KEY PERFORMANCE INDICATORS

Transcription

1 KEY PERFORMANCE INDICATORS GCAL Hospital Discharge GCAL referrals for non-enrolled individuals with urgent needs are scheduled for an appointment within one (1) business day of referral. The 3.1 appointment is to occur as soon as possible, but no later than 3 calendar days from the date of referral. 100% of GCAL no shows have an outreach attempt within one (1) business day of missed crisis (urgent and emergent) appointment. 3.2 Access to monitor BHL web for GCAL referrals Download triage form Search for client in CareLogic If no record exists, create POE using information from triage form. Enter call date as GCAL referral date, add GCAL as referral source, mark Triage & Routing page as Urgent, schedule Intake (BHA- Initial) for next business day at 8am on Center Director s schedule (in the description box of appointment note- GCAL referral). If client is seen, move existing 8am scheduled appointment to assigned clinician and adjust start/end time, as appropriate. Clinician to proceed with workflow. If client does not show - select DNS as status and complete case management note to document that Engagement Specialist (ES) will follow up. ES to monitor DNS activities > follow up within 24 hours. o Note: if new client does not complete BHA-Initial - status will be listed as Referral or Incomplete POE. o To document follow up within 24 hours, ES will go to client ECR > show menu > under BH Progress Notes heading > select GCAL Outreach Note > add note and document details about the outcome of the follow up attempt. REMINDER: GCAL referral should be scanned/uploaded to ECR. What percentage of individuals are seen by a licensed or credentialed professional (Associate or Independently Licensed Clinician, Certified Addition Counselor if Additive disease need) within seven (7) business days of discharge? Should be at least 90% What percentage of individuals are seen by a licensed physician/psychiatrist within fourteen (14) business days of discharge? Should be at least 90% For NEW CLIENT - schedule Hospital Discharge- BHA (In clinic) - Initial for next business day 8am. KPI data requirement- use the Director s schedule. If client does not show- select DNS as status (DO NOT ERROR IF CLIENT DID NOT SHOW) and complete case management note to document that Engagement Specialist will follow up. Engagement Specialist to monitor DNS for Hospital Discharge activities > follow up within 24 hours and complete case management note from ECR to document attempt(s). If client comes in for scheduled appointment > go to Director s schedule > click on Schedule > make changes to start/end time as appropriate and select assigned clinician who will compete discharge activity AND schedule MD appointment (must occur within 14 days of hospital discharge date). If client does not show select DNS- DO NOT ERROR APPOINTMENT Engagement Specialist to monitor DNS and CBC status for Hospital Discharge activity and make follow up contact(s) For ACTIVE CLIENT- Hospital Discharge activity will vary. HDBHAINT- Hospital Discharge- BHA (In clinic)- Initialo Note: this activity has multiple documents- select Update BPS HDBHASPD- Hospital Discharge- Service Plan Development HDINDCOUN- Hospital Discharge- Individual Counseling If MD/APRN or RN service is scheduled o MD/APRN- E&M or Diagnostic with Medical Services o RN Nursing Assessment or Nursing Service REMINDER: Hospital Discharge documents should be scanned/uploaded to ECR. IMPORTANT KPI DATA REQUIREMENTS In order to generate accurate data for KPI reporting, specific documents and/or activities must be entered correctly and timely. GCAL Hospital Discharge POE call date, GCAL listed as referral source, Triage & Routing marked as Hospital Discharge form URGENT Hospital Discharge activity BHA Initial on credentialed staff schedule GCAL Outreach note for any DNS or CBC statused appointment Rev 12/2015

2 Instructions for tracking GCAL referrals Referral from GCAL - use BHL web list- Front Desk or Access SEARCH for client in CareLogic Go to POINT OF ENTRY to complete client search If no record of CareLogic ID exists- (below message will display) If CareLogic ID exists (below message will display) IMPORTANT!!! Carefully review records and blue/red warnings that appear from client SEARCH ***DO NOT CREATE DUPLICATE RECORD*** Add new client to create CareLogic ID Complete POE o Demographics Call date = enter date of GCAL referral (based on BHL web list) o Referral Source (scroll down on Demographics page) Enter GCAL as referral source (click or tab to populate name in drop list) o Triage & Routing Enter Primary Triage: Urgent= GCAL referral Schedule Intake (BHA-Initial) appointment for next business day 8am using Director s schedule. (In the description box note- GCAL referral). Scan GCAL referral documents to ECR If client does not show- select DNS as status and complete case management note to document that Engagement Specialist (ES) will follow up. ES to monitor DNS activities > follow up within 24 hours. o Note: if new client does not complete BHA-Initial - status will be listed as Referral or Incomplete POE. To document follow up within 24 hours, ES will go to client ECR > show menu > under BH Progress Notes heading > select GCAL Outreach Note > add note and document details about the outcome of the follow up attempt. See attached sample- page 2 V2- Revised 5V4- Rev 8/2015

3 From client ECR > show menu > select GCAL Outreach Note > click ---SAMPLE---

4 Hospital Discharge 3.1 and 3.2 eff 12/4/15 KEPT appointment Move existing Hospital Discharge appointment from Director s schedule (update start/end time and change to clinician s schedule). Status of appointment should be marked KEPT. Front desk or clinician must schedule MD/APRN within 14 days of hospital discharge date (verify date that is listed on hospital discharge form) unless client can be worked in for same day appointment with MD/APRN. DNS or Cancelled appointment From Director s schedule, mark status as DNS, CBC or CBT and complete case management note. Staff to make engagement effort and encourage open access/walk in appointment. New client who does not show or cancels Hospital Discharge appointment but later returns to center must be scheduled as BHA Initial/Intake. ***DO NOT LIST AS HOSPITAL DISCHARGE*** Active client who does not show or cancels Hospital Discharge appointment but later returns to center should be scheduled for outpatient service based on need (e.g. Service Plan Development, Individual Counseling, BHA In-clinic). ***DO NOT LIST AS HOSPITAL DISCHARGE*** IMPORTANT REMINDERS Verify any scheduled appointments with DNS, CBC or CBT status by checking Service History or Face Sheet. Open access/walk-in appointment that identifies as Hospital Discharge. Staff must verify date of discharge from Hospital. If discharge date is within 7 days, staff should schedule Hospital Discharge activity. New Client: if more than 7 days since hospital discharge, staff should schedule Initial BHA/Intake appointment for new client Active Client: if more than 7 days since hospital discharge, staff should schedule outpatient service based on need (e.g. Service Plan Development, Individual Counseling, BHA In-clinic). Use Service History report to monitor all KEPT Hospital Discharge appointments to ensure MD/APRN appointment is scheduled within 14 days of Hospital Discharge date. Prison or jail release papers are not considered Hospital Discharges. Documents should be saved to ECR but appointment should not be listed as Hospital Discharge.

5 Instructions for tracking Hospital & CSU Discharges Referral from Hospital or CSU (fax or call) Front Desk or Access SEARCH for client in CareLogic New Client Existing or Active Client Go to POINT OF ENTRY to complete client search If no record of CareLogic ID exists- (below message If client has CareLogic ID- see below for search results will display) If following warning appears - do not create a new CareLogic ID IMPORTANT!!! Carefully review records that appear from SEARCH ***DO NOT CREATE DUPLICATE RECORD*** Add new client to create CareLogic ID Complete POE (reminder: must add name of referral source using drop box list) Schedule Intake (Hospital Discharge- BHA (In clinic) - Initial) appointment for next business day 8am Scan hospital/referral documents to ECR Complete and sign Hospital Discharge Form See above illustration Open Intake= incomplete POE exists > click on Open Intake to complete POE > Schedule Intake (Hospital Discharge- BHA (In clinic) - Initial) appointment for next business day 8am Start VPH- Episode= client has CareLogic ID > click on Start VPH- Episode to initiate a new episode of care > complete POE > Schedule Intake (Hospital Discharge- BHA (In clinic) - Initial) appointment for next business day 8am Face Sheet= if this is the only button that displays, this client is ACTIVE and does not need POE completed > use client ID displayed and go to ECR > review Program History > add new ORG, if applicable. Make appropriate selection based on descriptors listed above o Complete POE if listed as Open Intake or Start VPH Episode. (reminder: must add name of referral source using drop box list) Schedule according to client status (shown above) Scan hospital/referral documents to ECR Complete and sign Hospital Discharge Form HOSPITAL DISCHARGE FORM From client ECR- Hospital Discharge Form is located on show menu under GENERAL and CLINICAL sections

6 SCHEDULE APPOINTMENT Activity Document NEW CLIENT HDBHAINT- Hospital Discharge- BHA (In clinic) - Initial Comprehensive Assessment EXISTING CLIENT (has HDBHAINT- Hospital Discharge- BHA (In clinic) - Initial Comprehensive Assessment CareLogic ID- status listed HDBHAINT- Hospital Discharge- BHA (In clinic)- Initial Update BPS as referral, incomplete (select this document for client with expired auth POE or discharged) in need of reassessment) ACTIVE CLIENT HDBHASPD- Hospital Discharge- Service Plan Development Service Plan Development HDINDCOUN- Hospital Discharge- Individual Counseling General Progress Note If MD/APRN or RN service is scheduled o MD/APRN- E&M or Diagnostic with Medical Services o RN Nursing Assessment or Nursing Service IMPORTANT REMINDERS For NEW CLIENT - schedule Hospital Discharge- BHA (In clinic) - Initial for next business day 8am KPI data requirement- use the Director s schedule. o If client does not show- select DNS as status and complete case management note to document that Engagement Specialist will follow up. Engagement Specialist to monitor DNS for Hospital Discharge activities > follow up within 24 hours and complete case management note from ECR to document attempt(s). o If client comes in for scheduled appointment > go to Director s schedule > click on Schedule > enter updates (see illustration below) If client does not show select DNS- DO NOT ERROR APPOINTMENT Engagement Specialist to monitor DNS and CBC status for Hospital Discharge activity and make follow up contact(s) Staff who receives call or fax- completes Hospital Discharge form and upload scanned document(s) to ECR.