Hopewell Center: The Suggestion System

we could change the appointment system so a Gp each morning would have no appointment s booked in advance they would see every patient that needed to be seen between the times of 8:00 and 11:00 this way the patient would be seen within the expected time of 48 hours,

If his suggestions are within reason, I would make every attempt to make that happen. Conversely, if his suggestions were entirely unreasonable, I would ask that he talk with the director supervisor(s) for the clerk and DON regarding his concerns. Regardless, of the physician being an important customer and employee, if his behavior and/or complaints are unsubstantiated or out-of-line, his behavior needs to be address as well.

This would ultimately be a loss for both patients, who would need to find another doctor, and the practice itself, that would potentially take a revenue hit.

However, that is not always possible because their in-network hospital may not have a bed available. I have to make sure that all the outpatient providers are in-network with the insurance as well otherwise it will not be covered by the insurance and the patient will not be able to afford the cost of care. I thought having a hospitalist and working closely with the Kaiser case manager to address discharge planning needs helped maintain care quality and contain the cost of care. Successful discharge planning that reduces readmissions are high priority issues addressed in the healthcare reform agenda because it affects both quality and cost of care (Weiss et al., 2015). Weiss et al. (2015) also stated that "...hospitalized patients, regardless of risk status or the setting to which they are being discharged, require some

Patients who request for their own doctors should have their wishes respected as a matter of a patient's rights. It does not matter whether those requests occur in the ER or during their hospitalization under the UCR hospitalists. These requests have been routinely ignored, or transmogrified into an ugly

Legally and ethically under Informed consent a patient has the right to refuse specialty treatment or referral but needs to be informed about the risks involved with delay or lack of the specific treatment recommended. Mostly, if the patient does agree to visit the specialist then, the specialist is responsible for the informed consent for the specific treatment. But is has been contested and help in courts that the primary care physician still is responsible for the patients welfare in all phases of treatment. For a provider in a busy practice it is difficult to keep track of all the referrals and at times, the specialist’s office has a different outlook on the matter.

There are many factors to why appointments are delayed or re-scheduled that are beyond the structuring of time, however, there are some ideas that can help ease the annoyance of having to wait. The best thing to address is making sure the patient feels comfortable. Keep people abreast of the wait time and what’s going on. People understand things happen. However, they don’t want to feel forgotten. Some doctor’s offices have grasped the ideas of distraction, provide TV with news and valuable information, brochures and literature read, even hiring nurses or

The office would need to establish a goal to accommodate all post-discharge patients. When appointments cannot be made then an escalation process to the office manager needs to occur. In order to foster communication with professional partners, an investigation of the system failures. How can the transition to home be improved? The workflow should include a validation step that would entail hand-off communication between hospital rounders and office schedulers. If missteps occur, then the office staff could catch the near misses and call the patient at home. Care coordination among providers on an outpatient basis could be supported by the electronic medical record and having verbal care conferences. Next strategy could involve the hospital completing a call back within twenty-four hours to all patients discharged. This intervention could potentially catch some of the missed opportunities. Another approach involves face to face reinforcement of the patient-centered partnership with H. H. According to Counsil et al. (2012), “patient-centered care plans for complex patients changed the relationships with the health team” (p. 190). The development of this patient directed plan of care and partnership is

2. This organization could require all physicians to adhere to hospital protocols regarding booking of OR. Attica Memorial Hospital could then reduce the OR time blocks booked by Dr. Ingelson to decrease underutilization and cost.

t is our goal to accommodate provider requests to add patients on to be seen. However, please refrain from scheduling patients from 12:00 pm – 12:30 pm. If you receive a requests from a provider to schedule patients during those hours, please contact me or Leigh Tuttle for approval. We need to ensure that all staff are taken lunch and also ensure that we have staff availability to assist the provider during those hours.

During the second week, I had the opportunity to accompany Mr. Price to meetings that he had with the managers of the nurses and schedulers. During those meetings, the managers discussed the ideal approach of how to accommodate patients who call the schedulers to acquire appointments for urgent medical concerns. There seemed to be a problem with patients taking up appointment slots when they do not have a true need to be assessed by their doctor. It was ultimately concluded that the schedulers would coordinate communication between the patient and the registered nurse. The nurse would then triage the patient’s concerns over the phone and provide medical guidance,

It is easy to understand the rushed appointments. Physicians regularly see close to 20 patients per day. Furthermore, the medical model focuses primarily on diagnosing and treating the illness at hand, at the expense of seeing the whole clinical picture. This often leads to frustration and decreased motivation to seek follow-up care.

It has been brought my attention that some of our Sunnyside Hospital affiliated members have filed complaints that their primary care physician issued referrals to designated specialists are not being approved. There are also complaints

Within the case, The Carbondale Clinic, it is apparent that a scheduling problem exists which has then resulted in patients being unsatisfied with the amount of time they must wait to be seen for his or her scheduled appointment with the physician. It is also evident that physicians prefer to have a full schedule without taking into consideration the possibility of emergencies that may arise throughout the day that will contribute to patients having to wait even longer. It is pertinent that the manager sits down with the staff to determine what is the most logical solution to help resolve the scheduling problem, taking into consideration what the physicians want along with ensuring patient satisfaction.

Currently, at Rutland Regional Medical Center (RRMC) there is no structured process for case management to provide handoff to the primary care offices when patients are discharged from the hospital. The transition of care from hospital to home is a critical time, during which the risk of adverse event occurrence is high. According to Shivji, Ramoutar, Bailey, & Hunter (2015), 19%-23% of patients experience an adverse event following discharge to home. Elderly patients are at greater risk due to functional and cognitive limitations; this is compounded by the presence of co-morbidities and multiple providers (Nelson, & Carrington, 2011). According to the Rutland County Health Assessment (2012-2015), by 2017 it is estimated that the elderly (age > 65) will comprise approximately 21.1% of the county’s population. Clear, concise, and timely communication with cooperative care providers at discharge is critical for the elderly population (Morris & Hoke, 2015). Furthermore, according to Lattimer (2011), the lack of cooperation between providers at discharge can endanger patients ' lives and waste fiscal and human resources. The purpose of this paper is to examine the problem of handoff communication to primary care offices and to plan a recommendation for change to provide a consistent and structured process; thereby ensuring the safety of the community during transitions of care.