Medworxx at HSC - Patient Status Entry and Discharge Planning - ADULT MED-SURG - TEST EXAM

This is the exam portion of this course.

Workflow

What is the correct order of steps to enter the daily status updates for all of your assigned patients in the most efficient way?

  • Set the patient list
  • Enter the operational comment for the first patient.
  • Enter the status update for the first patient.
  • Enter any flags if required for the first patient.
  • Click the right arrow above the Encounter Details to move to the second patient on your list.
  • Enter the operational comments, status updates, and any required flags for any subsequent patients on your list.
  • Print the Patients by Bed by Unit report.

Operational Comments - "GoAHEAD"

Please answer the following statements as True or False.

  • GoAHEAD helps the care team plan for discharge.
  • GoAHEAD is an acronym to help document key points for care and discharge, such as allergies, medical history, and discharge.
  • GoAHEAD indicates the patient is ready for discharge.
  • The Operational Comment box is included in the reports used in bullet rounds.
  • The information recorded in the GoAHEAD format allows bullet rounds and other rounds to be more efficient.
  • Using the GoAHEAD acronym in the Operational Comments box helps create consistency in the data entered for each patient and avoids confusion among the care team members.

Where on the Status Entry screen is the GoAHEAD recorded?

Click on the screenshot below to indicate where you would record the GoAHEAD.

How often should the Operational Comment box be updated?

  • When the patient's disposition or circumstances change.
  • Once every 24 hours.
  • Upon admission.
  • Upon admission and then at least once every 24 hours.

Status Updates, Part 1 - The Patient Requires Acute Care

Please answer the following statements as True or False about the MET category.

  • MET means they've met the criteria to be discharged.
  • MET means the patient meets the criteria to justify an acute stay in hospital.
  • If the patient meets any criteria in the MET section, record as many criteria that are applicable to the patient's situation.
  • The status update needs to be entered on the day of admission and then updated once in a 24 hour period.

Status Updates, Part 2 - The Patient Faces a Barrier to Discharge

Define each of the NOT MET subcategories.

  • Physician
    Delay of discharge due to physician directive or lack of a discharge plan.
  • Hospital
    Delay in non-physician related in-hospital services.
  • Community
    Delay in arrangements from community services to be finalized.

Please answer the following statements as True or False about the NOT MET category.

  • If the patient does not meet any criteria in the MET section but cannot be discharged, record only the main reason in the NOT MET section.
  • NOT MET means the patient is clinically stable but is either not functionally ready for discharge or, if they are functionally ready for discharge, is waiting for the arrangement for follow up care, such as placements, programs, etc.
  • Record as many barriers for discharge as are applicable.
  • MET and NOT MET criteria are mutually exclusive: if the patient meets any criteria in the MET category, you cannot record any criteria in the NOT MET category and vice versa.
  • The sub-categories and criteria in the NOT MET category are listed in order of priority. If the patient faces two or more barriers to discharge, record the one that's of the highest priority.

Flags and Alerts

Please answer the following statements as True or False about the High Risk Discharge flag.

  • The High Risk Discharge flag denotes a patient who requires more complex discharge planning.
  • The High Risk Discharge flag should be set as early as possible which might be at the time of admission.
  • The High Risk Discharge flag automatically puts a patient in isolation.

Where would you click to flag a patient as a high risk discharge?

Which of the following are indicators for a high risk or complex discharge?

For this question, please consult the High Risk Discharge Indicators document. You can download it from the link below. It is also a good handout to keep for future reference.

High Risk Discharge Indicators

Note:

  • This link going to the Planned Patient Discharge SharePoint site. It's a good page to bookmark for easy access to all the Medworxx reference materials in the future.
  • You may need to log in. If so, use your personal network login.

  • Multiple medical problems or progressive/chronic disease
  • Hospitalized > 3 times, and/or multiple Emergency Department visits within the last 12 months due to similar conditions
  • Inability to manage instrumental activities of daily living and have inadequate supports
  • Falls
  • Evidence of caregiver stress
  • Evidence of physical, financial, or emotional abuse
  • Funding and accommodation issues
  • Family lives out of town
  • Cognitive impairment that is interrupting the delivery of the Patient Care Plan
  • History of substance abuse
Mark all that apply.

Please answer the following statements about the Isolation flag.

  • The isolation flag is used to indicate when a patient requires isolation precautions, regardless of the type of precautions or the reason for isolation.
  • If a patient is flagged as being on isolation it should be reflected in the first A of GoAHEAD in the Operation Comment box.
  • Flagging a patient as being on isolation is an indicator that the patient must be in a MET category.

Where would you click to flag a patient as requiring isolation precautions?

Staff Reports

Which report do you print in order to take to bullet rounds, as your patient list, or as a shift hand-off report?

  • Patient List by Bed by Unit Report
  • Patient Bed Report
  • Operational Comment Report