Documents
Resources
Learning Center
Upload
Plans & pricing Sign in
Sign Out

ROLES_ EXPECTATIONS_ AND COMPETENCY

VIEWS: 7 PAGES: 5

									                 ROLES, EXPECTATIONS, AND COMPETENCY

In order for each team to run efficiently, each team member must function to the full
potential of their training. In addition to required competency and PD, each staff member
will observe the following:

Administrative Clerk: In addition to PD and competency as noted in the clinic parent
SOP, the following is expected:
   Welcome the patient and introduce yourself by name and what you will be doing.
       Ex. “Welcome, I am HN Smith and I will be checking you in today.”
   Ensure effective and expeditious check-in process and optimal customer service
   Verify ID using two patient identifiers, verify insurance, and PCM
   Once you know the patient’s name call them by their name using Mr. or Ms. or if
       AD or retired AD use their rank.
   Check for eligibility of care and DEERS update to include current address and
       best phone number to reach them, preferably a cell number. These are very
       important for return calls for T-Cons and CHCS reminders.
   Print out SF 600, outpatient Medication Reconciliation Form, and any other
       pertinent document for the patient visit
   Ask if you may ask what the visit is for. If there are any forms to fill out, give the
       patient the appropriate form based on their reason for the visit.
   Give the patient the Population Health Survey
   If the patient is here for a procedure, ensure a consent form is included for the
       MA at check in.
   If the patient has brought forms that need to be filled out please fill in the clinic
       name address and telephone numbers as required. Your clinic may have a stamp
       for this information.
   Once the patient is checked in, tell them what to expect next. The Corpsman or
       MA will be out and call your name and take you back to the exam room to
       prepare you to see the provider. Tell them the entire time for preparation and
       seeing the provider will take approximately 30 minutes. Tell them if the provider
       is running on time or late so they know what to expect. This is good expectation
       management.
   If a patient is late, ask the RN to see them to determine how to manage the
       situation. If the RN is not available, the Corpsman or MA should see the patient
       and inform the RN of the situation. Clerks should not make the determination of
       how to handle a late patient but should inform the RN.
   Continuously watch for patients that have been in the waiting area for more than
       10 minutes beyond their appointment time. Find out why the provider is running
       late and how late and keep the patient informed. When possible, go to the patient
       and speak to them in private rather than calling them to the window. This will
       show the patient the clinic’s concern with the situation.
   Stay in touch with the Corpsman and MAs and be aware of the flow at all times
       so the patients can be kept informed.
      If you ever observe a patient in distress follow the clinic code blue protocol
      Ensure effective communication of flow process and patient issues to clinical staff
      Conduct appointment booking as per PCMH model
      If a patient presents to you after their visit requesting an updated Medication
       Reconciliation form or follow up appointment, print out the form and give to the
       patient and book the appointment as needed.

Medical Assistant/ Hospital Corpsman: In addition to PD and competency as noted in the
clinic parent SOP, the following (although not all inclusive) is expected:
     The day before review all patients with appointments.
            o Retrieve any lab or x-ray results that were ordered
            o Retrieve any consult reports since last visit
            o Place results in AHLTA for the next day’s visit
            o If the patient has any chronic diseases, retrieve any preventive labs or
                imaging studies done and any history of educational sessions.
                     Use specific chronic disease data bases if available
                     Consult with RN Care Manager on these patients the day before
            o If the visit is for wellness, retrieve any lab or imaging results since the last
                visit and determine what immunizations will be needed.
            o Check PCM enrollment to ensure the patient is scheduled to see their
                assigned PCM
            o Discuss all the patient’s with the RN and Provider the day the before to
                determine if there is any need to call the patient to obtain additional tests
                or instructions before the visit.
            o Discuss if any complicated patients need to be called by the RN before the
                visit to determine priorities and to carry out any existing or needed care
                plans to make the visit efficient and to ensure the provider addresses
                priority issues first.
            o When calling patients to confirm their appointment, note the reason for
                their visit and ask them to bring all pertinent medical information (any
                civilian records, vaccination cards, glucometer, medication lists, consult
                reports, etc)
     When calling the patient back from the waiting area, call the patient by their name
        always using their title; Mr. or Ms. When AD or retired AD always use their
        rank.
     Welcome them to the clinic and introduce yourself by name. If the clinic is
        running late, apologize. Tell them what they should expect; I will take you back
        to the exam room and prepare you for your visit with Dr. Smith. I will ask you
        some health related questions for Dr. Smith and weigh you and take your BP,
        pulse, and temperature.
     Confirm Patient ID using two separate patient identifiers
     Preparation of the Patient in the Exam Room
            o Go over Medication Reconciliation form and update
                     Enter meds into AHLTA
            o Review Populatoin Health Survey with patient-:
                    see Example population health survery (encl 1)
o Vital Signs
      BP
                 Repeat BP manually if electronic reading is unusually high
                 Do orthostatic BP for patient with dizziness
         Pulse OX reading and peak flow for patients with respiratory
            concerns, example asthma, flu, COPD, etc. Do peak flow on all
            asthma patients regardless of symptoms or not.
         Once you are finished with the vital signs, ask the patient to
            remove the appropriate clothes for the exam and/or procedure.
         Pediatric Patients
                 BP for all children 2 years and older
                 Eye exam for all pediatric well visits
                 Height, weight, and head circumference measured and
                    plotted.
                 Direct pediatric patients to immunizations while waiting to
                    be placed in a room
                 Once you are finished with the vital signs, ask the patient to
                    remove the appropriate clothes for the exam and/or
                    procedure.
o   AIMS forms
         If the patient has filled out an AIMS form, review it and ask for
            any clarifications about the patient’s entries. Use this form to fill
            out the Support Staff AIMS form.
o   AHLTA Entry
         Enter the SUBJ portion of AHLTA; reason for visit, symptoms,
            duration of symptoms, concerns, enter all patient concerns they
            would like addressed this visit..
                 Chronic Disease Procedures
                        o Download glucometer readings for diabetic patients
         Enter Past Medical History into AHLTA. This may be on AIMS
            form patient fills out.
                 Document last menstrual cycle for all female of
                    reproductive age
         Enter Tobacco/ETOH and pain screening into AHLTA
o   Inform patient when the Provider will be with them.
         If the provider is running late, tell the patient why and estimated
            time of provider arrival. Continue to update the patient every 10-15
            minutes of the status.
o   Make sure order form for labs and imaging is available for the provider
o   Keep provider informed of patient flow and schedule
o   Inform check-in clerk and RN if there is any inordinate delay
o   Once the provider is in with the patient, be available for any anticipated
    stand by needs and/or assistance with exams or procedures. While
    checking in next patient watch for the yellow flag. If a standby or
    assistance with a procedure is required, inform the RN and/or LVN so
              additional help can be arranged for patient check-in and intake or assisting
              with the procedure/exam.
      Health Reconciliation at the End of the Visit
          o After the visit with the provider is over
                   Ask if the patient has any questions
                   Enter any labs or imaging orders into AHLTA
                   If the patient needs a follow up visit within 6 weeks, give them an
                     appointment then or the phone number or TOL options if they wish
                     to make it later. If the visit is greater than 6 weeks, give them a
                     card with the follow up time and appointment number and TOL
                     url.
                   If the patient has a consult, give them the consult printed
                     instructions and how to call the RMC for questions about in-house
                     consults and the TriWest number and url for network consults.
                   If the patient had labs, x-rays, pharmacy, or immunizations give
                     them directions and expected wait times
                   Enter any patient education or procedures done by the MA during
                     this visit
      Other
          o Maintain patient safety at all times especially with children and the elderly
          o Provide pleasant customer service at all times
          o Inventorying of C-lockers to ensure proper stocking and removal of
              expired items
          o Be visible at all times to assist providers as needed. Response to the
              “Yellow flag”
          o Anticipate provider’s need and prepare for them accordingly
          o Have all equipment ready for procedures(NTG spray, etc)
          o Again, this is not all inclusive. Seek guidance from your provider and
              lead RN

Registered Nurse: The Registered Nurse is the team leader for the support staff assigned
to each provider team. He or she, in addition to the PD and competency as outlined in the
clinic parent SOP, will:
     Lead and direct the entire clinic team in quality patient care
     Obtain provider team schedule for following day and do a schedule scrub with
        provider, LPN/LVN, Medical Assistant(MA) ,and/or Corpsman(HM/HN) as
        applicable
            o Review any patients with chronic diseases and any preventive labs or
               imaging studies done and any history of educational sessions.
                    Use specific chronic disease data bases if available
            o Discuss all the patients to determine if there is any need to call the patient
               to obtain additional tests or instructions before the visit.
            o Discuss if any complicated patients need to be called by the RN before the
               visit to determine priorities and to carry out any existing or needed care
               plans to make the visit efficient and to ensure the provider addresses
               priority issues first.
   Manage all T-Cons per Tel Con SOP
       o Screen for access T-Cons. Look up last appointment in AHLTA and call
           the patient back within 2 hours of the patient leaving the message
       o All other T-Cons; look up last appointment and any lab or imaging results
           or RX history needed and have a team member call the patient back within
           72 hours of the patient leaving the message.
       o Send completed T-Cons to provider for approval as appropriate
   Assist with procedures and be available as stand-by as necessary
   Ensure effective and efficient patient flow
   Develop curriculum for proper training for clinic functions for Corpsman, MAs,
    and LVNs
       o Working with the Senior Enlisted Leader (SEL) ensure expectations are
           clear and that Corpstaff, MAs, and LVNs s are performing to expectations
       o Evaluate support staff at least monthly to determine if they are meeting
           expectations. Include Providers in this objective evaluation. This
           evaluation should be standardized and objective for the clinic.
           Satisfaction of the providers should be evaluated but should not be the
           only evaluation of performance. Other objective measurable factors
           should be measured, monitored, and tracked and feedback given to support
           staff for improvement.
       o A portion of the RN’s evaluation should include support staff
           performance

								
To top