Clinic Assistant Training: Level 1

Transcription

1 Clinic Assistant Training: Level 1 Role Overview and Expectations Work-up Walk-thru Scenarios and Mock Work-ups Safety Tips and Tricks Frequently Asked Questions VFC History and Facility Tour

2 Introductions VFC Volunteer Services Department (Accessible to all Vol. Services Staff) Cassie Roque Volunteer Services Manager Waverly Paradox Volunteer Services Coordinator Nadine Del Rosario General Volunteer Coordinator LMU Service Corps

3 Role Overview and Expectations VFC s Mission (and thus every CA s Mission): Provide quality health care to people in need Clinic Assistant Expectations Consistent Attendance Three Strikes Rule Consistent Communication Huddles Clinic Assistant Updates & Trainings Accountability MA Work-Up Reviews Quarterly Clinic Assistant Competency Checks

4 Role Overview and Expectations Level 1 Clinic Assistant Role Provide quality customer service to each patient Provide constant support to clinic staff Room Checks Patient Checks Running documents for Physicians and Specialists Shadow Medical Assistants and LEADs Learn clinic work flow Practice patient vitals & Intake Checklist Communicate with Clinic Staff MA Reviews

5 Role Overview and Expectations What to Do Before Your First Shift Submit your up-to-date immunization records Review your Clinic Assistant Handbook Get scheduled by the Vol Services Department Get assigned an experienced CA buddy What to Do During Your First Shift Introduce yourself to staff and other CAs Shadow your experienced CA buddy Get familiar with the flow of the clinic

6 What You ll Need for Your First Shift: Clinic Assistant Nametag Scrubs or Business Casual Attire Stethoscope Pen and Pocket Notebook Watch Copy of this Presentation

7 (see-i-care) Providing Quality Patient Care Clinic Assistants are role models of providing excellent customer service to our patients What does good customer service look like to you? Patient Expectations Eye Contact Body Language Active Listening Follow-through Well-Trained & Knowledgeable

8 (see-i-care) Guidelines for what is expected of every team member at UCLA Health: Video Connect with Compassion by addressing the patients as Mr./Ms. or by the name that they prefer. Introduce yourself with Integrity by stating your name and your role. Communicate with Teamwork what you are going to do, how long it is going to take, and how it will impact the patient. Ask with Discovery by anticipating the patient needs, questions, or concerns. Respond with Respect to patient questions or requests with immediacy. Exit with Excellence by ensuring all of the patient's needs are met.

9 PCMH: Patient Centered Medical Home Patient-Centered Medical Home (PCMH) Model of care that aims to transform the delivery of comprehensive primary care to children, adolescents, and adults.

10 PCMH: Patient Centered Medical Home Stay Committed! Venice Family Clinic is committed to the PCMH model of care in order to offer the highest standard of care to our patients Stay Informed! VFC Clinic Assistants need to be informed on all PCMH related policies and procedures PCMH GOALS for 2016 Self-Management for Targeted Patients Depression Screening Domestic Violence Screening Alcohol Screening Reproductive Life Plan Chlamydia Screening

11 PCMH: Patient Centered Medical Home Patient Intake Process Huddle with Medical Staff Review Azara Patient List w/ Medical Assistant Always stay in close communication with Nursing Staff Reference Patient Intake Checklist Complete relevant Patient Intake Screenings

12 PCMH: Patient Centered Medical Home Patient Intake Screenings PCMH Screenings enable VFC to provide the best comprehensive and coordinated preventative health care services. Remember to always practice CI-CARE when asking screening questions! Asking Difficult Questions Take time to CONNECT with patients Ask patient for consent to ask difficult questions Explain reasons for personal questions Listen, Listen, Listen Respond with COMPASSION and RESPECT

13 PCMH Intake Goals: Self-Management Targeted Patient Populations o Adult Diabetic Patients o Obese Pediatric Patients o Breastfeeding Mothers Give patients Self-Management Goals (SMG) packet to targeted patients For follow-ups, give SMG cover sheet only Introduce packet and encourage patient to think about Self-Management Goals

14 PCMH Intake Goals: Depression Screening Depression Screening (PHQ) o Applies to all patients ages 12+ o Patients screened annually o Coordinated Care Mental Health What is the purpose of Universal Depression Screening? The Universal Depression Screening is integral in our continuing efforts to better integrate our behavioral health program with primary care.

15 PCMH Intake Goals: DV Screening Domestic Violence (DV) Screening o Applies to all adult female patients o Patients screened annually o Coordinated Care Mental Health What is the purpose of Domestic Violence Screening? We have a Domestic Violence Advocate in the Mental Health Department who will help anyone who is ready to get help. The advocate will help with restraining orders, shelters, and counseling.

16 PCMH Intake Goals: Alcohol Screening Alcohol Screening o Applies to all patients 18 and over o Patients screened every 6 months What is the purpose of the Alcohol Screening? The Alcohol Screening is integral in our continuing efforts to better integrate our behavioral health program with primary care. Addiction and Substance Use Disorder is a behavioral health concern that has serious consequences on patients overall health and well-being.

17 PCMH Intake Goals: Reproductive Life Plan Reproductive Life Plan (RLP) o Applies to all patients of child-bearing age o Patients screened annually What is the purpose of the Reproductive Life Plan? Indicating the RLP in Next-Gen prompts the patient s medical provider to initiate either preconception counseling or birth control counseling. The RLP is essential to Venice Family Clinic s Family Planning Program, which allows us to qualify for related grants.

18 PCMH Intake Goals: Chlamydia Screening Chlamydia Screening o Applies to all female patients years old o Patients screened annually o Nursing Staff responsible for completing Chlamydia Screening Standing Order in Next-Gen

19 Homeless Patient Screening It is important to practice positive and conscientious interviewing skills for sensitive topics drug & alcohol use, gender-based violence, sexual behavior, sexuality, and housing situation Be honest and ethical Treat all patients with respect Seek advise and support from the Nursing Staff on how to ask difficult or sensitive questions Do not allow personal judgments or cultural values to influence the patient interaction

20 Clinic Assistant Skills: Skills Checklist Name Tags & CA Skills Checklist: Our Clinic Assistant name tags are color coded to identify each CA s skills and experience level. GREEN : Clinic Assistant Level 1 YELLOW: Clinic Assistant Level 2 RED: LEAD Clinic Assistant Clinic Assistant Level 1: Basic Skills Goal: Master Basic Skills tasks -- Height & Weight, Temperature, Pulse, and Blood Pressure Congratulations! You completed your Skills Checklist: What s Next? Alert the Volunteer Department by ing us at - VFCvolunteer@mednet.ucla.edu We will print a new yellow (level 2) name tag for you, which will include the Special Skills Checklist for you to complete

21 Clinic Assistant Skills: Hands-On Training Hands-On Training involves shadowing a LEAD Clinic Assistant for your first 3 volunteer shifts! Day 1: Quality Patient Care & Customer Service Day 2: Clinic Work Flow Day 3: Patient Intake Process De-brief with LEAD after each patient work-up Tips on how to best manage the patient interaction Discuss how to best assist the Nursing Staff

22 Clinic Assistant Skills: Hands-On Training Day 1: Quality Patient Care & Customer Service Greeting Patients How to introduce yourself General Customer Service Tips Prepare for the patient interaction Take an extra minute before you walk out to greet your patient to review chart & Azara List o Greet the patient by name o Show awareness of his/her reason for visit Setting a friendly tone for the patient visit Smile Make eye contact Putting patient at ease Small talk Offer reassurance

23 Clinic Assistant Skills: Hands-On Training Day 1: Quality Patient Care & Customer Service Patient Interactions Making patients feel welcome and comfortable Handling frustrated or irate patients Asking sensitive questions Bedside Manners Patient Checks Lost / Wandering Patients Patient FAQs

24 Clinic Assistant Skills: Hands-On Training Day 2: Clinic Work Flow Rooming Patients Review where everything is located How to room patients after work-up Room Checks Regularly checking for available rooms Communication with MAs Patient Checks (Cont.) Check on patients in the exam rooms Advise patients of provider s status Direct patients to Coordinator as needed Cleaning & Re-stocking Rooms

25 Clinic Assistant Skills: Hands-On Training Day 3: Patient Intake Process MA Review Process Pairing off with MA & Joining huddles Review Azara Patient List MA to review patient work-up Intake Checklist Review required screening questions & procedures Normal Ranges What to look out for and when to notify Staff Next-Gen How to enter patient information into Next-Gen Practice utilizing Next-Gen login

26 Vitals by Patient Type First Visit Height Women Visit Last menstrual period (LMP) Specific OGYN Info Homeless Visit Homeless Screening Vitals for All Visits Pulse Weight Blood pressure Chief complaint Allergies Smoking History (ages 13+) Prenatal Visit Popra (a prenatal progress form that goes on top of chart) Peds/Teens Visit (Staff Only) Height Head circumference (if less than two years old) Blood Pressure (if three years of age and annually) Special Needs Visit Diabetic: Blood sugar Asthmatic: Peak flow (measures person's ability to breathe out air) and Pulse Ox (measures O2 saturation)

27 Entering Vitals: Next-Gen Please plan to attend a Level 2 / Next-Gen Training for more information! Reminders: DO NOT share your account information with anyone DO NOT forget or lose your account information DO NOT enter any information if you are unsure the staff is always happy to help! REFERENCE the Next-Gen training information and presentation that we have available online on the Volunteer Resources page *Level 1 Clinic Assistants should refrain from utilizing Next-Gen until you have attended a Next-Gen Training and have completed your Level 1 Clinic Assistant Skills checklist, or are otherwise instructed by a VFC Staff member!**

28 Work-up Walk-thru Step-by-Step Instructions for Each Work-up 1. Pick up a chart Review name, patient ID, DOB, and check for Staff Only indicators 2. Call patient from the waiting room & escort patient to work-up room Introduce yourself; C-I-CARE! Confirm patient s name and DOB Note: Each work-up room is set up the same 3. Take vitals and document on the back of the sticker sheets Obvious Vitals Less Obvious Vitals Height Allergies Weight Smoking History Pulse Last Menstrual Period Blood pressure Glucose (Diabetes) Chief complaint Peak Flow 4. Escort patient to exam room Add patient to list in doctor s charting area Note patient s name, exam room number, and any other special details 5. Input info into Next-Gen

29 Work-up Walk-thru Cleaning Rooms Assist staff to ensure that work-up and exam rooms are always fully prepped and cleaned! Preparing Rooms: 1. Check that examination rooms and work-up rooms are straightened and kept clean. 2. Make sure instruments are put away in their proper place. 3. Replace supplies, as needed. Cleaning Up: 1. Always assist with clean up at the end of your shift. 2. Clean all parts of exam and work-up rooms with Clorox and wipe thoroughly with paper towels (including door knobs, chairs, trash cans, tables, Blood Pressure cuffs, etc.).

30 Work-up Walk-thru Chief Complaint: Concise statement describing the symptom, problem, condition, diagnosis, or other factor that is the reason for a medical encounter. Determining Chief Complaint: 1. Ask patient the reason for their visit. 2. Be sure to identify only 1 3 chief complaints. 3. Ask patient how long they ve been experiencing symptoms (i.e. Start of day) 4. Determine intensity and consistency of the complaint.

31 Work-up Walk-thru Height & Weight Height: 1. Ask patient to take off shoes. 2. Ask patient to stand beneath machine. 3. Place measuring device on crown of patient s head. 4. Refer to measurement indicated by read here to obtain the height. Measure height only at patient s first visit. When measuring height, patient s shoes must be off. Weight: 1. Ask patient to step on the Stadiometer. 2. Record whether or not patient has shoes on. 3. Adjust weights until the scale is balanced. 4. Record patient s weight.

32 Work-up Walk-thru Temperature - By Mouth: Appropriate for everyone two years of age and older 1. Place thermometer in plastic sheath. 2. Place end of oral thermometer under tongue. 3. Tell patient to close mouth, but not to bite thermometer. 4. Leave in place until device signals, then remove thermometer. 5. Carefully dispose of plastic sheath. 6. Record patient s temperature. **If temperature > 102 F or <95 F notify a MA or Nurse immediately!**

33 Work-up Walk-thru Pulse If you are using a Blood Pressure, it will automatically take patient s pulse. Manual Pulse: 1. Place index and middle fingers on the inside of wrist, below the thumb. 2. Use a watch with a second hand and count pulse for 60 seconds. 3. Record pulse rate, the date, time, and which side was used to take the pulse. 4. Record anything specific you notice about the pulse, such as that it is weak, strong, or missing beats **If pulse is greater than 120 beats/min or less than 50 beats/min notify a MA or a Nurse immediately!**

34 How to Test Blood Pressure Choosing the Correct Cuff Size: 1. Cuff should cover 2/3 of the upper arm 2. There are four kinds of cuffs: 1. Children s cuffs 2. Regular adult cuffs 3. Large cuffs for obese patients 4. Thigh cuffs for extremely obese patients 3. Palpate brachial artery 4. Clothing should be out of the way of the cuff 5. Apply cuff snug and evenly, one inch above the elbow Stethoscope Placement and Inflation: 1. Place diaphragm of stethoscope on bare skin over brachial artery but NOT touching cuff or tubing 2. Apply slight pressure of diaphragm with one hand 3. With the other hand, inflate cuff rapidly, using a smooth, continuous rate, to around 160mmHg initially, or higher if necessary 4. Deflate slowly, 2-4 mmhg mercury per heart beat 5. Read the manometer at eye level

35 How to Test Blood Pressure Readings: Systolic Blood Pressure: The first audible beat (the number on top) Diastolic Blood Pressure: The last audible beat or the last beat before a change in volume (this is the bottom number) Normal Range (Adult) : Systolic , Diastolic Normal range (Child) : Systolic , Diastolic Reminders: Note which cuff size is used Always use EVEN numbers when recording blood pressure If you are unable to hear, try again after waiting about 1-2 minutes. Also you may try the other arm. If you are still unable to hear, ask a staff member to help.

36 When should you flag a patient for staff? Anyone with a Staff Only Indicator Noted under the Details section of each patient s Encounter Form Anyone exhibiting violent behavior or is very agitated Anyone exhibiting any of the following concerns (Staff may then ask you to ) Eye problems and/or complaints (Perform visual acuity exam Staff Only) Urinary complaints (Perform UA Staff Only) Complaints of cough (Give mask for client to wear) Fever (Check O2 saturation (pulse ox)) When you are unsure about anything! Any acutely ill adults

37 Acutely Ill Adults Definition: Conditions that require immediate care to relieve suffering & minimize mortality risk Indicators Include: 1. Complains of shortness of breath, wheezing or choking 2. Pulse Oximetry less than 92% on room air **Ask nearest staff member to notify RN on the floor while checking pulse-ox 3. Chest pain or pressure 4. Recent drug overdose, ingested poison or recent skin exposure with dangerous chemicals 5. Complains of severe headache starting in last 24 hours or new paralysis of any part of the body 6. Actively bleeding, vomiting blood or recently passing bright red blood in stool, check hemoglobin and report to provider 7. Has an abnormal blood pressure and or pulse: Systolic BP greater than 200mm Hg or less than 80 mm Hg Diastolic BP greater than 110mm Hg Pulse greater than 120/min or less than 50/min 8. Blood glucose: Less than 70; MUST TREAT with juice and notify provider and/or RN/LVN staff >350; MUST obtain UA (urine analysis) to check for ketones 9. Hemoglobin < 8 10.Temperature > 102 F

38 Specialties: Common Cold / Asthmatic Procedures: If patient has a common cold or is asthmatic, test peak flow and pulse oximetry Peak Flow: Measures patient s ability to push air out of the lungs. Peak Flow is an indicator of lung efficiency. How to test Peak Flow: 1. Locate peak flow machine and tube. 2. Use paper towel to insert tube into the machine. Peak Flow Machine 3. Ask the patient to take a deep breathe and blow into the tube. 4. Record three readings. 5. Use the best reading as an indicator. Tube

39 Specialties: Common Cold/ Asthmatic Clinical Procedures Pulse Oximetry: Measures O 2 saturation, which indicates the percentage of air in the lungs. How to test Pulse Oximetry: 1. Locate the machine. 2. Turn on machine 3. Ask patient to stay still and quiet. 4. Clamp machine on patients finger. 5. Record patient s O 2 Saturation reading.

40 Language Barriers How to work with a language barrier Review of basic Spanish phrases in each CA handbook Free Online Resources with audio! Basic Conversational Spanish Medical Spanish Terminology Medical Spanish Dialog per Symptom

41 Spanish Translators We have Spanish Translator volunteers that are available to assist you! Keep an eye out for any volunteers that have a blue Spanish tag on their name tag. If you are bi-lingual in Spanish, and you are interested in translating, please sign up for a Spanish Assessment in Volgistics to get your Spanish tag. Reminder: When working with Spanish Translators the conversation and relationship should be with the patient, rather than with the Translator. Be sure to face and maintain eye contact with the patient, and not the Translator.

42 Safety Tips and Tricks Judy De La Torre, Nursing Director Gloves Sharps and Sharps Containers Blue Charts Hepatitis B Vaccination Injuries Overall Safety & Security

43 Next Steps Volunteer Services will follow-up via within 1 week to confirm whether or not you are cleared to start! In order to be cleared, you will need to submit: HIPAA Certification Up-to-date TB test results: Negative results, within 1 year MMR Immunization Record or Positive MMR Blood Titer After all documents are submitted, we will ask for your current availability and match you with available shifts Clinic Assistant Shifts: Simms/Mann Health Center Monday to Friday 8:30 AM 12 PM (Morning) 1 PM 5 PM (Afternoon) 604 Rose Ave Clinic Monday to Friday 8 AM 12 PM (Morning) 12 PM 5 PM (Afternoon) 5 PM 8 PM (Evening) Irma Colen Health Center Monday to Friday 8 AM 12 PM (Morning) 1 PM 5 PM (Afternoon) Robert Levine Family Health Center Monday to Friday 9 AM 12 PM (Morning) 1 PM 5 PM (Afternoon)

44 How do I get added to the schedule? Within the next week, a member of the Volunteer Department Staff will send a follow-up to each new Clinic Assistant that has signed in for today s Clinic Assistant Training session. In this , we will request any remaining documents that we will need to get you scheduled. Once you are cleared to volunteer directly with patients, we will add you to the Clinic Assistant schedule at any of our four clinical sites, based on your availability and clinic needs. What if I need to miss a shift or two? If you know that you will need to miss a shift, please alert the Volunteer Department Staff by ing VFCvolunteer@mednet.ucla.edu. Notify us at least 48 hours in advance of your absence. May I buddy with a doctor instead of a CA or MA? No, you will need to buddy with an experienced Clinic Assistant or MA. We do not have opportunities available for our volunteers to shadow physicians.

45 When can I get proof of my hours? The Volunteer Department will provide an official Verification of Hours document to any volunteers that have completed our minimum time commitment requirement (at least 8 hours per month for a minimum duration of 6 months). When can I get a letter of recommendation? We are more than happy to commend our exceptional volunteers! However, in order to request a Letter of Recommendation from the Venice Family Clinic, you must complete over 100 volunteer hours at VFC. What do I do when there is nothing to do? Be proactive and get the most out of your volunteer experience! If it is slow, please ask the Nursing Staff if they need help with anything. There is always something to do, even if you are not working up a patient!

46 VFC History and Site Tour Founded in 1970 by Phillip Rossman, MD, and co-founder Mayer B. Davidson, MD Volunteers role in Venice Family Clinic Facility Tour

47 Congrats on Completing Your Clinic Assistant Training: Level 1 Thank you for coming!