welcome by sylvia brito - covenant health · by sylvia brito . reflection and prayer by chris...
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Welcome by Sylvia Brito
Reflection and Prayer
by Chris Shaver
Values in Action
Holly LaFebre Director of Mission Services
(806) 725-4555
What is VIA?
The Values in Action award is the highest
honor bestowed by St. Joseph Health System
and Covenant Health System. The program
formally recognizes those individuals who
demonstrate daily the core values of Service,
Excellence, Dignity, and Justice. Annually,
one person from CHS is selected from all
nominations for each value.
Our Values:
Dignity
We respect each person as an inherently valuable
member of the human community and as a unique
expression of life.
Service
We bring people together who recognize that every
interaction is a unique opportunity to serve one another,
the community, and society.
Excellence
We foster personal and professional development,
accountability, innovation, teamwork, and commitment
to quality.
Justice
We advocate for systems and structures that are attuned
to the needs of the vulnerable and disadvantaged and
that promote a sense of community among all persons.
Who Can Be Nominated?
• Employees
• Physicians
• Volunteers
• Trustees
NOTE: Individuals nominated in a previous year may be nominated again in subsequent years.
Nominator Benefits
• Electronic nominations have chance to
win $50 gift card
– Online survey only
– Nominate some by or before April 2, 2011
– Drawing held April 18, 2011
• Satisfaction of recognizing your deserving
co-worker
Nominee Benefits
• 10,000 Rewards Points
• Recognition at a Nominee Reception
– Held two times per year (usually November & May)
• Special VIA Name Badge Clip
• Nominee Certificate
• The recognition they deserve
VIA Award Recipient Benefits
• VIA Plaque presented at awards reception
at CHS
• Recipient and a guest attend SJHS awards
ceremony in Orange, CA
• 15,000 Rewards Points (in addition to the
10,000 from the nomination, totaling 25,000 points)
2010 VIA Award Recipients with Clarke Cochran, Richard Parks, & Deborah Proctor
Your Role
• Encourage participation in your
office/department
• Recognize deserving individuals on your
staff and from other departments
• Provide access to computers for staff to
complete nominations
VIA Contacts
Sandra Cortez VIA Coordinator
725-0260
Or
Holly LaFebre Director of Mission Services
725-4555
Questions?
Medical Records/Coding
Beverly Brooks
Physician Orders for Tests
• Please include the reason for each test on the order
• Check preprinted orders that are used:
Do they include the reason /diagnosis for each test? This will serve as a reminder to include on every order.
• If you are including narrative : don’t use rule out or suspected for outpatient tests. Include the symptoms.
Physician Orders for Tests
• If you are including ICD-9 codes , please make sure codes are valid. It is really helpful to include both narrative and the ICD-9 codes.
• Check your preprinted charge sheets to insure that the codes are valid.
• This will prevent having to resend the order.
• Make sure the orders are signed by the physician .
• Best Practice If including the code, also include the narrative.
Physician Orders for Tests
• New information: “Pre-op testing” is a valid reason for test as long as you also include the reason why the physician is ordering the test.
• Example: Chest x-ray: why is the physician ordering this prior to surgery?
• Example: EKG: why is the physician ordering this prior to surgery.
• Does the patient have a chronic condition to warrant this test?
• These should also be documented in your physician office record
Physician Orders for Tests
Best Practice examples include on orders:
CT of Chest w/contrast
DX/reason_________________
EKG
DX/reason _________________
Chest X-Ray
DX/reason _________________
Persantine Thallium Stress Test
DX/reason _________________
MRI Chest
DX/reason _________________
CBC
DX/reason _______________
CONTACT INFORMATION
• HIM ON-CALL PHONE: 806-392-5645
• HPF SUPPORT :
• Gary Williams 806-300-2350
• if you need:
• Assistance with HPF issues or
• If physicians are having issues
completing their charts .
DICTATED REPORTS
• BEST PRACTICE:
• HISTORY AND PHYSICAL – COMPLETE WITHIN 24 HOURS OF ADMISSION.
• OPERATIVE NOTE – COMPLETE WITHIN 24 HOURS OF PROCEDURE PERFORMED
• DISCHARGE SUMMARY COMPLETE AT TIME THE DISCHARGE ORDER IS WRITTEN OR WITH 24 HOURS OF DISCHARGE.
• THE PHYSICIAN DOES NOT NEED TO WAIT FOR THE DEFICIENCY TO BE ADDED IN HPF TO COMPLETE THE DICTATION.
Direct Admits to Covenant
Rachel Stehling
Pediatric Direct Admission Process
•Call Bed Management 725-0460
•Bed Management will request the following information: patient Name, DOB, diagnosis/chief
complaint, physician, and type of bed needed
•Patient Placement Coordinator (PPC) will request a bed in Teletracking, thereby paging the Charge
Nurse
•Physician office will be asked to fax:
1.Clinic demographic sheet to Bed Management ,725-1010
•Once the Demographic sheet is received Bed Management will pre-register the
patient in Meditech and scan the demographic sheet into HPF
•Pediatric Unit will assign a bed within 15 minutes.
•When a bed has been assigned
1.Bed Management will notify the Physician’s Office of room number.
2.Bed Management will have Physician’s Office fax orders to Pediatric unit at 725-0017or PICU
725-0016
3.The physician’s office will be asked to have the patient present directly to the Nurse’s station.
•Upon arrival to the Nurse’s station:
1.The nursing staff will take the patient to their assigned room
2.The Unit Secretary will notify Lakeside Admitting of patient’s arrival at 5-6171 before 6:00 P.M.
(After 6:00 P.M. notify Bed Management at 5-0460)
Once Admitting is notified of patient’s arrival they will Activate the account.
If admission is after 1800 then Bed Management will be notified to Activate the
Account and Admitting Personnel will go to the patient’s room the following
day to obtain signatures for admission paperwork.
Adult Direct Admit Process • Call Bed Management 725-0460
• Bed Management will request the following information: patient name, DOB, social security
number, chief complaint/diagnosis, physician, and type of bed needed
• Patient Placement Coordinator (PPC) will request a bed in Teletracking, thereby paging the
Charge Nurse
• Bed Management can call the physician office with the patient’s room number upon request
• The physician’s office will be asked to have the patient present to Main Admitting at CMC
• Patient may bring a copy of the physician orders
• Critical Care patients will be asked to present to the ED so a licensed staff member can escort
them to their room
• If we don’t have a bed available you will be asked if the patient can wait at home or in the
physician office until a bed becomes available
• Patient’s may present to the ED if there is an urgent need for them to be evaluated and treated
Direct Admits to
Covenant
Call Bed Management
725-0460
Effective April 1, 2011
Medicare Home Health Face-to-Face Requirement
•Mandated by the Affordable Care Act (ACA)
•Condition for payment
•Prior to certifying a patient’s eligibility for the home health benefit, the
certifying physician must document that he or she, or an allowed non-
physician practitioner (NPP) has had a face-to-face encounter with the
patient
•Documentation regarding these encounters must be present on
certifications for patients with starts of care on and after April 1, 2011
•The face-to-face encounter must occur within the 90 days prior to the start
of home health care, or within the 30 days after the start of care
•http://www.cms.gov/center/hha.asp
Face-to-Face Overview
Radiology Outpatient Scheduling
806-725-6820
MEDICAL CENTER
WOMENS & CHILDRENS
98TH STREET
Who Remembers
Who remembers when you called
and all we needed was: Name,
Age, Exam , and Ordering
Physician.
What’s changed?
Insurance companies and reimbursement
The DREADED pre-cert
We must have CURRENT Insurance
information
Policy Name Policy Number
Why we ask so many questions
Radiation
If a patient is a female between the ages of
13 and 50 and has not had a hysterectomy, and on the date having the exam it is more than 10 days from the onset of her last menses, she will have to have a BETA. (10 day rule)
CONTRAST
I.V. contrast (Iodinated) Ct, IVP, Venograms, etc.
If the patient is
over 65, and/or has a history
of renal cancer or disease,
labs will be required.
(BUN & Creatinine)
We really don’t want to put your patient into renal failure.
Basic Guidelines for Renal Function/Iodinated contrast
Kidney disease, tumor, surgery, solitary kidney or Renal transplant
Diabetes (Do you take Glucophage/Metformin)
Age 65 or over
Collagen Vascular Disease (SLE, Scleroderma, Rheumatoid
Arthritis)
Do you take Aspirin, Ibuprofen, Naprosyn or Excedrin
Normal Creatine Range 0.6-1.3 . (If greater than 1.5 contrast will
be given at Radiologist discretion)
Basic lab guidelines for Mri contrast
• Renal disease, Kidney tumor, surgery, solitary kidney
• Renal transplant
• High blood pressure > 140/90
• Over the age of 60
• Diabetes
• Liver Disease, cirrhosis, liver failure
• Liver Transplant in the last 6 months
• Acute Renal Failure –NO CONTRAST
• Depending on Results of GFR
0-45 cc/min –NO CONTRAST
45-60 cc/min – Half dose of Prohance or Multihance
60 and above cc/min- Dose
May use previous Lab values back 6 weeks if patient has not had major change in health
Additional MRI Questions
• Is the patient claustrophobic?
• Does the patient have a pacemaker or
neurostimulator?
• Has the patient ever done any welding?
• Has the patient ever been shot or have any
metal in the body?
If it can do this to a bed
think what it could do to a pacemaker.
And we still get patients sent to us with pacemakers.
PET SCANNING
Why does it take longer to schedule a
PET Scan?
v The dosage for PET is very expensive
v The dosage can only be used on the patient it was formulated for. (weight, height, etc.)
v The dosage can be used prior to the time it was formulated but not past the time it was formulated for.
v No “extra” doses are made, so if everything is not set to go when the patient arrives they will have to be rescheduled and another dose made.
NUCLEAR MEDICINE
• Medical Center 806-725-0435
• Womens and Childrens 806-725-6836
There is still a technical
aspect in Nuclear Medicine
that we are working through so
please call the above listed
numbers for nuclear exams.
INTERVENTIONAL / SPECIALS
FOR INTERVENTIONAL STUDIES
SUCH AS BIOPSYS, ANGIOS,
VERTEBRO & KYPHOPLASTYS
PARA & THORACENTESIS,
PLEASE CALL :
725-2030
PATIENT VERIFICATION
After we know what exam you are scheduling, the next thing we have to know is LEGAL name and SS#.
If the patients LEGAL NAME is William Robert we need William Robert, not Billy Bob, Junior, Willy, Bobby, Billy or any other derivatives of their name.
Do you know how many patients we have in our data base?
Since July 2008 we have registered 5 million accounts into our MediTech system.
The region we serve
John Smith-58
Jose Garcia-124
Mary Martinez-86
What we are doing to help expedite
the process • Last year we had 8 phone numbers
• And 14 different fax numbers for you to send orders to
YIKES!
This year we have 4 different numbers to
call to schedule a exam
BUT
Only one number you need to fax an order
to!
806-796-5199
HOORAY
THE END RESULT IF WE DON’T
GET THE INFORMATION WE
NEED IS: DELAYS
IN
PATIENT
CARE
MONEY
DOWN
THE
DRAIN
AND WERE NOT TALKING
ABOUT US. WE’RE TALKING
ABOUT YOUR PATIENTS
Hotel Rooms Gas money
Time off work
Other Information • Contacts
Radiology Scheduling Supervisor
Maria Parsons 806-725-6598;
Radiology Scheduling Manager
Lashelle Doss 806-725-4447
• Film and CD pick up
Films and or CD’s need to be picked up at either
Medical Center or Women’s and Children’s campuses
We also print 98th street images
Medical Center Fileroom 806-725-4329
Women’s and Children’s Fileroom 806-725-6829
QUESTIONS
Verbal / Telephone Orders
Suzy Griggs
Physician Orders: Reminders
1. Written Orders for Treatment • Signed, dated, and timed by the ordering physician
or mid-level practitioner before faxing or transmitting to the hospital.
2. Telephone Orders for Treatment • Must be given to “qualified designated personnel”*
who will document the order in the patient record. • Example: T.O. Dr. Jones / M. Smith RN
• * Nurse, Pharmacist, registered or certified ancillary personnel pertaining to therapy they are providing, Social Services personnel, etc.) MS R&R, Section 8.20, 12/17/10
• Ask for a “Read-back” of the order to ensure accuracy.
Physician Orders: Reminders
3. Telephone Orders for Treatment (cont.) • All verbal and telephone orders must be signed,
dated, & timed within 48 hours by the practitioner or another practitioner who is responsible for care of the patient. • Example: T.O. Dr. Jones / M. Smith RN
4. Orders for Chemotherapy • Verbal or telephone orders for chemotherapy are
not accepted.
• Covenant requires the use of pre-printed orders for chemotherapy. (Nursing Policy IX-E-6d)
Patient Parking Pointers
Tips and Hints for Patient Parking
Mark Whitley
Valet
• If you are giving directions to the hospital use
Entrance A rather than the Valet entrance.
• Valet is a $6 charge, and $3 for Seniorcare
members or Handicap tag holders.
• Valet Hours Monday – Friday 5:30am to 7:00pm
• Valet vehicles can be returned during off hours.
Valet Canopy
• Our Canopy is used for our patients and visitors.
• Our goal is to keep the canopy clear in case of
emergency situations.
• Employee drop off or pick up is permitted,
however parking is not allowed as we place our
patients and visitors first.
• Lane 1- Dismissal Lane
• Lane 2 & 4 - Drive Thru Lanes
• Lane 3 & 5 - Valet Lanes
10 Minute Tickets
• Patient’s/Visitor’s needing to go inside for
a few minutes will be issued a Valet ticket,
after 10min there vehicle may be moved
and subject to Valet fees. Example: Picking up
medical records.
Dismissal Patients
• Dismissal patients may be picked up at
entrance A.
• Parking is allowed in the dismissal lane to
wait for patient to be dismissed.
• If they need to go inside a separate valet
ticket will be issued to identify they are
picking up a patient.
Parking Garage
• The East Parking Garage is designated for patient/visitor parking.
• Each patient is given two 7 day passes to park in the garage. They can be used for their family and may be renewed if their stay is longer than 7 days.
• These are not valid for Valet.
Managed Care Contracts
Lindy Lauderdale
Managed Care Contracts • Accountable/Interplan
• Aetna
• Beech Street
• BlueCross BlueShield
(Texas & NM)
• Care Improvement Plus
• Cigna
• Cimarron Commercial
• Coventry/First Health
• FirstCare
• Galaxy
• Great West
• HealthSmart
• HealthSpring
• Multiplan/Admar
• New Mexico Mutual
• Molina
• OMNI
• PHCS
• Superior
• TDH Star
• Texas True Choice
• United
• Universal American
CHS Leaders
Covenant Health System
Troy Thibodeaux
Chief Executive Officer
Covenant Health System
Richard Parks
President and CEO
Covenant Health System
