Bounceback prevention: Difference between revisions

Latest revision as of 09:08, 16 April 2018

Step 1

Identify High Risk patients:

High risk complaint without definitive diagnosis on discharge (eg Abdominal Pain, Chest Pain, Headache, Fever)
Abnormal vital signs
Condition making it less likely patient will return for worsening symptoms (mental/psych/substance abuse)
Chronic disease with decompensation
Difficulty obtaining accurate data (language, dementia, inebriation, etc)
Advanced age
Upset patient
Unmet patient expectations
Bouncebacks (a patient return, usually within 72h)

OVERALL: a patient you will worry about after your shift

Step 2

Review your evaluation prior to discharge:

Address ALL documented complaints in H&P
Confirm history is accurate
Consider potentially serious diagnoses
Explore abnormal findings
Write a progress note explaining medical decision-making process (if unclear in H&P)
Assure that aftercare instructions are specific and clear. Ensure follow up schedule is timely and available
Confirm that patient understands and is comfortable with the plan

OVERALL: Complete a medically and legally defensible eval which is reflected in the documentation on the chart

References

"Bouncebacks" (Weinstock, Longstreth)

Authors:

@@ Line 1: / Line 1: @@
-STEP 1
+==Step 1==
 Identify High Risk patients:
+*High risk complaint without definitive diagnosis on discharge (eg [[Abdominal Pain]], [[Chest Pain (DDx)|Chest Pain]], [[Headache]], [[Fever]])
+*Abnormal vital signs
+*Condition making it less likely patient will return for worsening symptoms (mental/psych/substance abuse)
+*Chronic disease with decompensation
+*Difficulty obtaining accurate data (language, dementia, inebriation, etc)
+*Advanced age
+*Upset patient
+*Unmet patient expectations
+*Bouncebacks (a patient return, usually within 72h)
--High risk complaint without definitive diagnosis on d/c (eg A/P, C/P, H/A, F)
+OVERALL: a patient you will worry about after your shift
--Abnl VS
--Condition making it less likely pt will return for worsening symptoms (mental/psych/substance abuse)
--Chronic dz with decompensation
--Difficulty obtaining accurate data (language, dementia, inebriation, etc)
--Advanced age
--Upset pt
--Unmet pt expectations
--Bouncebacks (a pt return, us within 72h)
--OVERALL: a pt you will worry about after your shift
-STEP 2
-Review your evaluation prior to d/c:
--Address ALL documented complaints in H&P
--Confirm hx is accurate
--Consider potentially serious dx
--Explore abnl findings
--Write a progress note explaining medical decision-making process (if unclear in H&P)
--Assure that aftercare instructions are specific and f/u is timely and available
--Confirm that pt understands and is comfortable with the plan
--OVERALL: Complete a medically and legally defensible eval which is reflected in the documentation on the chart
+==Step 2==
+Review your evaluation prior to discharge:
+*Address ALL documented complaints in H&P
+*Confirm history is accurate
+*Consider potentially serious diagnoses
+*Explore abnormal findings
+*Write a progress note explaining medical decision-making process (if unclear in H&P)
+*Assure that aftercare instructions are specific and clear. Ensure follow up schedule is timely and available
+*Confirm that patient understands and is comfortable with the plan
-Source
+OVERALL: Complete a medically and legally defensible eval which is reflected in the documentation on the chart
+==References==
+<references/>
 "Bouncebacks" (Weinstock, Longstreth)
+[[Category:Misc/General]]
-[[Category:Policy]]