Bounceback prevention: Difference between revisions
Neil.m.young (talk | contribs) (Text replacement - " pt " to " patient ") |
(→Step 2) |
||
| (2 intermediate revisions by one other user not shown) | |||
| Line 2: | Line 2: | ||
Identify High Risk patients: | Identify High Risk patients: | ||
*High risk complaint without definitive diagnosis on discharge (eg [[Abdominal Pain]], [[Chest Pain (DDx)|Chest Pain]], [[Headache]], [[Fever]]) | *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) | *Condition making it less likely patient will return for worsening symptoms (mental/psych/substance abuse) | ||
*Chronic | *Chronic disease with decompensation | ||
*Difficulty obtaining accurate data (language, dementia, inebriation, etc) | *Difficulty obtaining accurate data (language, dementia, inebriation, etc) | ||
*Advanced age | *Advanced age | ||
*Upset | *Upset patient | ||
*Unmet patient expectations | *Unmet patient expectations | ||
*Bouncebacks (a patient return, | *Bouncebacks (a patient return, usually within 72h) | ||
OVERALL: a patient you will worry about after your shift | OVERALL: a patient you will worry about after your shift | ||
| Line 16: | Line 16: | ||
Review your evaluation prior to discharge: | Review your evaluation prior to discharge: | ||
*Address ALL documented complaints in H&P | *Address ALL documented complaints in H&P | ||
*Confirm | *Confirm history is accurate | ||
*Consider potentially serious | *Consider potentially serious diagnoses | ||
*Explore | *Explore abnormal findings | ||
*Write a progress note explaining medical decision-making process (if unclear in H&P) | *Write a progress note explaining medical decision-making process (if unclear in H&P) | ||
*Assure that aftercare instructions are specific and | *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 | *Confirm that patient understands and is comfortable with the plan | ||
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)