Inpatient or Day Case Waiting List (Non partial booking process) ADM02 Version 3.2 Medical Secretaries Operational Areas Included Roles Responsible for Carrying out this Process Gynaecology Medical Secretaries All other areas Operational Areas Excluded GEN01 Logging into Lorenzo GEN02 Searching for a Patient Associated Procedures ADM03 Scheduling an Inpatient or Day Case for surgery (Partial booking process)
Contents... 1 Description... 4 Adding a Patient to Inpatient or Day Case Waiting List... 5 Appendix 1: Deleting a Procedure or Diagnosis Added in Error... 33 Appendix 2: Viewing Access Plan Entry Details... 35 Appendix 3: Access Plan Glossary... 43 Page 2 of
Process Flow Decision is made that patient needs planned surgery Letter dictated to secretary Patient added to waiting list Pre assessment appointment booked if needed Page 3 of
Inpatient or Day Case Waiting List (Non partial booking process) Description Following the consultant s decision that a patient requires a planned procedure, a letter will be dictated to the medical secretary. After receiving dictation the medical secretary must add the patient to a waiting list within 5 working days and then send a TCI letter to the patient confirming the date and details of their planned surgery date. If the patient has not already been triaged by pre-operative assessment, the medical secretary must add patient to the waiting list and book a pre-op appointment for the patient. Page 4 of
Adding a Patient to Inpatient or Day Case Waiting List 1. Log into Lorenzo using your smart card. See GEN01 Logging in to Lorenzo if you require further guidance. Once opened, Lorenzo defaults to the My work application tab. 2. Select Access planning from the My work menu on the left hand side. 3. The Access Planning screen is displayed Page 5 of
4. Select Create access plan 5. The road map is displayed at the top of the Patient search screen 6. Patient search screen is displayed, the Search criteria defaults to Advanced search faux tab 7. In the Search criteria search for the patient using the Trust search protocol. Search 1 Enter NHS Number in the Identifier field, continue to step 8 Search 2 Enter Hospital Number in the Identifier field continue to step 8 Page 6 of
Search 3 Against the correct fields enter Surname, Gender and Date of birth from (dd/mm/yyyy) continue to step 8 Search 4 Search using Surname, Forename, Gender, Date of Birth From field and ensure the best match option is selected by clicking on the drop down arrow against External soundex search field continue to step 8 For further guidance on how to search for a patient refer to GEN02 Searching for a Patient 8. Click on Find 9. If the Patient is Found If a patient is found then the patient will appear in the Search results pane. Verify and confirm patient s demographic details using the scroll bar and if details are correct proceed to step 13 If the correct patient is not identified, click on the Search criteria Click Clear and go to step 7 Page 7 of
If multiple patients are found a message will appear stating match the search criteria. It is advisable to refine your criteria. Please note if the user chooses to view the search results, this action will be audited Click No to view the matches, proceed to step 12 10. If the patient is not found Depending on method of searching one these screens will appear 1. Click Ok go to step 11 2. Click on the Search criteria tab go to step 11 11. Click Clear Return to step 7 to perform a new search and enter the next Search criteria NOTE: If all 4 searches are complete, the patient must be registered, refer to GEN33 Registering a Patient. Page 8 of
12. Multiple matches Verify and confirm patient s demographic details by using the scroll bar If the correct patient is identified click the select box against the patient, a symbol will appear, continue to step 13 If the correct patient is not identified, click on the Search criteria Click Clear and go to step 7 13. Click on Next 14. The Referrals screen is displayed Click on the Search For Select (SFS) button against the Referral type field Note: any existing referral that the patient has will prepopulate this Referral section if it is the only open one against their record. Unless you are absolutely certain that this is the correct referral to use, follow the steps below instead. Page 9 of
15. Search results are returned with all referrals registered against the patient record NOTE: Patient may have more than one referral To confirm referral details use the scroll bar. 16. Identify the correct referral by checking details in following columns Received Date Referred By Referred to Speciality 17. Once the correct referral is identified select it by placing a tick in the tick box Once selected an arrow icon is displayed Click Select Page 10 of
18. On return to the Referrals window, the referral details will populate the empty fields. Click Next 19. The Type/Source Selection screen is displayed 20. From the Access Plan Type drop down menu, select Elective Admission Page 11 of
21. The Health Organisation field defaults to Tameside Hospital NHS Foundation Trust 22. Click on the search button at the end of the Profile Code field. 23. The Access Plan Profile search window appears, allowing you to search for the correct plan to put the patient on. Enter the name of the profile you are searching for in the Profile Name field e.g. General Surgery Planned List Tip: If you are unsure of the profile name the wildcard character % can be placed before and after the name e.g %Surgery% Click Find Now. Page 12 of
24. Select the relevant Profile Code by clicking in the box to the left of the correct row. For planned patients, only planned type lists should be chosen, not elective. The two different types will offer different options later on, so this is why elective ones should not be chosen. A symbol will appear. Click Select 25. The Profile Code will display Click Next 26. The Access Plan Details screen will display Page 13 of
27. The Access plan entry needs to be recorded under the requesting Consultant, rather the speciality team. 28. Select the Care Provider radio button 29. Click on the search icon at the end of the Care Provider field. Page 14 of
30. Enter the consultant s name in the Surname field, followed by the wildcard symbol % e.g. Mahmood% Click Find Now 31. Search results will display on the right hand side. Further details to help you confirm the correct consultant can be viewed using the scroll bar. Select the consultant by clicking in the box to the left of the correct row. Click Ok 32. On return to the Access Plan Details window, the Care Provider details are pulled through Page 15 of
33. Select the relevant Priority NOTE: For Trauma and Orthopaedics, the priority will always be Routine, for rest of specialities enter according to the clinician s dictated preferences. 34. Select NHS Patient from the Administrative Category field. Note that the status of any private patients should be indicated by placing them on a private patients access plan. 35. The Elective Admission Type field will always default to Elective Planned if a planned access plan has been previously selected. 36. From the Intended Management field select: Day Case (No overnight Stay) for patients who will not be staying overnight in hospital. Ordinary Admission (at least one night) for patients who will need to stay in hospital at least overnight. Page 16 of
37. Further information can be recorded in the Comments box e.g. Anaesthetic type, procedure details NOTE: Any information added in the Comments box will be visible when booking the patient in for surgery. 38. The Access Plan Start Date is populated automatically with today s date. 39. In the Do not offer activity before Date field you must enter a date which is the earliest date the patient should be seen. For example, if the patient needs to have a hip replacement in 1 year, they should not be scheduled before that date. 40. Click on Next Use the drop down calendar to select a future date. Selecting today s date and opening the More arrow will also allow you to select a date exactly 5 years, 6 months etc after the current date. 41. The question box may display asking: An access plan entry with similar intended RTT status exists. Do you wish to continue? Select Yes Page 17 of
42. The General Resource Requirements screen is displayed 43. If an interpreter is needed, tick the Interpreter Required box Select the relevant language from the Preferred language drop down list. NOTE: This does not book the interpreter, it just indicates on the waiting list that one will be needed. NOTE: If a need for an interpreter has been previously recorded against the patient s record the Interpreter field will be automatically ticked. Select the Transportation Requirements tab. Information about any transport needs that the patient has should be included here so that they can be arranged for both the pre op appointment and the surgery. Page 18 of
45. Click the Inpatient Scheduling tab 46. If you know that the patient is available at short notice, place a tick in the tick box 47. You can enter now the short notice period. 48. Leave the radio button as No against the Patient confirmation required? field. This is crucial as once an offer has been made for the patient, it will place the date in a confirmed status. Yes should only be selected if you are following the partial booking process the TCI date will then be put on hold (reserved), until the patient makes contact to confirm or reject. Page 19 of
49. If you want to request a preop appointment before surgery, check the tick box next to Pre admission appointment required. 50. Click on the search button at the end of the Preferred clinic(s) field. 51. The Clinics search window opens allowing you to select a type of clinic that the patient will need to be booked into. Page 20 of
52. In the Name field, enter Preop followed by the wildcard symbol %. Click Find NOTE: To display a list of all Trust clinics, enter %% and click Find. 53. Select the clinic by clicking in the box to the left of the row. Click 54. On return to the Inpatient Scheduling tab, the Associated to option defaults to care provider. Change this to Team. 55. Click the search button at the end of the Team field. Page 21 of
56. The Team search window opens 57. In the Name field, enter the name of team you want to assign the patient to for their pre op appointment i.e. Preop Team. Enter the name Pre-Op followed by the wildcard character %. Click Find NOTE: To display all the available teams enter %% in the name field and click Find 58. Select the Pre-op team by clicking in the box to the left of the correct row. Click OK. 59. On return to the Inpatient Scheduling tab, click Next Page 22 of
60. The Resource Monitoring screen is displayed If you want to book a date for the patient straightaway, place a tick in the tick box against Have all Resources been identified? This will allow the Manage Offer window to open on completion so that you can search for a suitable TCI date. If the patient is to be placed on a waiting list and not immediately scheduled, leave this box unchecked. 61. Click Next 62. The Coding and grouping window is displayed 63. For all planned surgery select either Procedure or Investigations from the Category field. Page 23 of
64. Click on the next to Code Click on the Description radio button NOTE: You can look for the procedure in several different ways. Choose Description if you want to type the procedure name manually. If you know the code of the procedure select Code Under Recent 25 you will find the last 25 procedures that you searched for. 65. Type the procedure name and click NOTE: If you are not sure what the full description of the procedure is and you want to bring back all the results for a certain area, use the wild card character %, e.g. hip% 66. The Search results will display. Select the desired procedure. Page 24 of
67. The planned procedure is now recorded. If you want to add another procedure repeat step 65. If you want to delete a procedure added in error refer to Appendix 1: Deleting a Procedure or Diagnosis Added in Error 68. Click on Finish 69. If you indicated that all resources have been identified (as in step 60), the question Do you wish to create an offer? Will display. Select Yes If you have not indicated that all resources have been identified, the question will not appear. The patient will instead be added to a waiting list and scheduled at a later date. To schedule a patient for a planned procedure refer to ADM03 Scheduling patient for surgery (partial booking process) Appendix 1 70. The Search to come in Offer window opens. Page 25 of
71. Ward name Select the intended ward for the patient to come in by. To enter a ward other than one of those listed go to the next step, otherwise go to step 77. 72. Click on the search icon at the end of the Ward name field. 73. The Service point window will display allowing you to select an additional ward. Page 26 of
74. Enter the ward name followed by the wildcard symbol in the Name field, e.g. Ward% Click Find 75. Select the ward by clicking in the box to the left of the correct row. Click OK 76. On return to the Offer screen, the new ward has now been added to the list. Unselect the other wards. 77. If the patient is available at short notice, this will be visible against the Available at short notice field along with the relevant notice period. Page 27 of
78. Start search from select the first reasonable offer date NOTE: A reasonable offer is defined as a date given with at least 3 weeks notice, unless the patient has requested a short notice date. 79. End search select the end search date. 80. Change the Search for drop down to Dates and Days preferred. This will allow offers only matching the patient s preferences to be shown. If it brings no results back, change this back to All. 81. Against the Expected time of admission enter the TCI time. This should be the time you would like the patient to arrive on the ward prior to surgery. Page 28 of
82. Expected length of stay defaults to 1 day. Change it if appropriate e.g. the patient is to be admitted as an inpatient and will stay in hospital at least one night. It can be changed at any point after admission, so it does not matter if this is an approximate length of time. 83. Click on Check Availability 84. Search results matching the criteria entered are displayed. NOTE: If a large number of dates are available they will be shown over multiple pages. To move to the next page click the icon Page 29 of
85. Select a suitable TCI date by clicking in the box to the left of the correct row. Temporary beds should not be chosen. Note: Booking a bed will ensure better bed planning, although it does not hold the patient to that particular ward or bed if the details change on admission. Patients can be overbooked onto the ward (although not over admitted). Click Next. 86. The Create to come in Offer window opens. If no patient confirmation is required, the Offer type will be defaulted to Written. This will confirm the booking as soon as Finish is pressed. 87. Check the offer details using the scroll bar. Ensure the Booked date/time is correct. NOTE: Any comments that have been added while creating the Access Plan will be visible now in the comments box. You can verify them at this stage. Click Update 88. The Offer status will now be shown in an Accepted status and the patient will be ready to be selected by the ward clerk on admission. Page 30 of
89. Click Finish 90. The Select document templates window appears displaying all available TCI letters for the patient. Select the offer letter by placing a tick in the box to the left of the correct row and clicking OK. 91. The Select Printer window appears. Change the Print Options radio button to Local and select the Local Print button. 92. Select local printer from the Name field Click OK. Page 31 of
93. The confirmed TCI date is now booked and invitation letter can be sent to the patient. Page 32 of
Appendix 1: Deleting a Procedure or Diagnosis Added in Error 1. Use the scroll bar to identify the procedure that has been added in error. 2. Select the incorrect procedure by clicking in the box to the left of the row. 3. Scroll across and click in the Update Reason column field. 4. In the Update reason column type why are you removing the procedure/diagnosis e.g. clinician decided to perform a different procedure. Page 33 of
5. Select Remove 6. The procedure has now been removed. Page 34 of
Appendix 2: Viewing Access Plan Entry Details 1. Log into Lorenzo using your smart card. See GEN01 Logging in to Lorenzo if you require further guidance on how to do so. Once opened, Lorenzo defaults to the My work application tab. 2. Select Access Planning from the My Work menu on the left hand side. 3. Once the Access Planning search screen appears, select Elective Admission from the Access plan type field. 4. Click on the search button at the end of the Patient ID field. Page 35 of
5. The patient search screen is displayed. The Search criteria defaults to the Advanced search tab. 6. In the Search criteria search for the patient using the Trust search protocol Search 1 Enter NHS Number in the Identifier field, continue to step 7 Search 2 Enter Hospital Number in the Identifier field continue to step 7 Search 3 Against the correct fields enter Surname, Gender and Date of birth from (dd/mm/yyyy) continue to step 7 Search 4 Search using Surname, Page 36 of
Forename, Gender, Date of Birth From field and ensure the best match option is selected by clicking on the drop down arrow against External soundex search field continue to step 7 For further guidance on how to search for a patient refer to GEN02 Searching for a Patient 7. Click on Find 8. If Patient Found If a patient is found then the patient will appear in the Search results pane. Verify and confirm patient s demographic details using the scroll bar and if details are correct proceed to step 12 If the correct patient is not identified, click on the Search criteria Click Clear and go to step 6 If multiple patients are found a message will appear stating match the search criteria. It is advisable to refine your criteria. Please note if the user chooses to view the search results, this action will be audited Click No to view the matches, proceed to step 11 9. If the patient is not found Page 37 of
Depending on method of searching one of these screens will appear 1. Click Ok go to next step 10 2. Click on the Search criteria tab go to next step 10 10. Click Clear Return to step 6 to perform a new search and enter the next Search criteria NOTE: If all 4 searches are complete, the patient must be registered, refer to GEN33 Registering a Patient. 11. Multiple matches Verify and confirm patient s demographic details by using the scroll bar If the correct patient is identified click the select box against the patient, a symbol will appear, continue to step 12 If the correct patient is not identified, click on the Search criteria Click Clear and go to step 6. 12. Click OK Page 38 of
13. On return to the Access Planning search screen, the patient s details have now populated the Patient ID field. 14. Click on the search button at the end of the Care Provider field. 15. Search for the Care Provider by entering the consultant s last name in the Surname field. Click on Find now. Page 39 of
16. Results matching the search criteria are returned. If more than one result is returned, use the scroll bar to confirm the right consultant and select the correct one by placing a tick in the box. Click Ok 17. On return to the Access Planning search screen, the Care Provider details have now populated this field. 18. Against Access plan entry status select Resources Confirmed 19. Click on Find Page 40 of
20. The confirmed access plan entry is returned for the patient. NOTE: The patient may have more than one access plan entry Scroll across to check the access plan entry details. To select the correct Access Plan Entry please check the details in following columns: TCI/Appointment Date and Intended procedure 21. Select the Access Plan Entry you wish to view further details for by clicking in the box to the left of the correct row. Click on the slider bar at the bottom to expand the details pane. 22. Access Plan Entry Details are now displayed, defaulting to the APE Details tab You will be able to see general information about the access plan entry. Page 41 of
23. Click on the Offer Details tab to see the TCI offer details. NOTE: Under Offer details you will find all the surgery/admission dates that have been offered to the patient. If the patient has declined or cancelled any dates or the hospital has cancelled any TCI dates they will be recorded here. 24. Click on Date and monitoring details tab to check any RTT related information including RTT breach date and patient wait time. 25. Click on Preferences Details tab to see any preferences that have been recorded. 26. Click on Availability tab to check if any preferred surgery days/time have been recorded for the patient. 27. Select Suspensions tab to check if any suspension has been recorded. 28. Select the Coding Details to see the procedure details. Page 42 of
Appendix 3: Access Plan Glossary Access Plan Abbreviations Abbreviation Full Name APE Access Plan Entry APP Access Plan Profile C&B Choose and Book EPR Electronic Patient Record EROD Earliest Reasonable Offer Date GAD Guaranteed Date RTT Referral to Treatment TCI To Come In Date Access Plan Statuses APE Status Admitted Attended Closed Created Resources Confirmed Resources Identified Resources Reserved Description Used with inpatients; the patient has been admitted but not yet discharged Used in outpatients; patient has attended the appointment but the appointment has not yet been departed Access plan entry closed. The outpatient appointment has been attended, DNA d or cancelled. The booked inpatient stay has been admitted and discharged. Access plan entry newly created. Booking not yet made. APE created, booking (OP appointment made or IP TCI date) made for the patient APE created, ready for booking, no booking made APE created, booking on hold, used partial booking scenarios Access Plan Entry Details Tabs Tab Description APE Details This tab displays the main details about the access plan entry such as the type, date patient was added to the access plan etc. Offer Details This will show any offers (if any) associated to the access plan (e.g. TCIs, Booked Appointments or Planned Contacts etc) Dates and Monitoring Key target dates for the Access Plan Entry such as the Guaranteed Date (e.g. date the patient should have their appointment, contact or admission by) Preference details This tab will display the patient s required preferred ward / clinic / care provider etc Availability This tab will display a patient s preferred day for their admission /appointment or contact. Suspensions This tab will display any suspension periods for the access plan entry (if any), for example, patient has been on holiday. Coding Details If the access plan entry has been coded this tab will display any codes associated to the Access Plan Entry. For example, if a Patient has OA of the Knee and is awaiting a knee replacement the Diagnosis and Procedure codes could be displayed here. History This will be displaying all the events performed on the access plan entry. This will include the type of transaction, date and time of transaction, user who performed the action and reason for performing the transaction Page 43 of
Document Control Version Number Date Document Status Author / Modifier / Reviewer Details Approved Signatory 0.1 22/02/2013 Draft Marta Janiszewska Initial draft 0.2 28/03/2013 Draft Phil Taylor Initial Review 0.3 12/03/2013 Draft Marta Janiszewska Updated after review 2.0 19/06/2013 Draft Monika Vorberg Updated following BPV 3.0 03/07/2013 Final Mike Maitre Updated to Final 3.1 30/07/2013 Final Mike Maitre Inclusion of APE Glossary 3.2 22/08/2013 Final Monika Vorberg Update to patient response field