT SURGERY
Extended Recovery Location(s):
  WARD 4B
--------------------------------------------------------------------------------------
preScreen Pre-op pOst-op exTended pRint Help eXit
Enter/edit Post-Op Nursing information




                                                                                                 36
                          Post-PACU MOS for APVs



JOHNSON,TERI                           20/000-00-0000                 MAPV enter/edit
Tracking number: 2003-00989876                      Order number: 030624-00145
--------------------------------------------------------------------------------------
Post-op Location: OUTPATIENT SURGERY

Intervention
Start Time                              Stop Time          MOS
T@1400                                  T@1730             210

Date/time Patient Departed the Facility:




                                                                                         37
                           Extended Stay MOS for
                           APVs


JOHNSON,TERI                           20/000-00-0000                        MAPV
     enter/edit
Tracking number: 2003-00989876                      Order number: 030624-00145
--------------------------------------------------------------------------------------
Extended Stay Location: WARD 4B

Intervention
Start Time                              Stop Time           MOS
T@0615                                   T@0715             60

Date/time Patient Departed the Facility:




                                                                                         38
                  Processing a Daily Schedule
A.   Scenario: There is an APR Order and appointment in
     the system, but it is not Marked as KEPT yet:
       1. Go to MAPV
       2. Enter the patient’s name
       3. View the patient’s picklist
       4. Select the appointment on the MAPV screen
       5. Select the STATUS Action
       6. Change Status to KEPT
       7. The system updates the pre-op location arrival
           time automatically
       8. Additional MOS can be entered later.



                                                           39
                    Processing a Daily Schedule
B.   Scenario: Patient presents at check-in desk. There
     is an APR Order, but no appointment booked:
        1. Enter the MAPV option and select the patient
        2. The patient’s list will display with the new entry,
           but no STATUS listed, which indicates that an
           appointment has not been booked
        3. Select the entry
        4. Select the MOS Action
        5. Select the Pre-op Location
        6. Enter an Intervention Start Date/Time
        7. Respond Yes, that you want to Create a Walk-
           in Appointment
        8. Additional MOS can be entered later.
                                                                 40
                 Processing a Daily Schedule

C. Scenario: There is no APR Order yet in the system
   (e.g., an Emergency APV):
     1. Use the USV option to walk-in the patient
     2. MOS can be entered at a later time
     3. OR the order and walk-in appointment can be
          created through MAPV.




                                                       41
                  Canceling APVs

A.   Scenario: If you CANCEL an APV appointment
     before you mark it KEPT then the system will:
       1. Reset the APR order to PENDING
          APPOINTMENT
       2. Allow you to rebook through AHCF/BHCF
       3. Retains the link in MAPV and ORE with any
          orders linked to the APR
       4. Pre-op teaching MOS are retained with MAPV
          entry.




                                                       42
                    Canceling APVs
B.   Scenario: If you CANCEL an APV after you mark it
     KEPT, WALK-IN or SICK-CALL:
       1. If the APV was marked KEPT in error
          recommend that you enter a new APR or APV
          appointment.
       2. MAPV MOS can be documented for cancelled
          appointment if patient did arrive, nursing care
          was provided, but procedure was eventually
          cancelled.
       3. The APR order is considered complete when
          marked KEPT and all future orders have been
          activated. The order cannot be reset at this
          point.
       4. You will not be able to make changes to the
          appt status in MAPV or EOD.
                                                            43
Entering MOS for Pre Admission and
       Observation Patients




                APV Enhancements
The patient arrives     Observation Patients Process
 at the ER with an
    acute illness



                                 PCM admits patient
    Does patient's
                                   to Observation
   condition require    YES
     Observation?                   status in the
                                  Observation Unit



         NO                      Use the USV option
                                   to Walk-in the
                                       patient
     ER visit is
 documented and
workload is counted              Any ancillary orders
    under BIAA                    written should be
                                 associated with the
Any ancillary orders              Observation Unit
written will be under
        BIAA
                              Count visit for
                               Observtaion              Entry of MOS
                               Unit with a                using R-
                                  B***                   MEPRS of
                               Requesting               Observation
                                 MEPRS                  visit directly
                                                        into the Pre-
                                                        Admit Action
                                  Coding                  of MAPV.
                              performed per
                                guidleines
                                 provided
                                                                         45
                                 Pre-Op Teaching MOS for Pre-
                                 Admits or Observation Pts



JOHNSON,TERI AGE:44Y 20/000-00-0000                                           MAPV Enter/Edit
--------------------------------------------------------------------------------------
  Date        APU/Location               Status        MEPRS Tracking#          Order#
  24Jun03     GENERAL SURGERY            PENDING       BBA5  2003-00989876      030624-00145
  27Apr03     ORTHOPEDIC APU             KEPT          BAB5  2003-00875487      030427-00025
  01Jan03     APS APU CLINIC             CANCEL        BAA5  2003-00132234      030101-00024
  22Dec02     PRE-OP TEACHING                          ABAA  2002-00045455


Select ‘*’ an APU/Location to Edit.
-----------------------------------------------------------------------------
Edit New Pre-admit Status pRint Help eXit
Enter a Pre-Admission/Observation encounter




                                                                                                46
                            Pre-Op Teaching MOS for Pre-
                            Admits or Observation Pts



--------------------------------------------------------------------------------
                    PREADMIT/OBSERVATION INFORMATION
--------------------------------------------------------------------------------
            Enter MEPRS CODE: GENERAL
    1 GENERAL SURGERY ABAA 0381 GENERAL SURGERY
    2 GENERAL SURGERY ABAC 0124 GENERAL SURGERY
    3 GENERAL SURGERY ABAA 0387 GENERAL SURGERY
    4 GENERAL SURGERY ABAM 0519 GENERAL SURGERY
    5 GENERAL SURGERY ABAA 0124 GENERAL SURGERY
Type '^' to stop, or
Choose 1-5: 1




                                                                                   47
                            Pre-Op Teaching MOS for Pre-
                            Admits or Observation Pts




JOHNSON,TERI                         AGE:44Y 20/000-00-0000                      MAPV Enter/Edit
Tracking number: 200403290007                                      Order number:
--------------------------------------------------------------------------------------
Pre-op Teaching/Observation Location: CENTRAL SCREENING                                  ABAA

 Intervention
 Start Date/Time           Stop Date/Time             MOS
 22 Jul 2004@0900          22 Jul 2004@1652           472




                                                                                             48
                               Pre-Op Teaching Appts for Pre-
                               Admit or Observation Pts


JOHNSON,TERI                         AGE:44Y 20/000-00-0000                      MAPV
     Enter/Edit
Tracking number: 200403290007                                      Order number:
--------------------------------------------------------------------------------------
Pre-op Teaching/Observation Location: CENTRAL SCREENING ABAA
  Intervention
  Start Date/Time             Stop Date/Time               MOS
  22 Jul 2004@0900 22 Jul 2004@1652 472
Enter Pre-Op Teaching PROVIDER: MAURICE,JERRY                                          038-50-
     7421
           OK? Y
Creating new appointment...
Walk-in appointment created successfully



                                                                                                 49
Updated APV Reporting




          APV Enhancements
                                   APV Procedure
                                   Record/Cover Sheet
NAVY INPATIENT DIVISION                                          22 Jan 2004@1735 Page: 1
                              Personal Data - Privacy Act of 1974 (PL 93-579)
                              * * * PROCEDURE RECORD/COVER SHEET * * *
--------------------------------------------------------------------------------
Patient Name: NAGLE,CHARLIE FRANK
...
--------------------------------------------------------------------------------
Provider Name: LING,WILLIAM
Pre-op Teaching: TEACHING LOCATION - NI
Start Date/Time: 21 Jan 2004@1000                      Stop Date/Time: 21 Jan 2004@1100   MOS: 60
Pre op: MAIN APU - NI
Start Date/Time: 22 Jan 2004@1630                      Stop Date/Time: 22 Jan 2004@1645   MOS: 15
Post-op Recovery: RECOVERY FROM APV - NI
Start Date/Time: 22 Jan 2004@1730                      Stop Date/Time: 22 Jan 2004@1734   MOS: 4
Extended Recovery: COST POOL WARD - NI
Start Date/Time: 22 Jan 2004@1734                      Stop Date/Time: 22 Jan 2004@1735   MOS: 1
--------------------------------------------------------------------------------
Primary Diagnosis:                                                   Code:
Other Diagnoses:                                                     Code:
Primary Procedure: Removal of skin lesion                            Code: 11444
Other Procedures:                                                    Code:
--------------------------------------------------------------------------------
20/275-54-8635 FOGLE,CHARLIE FRANK USA ACTIVE DUTY ENLISTE Gender: M
...                                                                                             51
                                                     Roster of Nursing MOS
                                                     Report
                                  Sample of Detailed Report Section

                       Personal Data - Privacy Act of 1974 (PL 93-579)
                                             ROSTER OF NURSING MOS
                                             by APV Tracking Number
                                        APV Date Range: Jan 2004 - Jan 2004
===============================================================================
APV Tracking # Patient Name                               FMP/Sponsor SSN Bene Cat MEPRS/DMIS Hospital…
================================================================================
2004-01150003 ANDREWS,GEORGE 20/018-28-5730                                            3              BAA5/0124            APV CLINIC
Appt Date/Time: 29 Jan 2004@1054
Arrival Date/Time: 29 Jan 2004@1054
Pre-Op:                          APV CLINIC                                   MOS: 30 MOS MEPRS/DMIS: DGAA/0124
Post-Op Recovery:                 APV CLINIC                                  MOS: 25 MOS MEPRS/DMIS: DGAA/0124
Departure Date/Time:
------------------------------------------------------------------------------------------------------------------------------------
2004-01210001 BLUE,JOHN EDWARD 20/004-86-5952                                         1              BEA5/0124           ORTHO APU
Appt Date/Time: 22 Jan 2004@1330
Arrival Date/Time: 22 Jan 2004@1330
Pre-Op Teaching:                PRE-OP TEACHING                                MOS: 45 MOS MEPRS/DMIS: DGAA/6204
Pre-Op:                         ORTHOPEDICS APU                               MOS: 30 MOS MEPRS/DMIS: DGAA/0124
Post-Op Recovery:                ORTHOPEDICS APU                               MOS: 45 MOS MEPRS/DMIS: DGAA/0124
Departure Date/Time: 22 Jan 2004@1730
------------------------------------------------------------------------------------------------------------------------------------ 52
                                                    Roster of Incomplete APV
                                                    Tracking Times

Group ID: 0052 TRIPLER AMC                                                         08 December 2003@0759 Page 1
                                                                    Division: TRIPLER
                                               Personal Data - Privacy Act of 1974 (PL 93-579)
                                             ROSTER OF INCOMPLETE APV TRACKING TIMES
                                                               by APV Tracking Number
                                                      APV Date Range: Nov 2003 - Nov 2003
============================================================================================
APV Tracking # Patient Name                       FMP/Sponsor SSN Pat Cat MEPRS/DMIS Hospital Location Provider
============================================================================================
2003-11100005 DARKIN,EDWARD                             03/111-44-7777 F41                BBA5/0052            SDS – NI     STANLEY,C
Appt Dt/Tm: 18 Nov 2003@0800
Appointment Status:               PENDING
-----------------------------------------------------------------------------------------------------------------------
2003-11100006 DEAK,RICHARD                            03/166-44-8888 F41                BEA5/0052            ORTHO APU      STANLEY,C
Appt Dt/Tm: 10 Nov 2003@1524
Appointment Status:               KEPT
Pre-Op:                         **APV Tracking Times Incomplete**
Departure Date/Time: 11 Nov 2003@1640
APV Length of Stay has Exceeded 23 hours 59 minutes                                                Length of Stay: 25 hours 16 minutes

-----------------------------------------------------------------------------------------------------------------------
2003-11110001 FEARINS,KEVIN R 20/200-66-1111 F11                                         BBB5/0052           CARDIOLOGY APU SCHOOT,DON
Appt Dt/Tm: 11 Nov 2003@0900
Appointment Status:               KEPT
Post-Op:                         **APV Tracking Times Incomplete**
Departure Date/Time: **APV Tracking Times Incomplete**
                                                                                                                                   53
                           APV CPT Industry-Average &
                           Actual MOS Comparison

TRIPLER ARMY MEDICAL CENTER                           04 Dec 2003@1524
                     Personal Data - Privacy Act of 1974 (PL 93-579)
                   APV Industry Average & MOS Comparison Report
                         Date Range: 04 Nov 2003 - 04 Dec 2003
                                   Group DMIS ID: 0052
                        Division/Division DMIS ID: TRIPLER/0052
                        Hospital Location: PLASTIC SURG APU
=======================================================================
CPT Code                          Industry Avg Pre-op Industry Avg Post-Op
43458 (APV)                      Nursing MOS             Nursing MOS
                                 19.00                     3.00
=======================================================================
APV Tracking #                   Actual Pre-op          Actual Post-Op
Appt. Date                       Nursing MOS            Nursing MOS
=======================================================================
200311200005
20Nov03                            0.00                  130.00
=======================================================================
Clinic Actual MOS Averages:         0.00                  130.00
Industry MOS Average:             19.00                     3.00


                                                                             54
                WAM Reporting

• The MOS that are entered into the system will be
  captured in WAM.
• MEPRS Coordinators will no longer need to hand-
  enter MOS workload.
• The Summary version of the Roster of Nursing MOS
  Report (RAPV option) can be used for WAM
  validation by MEPRS Coordinators.




                                                     55
File and Table
Requirements




      APV Enhancements
                 File and Table Requirements
•    This information will be covered in Session II
     targeted at MEPRS Coordinators and DBAs.
•    Minor File and Table required to set up:
    – Creation of Ambulatory Procedure Profiles (APP)
    – Ensure that existing APUs (“S”-type locations)
        have been set up correctly.
    – Create new location types: Pre-Op Teaching
        Locations (“T”-type) and Recovery Locations
        (“V”-type)
    – Adding APV locations to Pharmacy Ward
        Groups, INCLUDING Wards that are used for
        Extended Recovery. Your existing APU clinics
        can be set up ahead of the software installation
        for a smoother transition.
                                                           57
REFERENCES




    APV Enhancements
                     APV References
 The following documents, and their attachments will be
 available on the Distance Learning Web site prior to
 deployment. The URL for the distance learning website is:
 <http://www.distributivelearning.net>.

• Ambulatory Procedure Visit (APV) Desktop Document
  Guide, SAIC D/SIDDOMS Doc. D2-NWDQ-5001A, 30 Mar
  2004.
• WAM APV Enhancement Release Notes, SAIC
  D/SIDDOMS Doc. D2-NWDQ-6001, 10 Mar 2004.
   – Release Notes for WAM Core FY04 v3.0 Data Update,
     SAIC D/SIDDOMS II Doc. D2-NWDQ-6003, 10 Mar
     2004.
   – Release Notes for Ambulatory Procedure Visits (APV)
     Data Update – FY 2004, Version 1.0.
                                                        59

				
DOCUMENT INFO
Shared By:
Categories:
Stats:
views:24
posted:2/6/2010
language:English
pages:59