APS02 Version 3.0 Appliance Services Operational Areas Included HCA Roles Responsible for Carrying out this Process All Other Areas Operational Areas Excluded GEN01 Logging into Lorenzo Associated Procedures
Contents... 1 Description.... 4 Opening the Clinic Pegboard View... 5 Walk-in patients from the Trauma and Orthopaedic Service... 7 Recording Walk-ins for Patients Collecting Appliances... 21 Appendix A: Scan Referral Letter... 29 Appendix B: Scanning Double Sided Documents... 30 Appendix C: PDS Interaction... 33 Page 2 of
Process Flow Walk-in patient attends appliance Service Referred by Trauma and orthopaedics Referred by other Tameside service Appliance collection only Open clinic Referral taken but patient cant be seen until triaged Open clinic Record referral Select existing appliance service referral Scan referral Book walk-in Book walk-in Complete electronic clinical documentation Appointment booked Depart patient Complete electronic clinical documentation Discharge patient Depart patient Discharge patient Page 3 of
Description. This process covers the walk-in activity that could occur in the appliance service. There are only two instances where a patient should walk in to appliance services without a specific appointment. Trauma patients where the appliance can be fitted by the surgical appliance team without intervention from the orthotics consultant. Patients collecting appliance after measurement All other scenarios will require a booking to the Orthotics consultant and will need to be booked by following APS01 Appliance Services Recording a triaged referral and booking into appliance service for new patients or as part of the follow-up activity. Walk in patients should not be booked into a Orthotic consultant s clinic session unless they are available and will see the patient. Walk in patients should be booked into specific clinic sessions for walk-in patients when they are dealt with by the Surgical appliance team. Page 4 of
Opening the Clinic Pegboard View Activity 1. Log into Lorenzo using your smart card. Additional Guidance See GEN01 Logging in to Lorenzo if you require further guidance. Once opened, Lorenzo defaults to the My work application tab. 2. Select Clinics from the My work menu on the left hand side. 3. In the Options pane type the clinic name or the session name e.g. or If you don t know the name of the clinic or the session, the wild card character % can be used, e.g. Bari% 4. Change the To date to today s date. You can remove the date entirely and use the shortcut TD and press Enter to enter todays date. 5. Click Find If you do not enter a To date, the system will return every session for the next two weeks. Page 5 of
Activity 6. Select the clinic session you would like to see. Additional Guidance Ensure the session is marked as Walk-in Multiple sessions can be opened by selected more than one session. Each session is an individual consultant s stream, e.g Bari Fracture Tues PM would be Dr Bari s fracture clinic on a Tuesday afternoon. 7. Click OK to open the clinic session 8. Click the pin icon in the corner of the Search Criteria pane. This will remove the pane and provide a larger view of the clinic information. 9. The clinic pegboard is displayed. This pegboard displays real-time information about a patient s status. Patients who not been arrived electronically will remain in a yellow colour. The colour legend and the bottom of the pegboard indicates the various stages a patient maybe in during their outpatient visit. Page 6 of
Walk-in patients from the Trauma and Orthopaedic Service This section is specifically for patients being referred to the appliance service by the Trauma team. Currently there is an agreement allowing the surgical appliance team to fit appliances for patients referred via the Trauma service. If the patient has been referred from any other service in the Trust this process should not be followed. Appliance Service walk-in clinics are specifically made with one slot only. That slot can, however, be overbooked as required depending on the patient flow. Activity 1. Ensure the clinic is showing today s session, by looking at the drop down calendar in the top right hand corner. Additional Guidance Walk-in slot with no booking Select the walk-in slot by clicking in the box to the left of the row. It does not matter if there is already a patient booked into the slot as the slot is over bookable Walk-in slot with a patient already booked 2. Select Walk-in from the Clinics menu on the left hand side Page 7 of
3. The patient search screen is displayed. 4. If the patient s NHS number or hospital number is available, enter either one in the Identifier field and proceed to step 5 Proceed to step 5 If the NHS Number or the hospital number is not available, enter the patient s demographic details, ensuring a minimum of 3 items are entered: Surname Gender Date of Birth Proceed to Step 5 Proceed to step 5 5. Click Find to initiate a patient search on the system. Page 8 of
If the following screen appears after clicking Find refer to Appendix C PDS Trace screen The PDS screen indicates either this patient is known in other NHS organisations but potentially has no record with us, or has some demographic details that have changed since they have last presented themselves at Tameside. 6. If the correct patient is found, click the box to the left of the search result and click Next If the correct patient is not found click the Search Criteria at the top of the window to return to the search criteria fields and return to step 4 Page 9 of
7. The Manage patient details screen is displayed This screen is used to make changes to the patient s demographics details. Clicking one of the links will open the relevant part of a patient s record and allow the user to change details. E.g. Manage address will allow the user to change the patient s home address. 8. Click Next to go to the Booking screen 9. Book Appointment screen is displayed Change the Arrival time to reflect the arrival of the patient Page 10 of
10. A referral to appliance services needs to be created for any patients referred to the service. Click Create referral/ episode 11. The Referral details screen is displayed. Details from the original referrer need to populate this screen focusing initially on Referral priority Referral type Referral source Referral media 12. From the drop down list select the Referral priority as determined by the referral. If the priority has not been listed select Routine 13. In the Referral type select Outpatient 14. In the Referral source field select: Consultant Other than in an Accident and Emergency 15. In the Referral media field select the format of the referral that has arrived at appliance service. Page 11 of
16. The Referred by section accurately captures where the referral has originated from. 17. As the Referral source is not the GP, click on the search icon at the end of the Organisation field to search for the referring organisation. Referred by organisations or individuals other than the patient s GP 18. If the referral is from a consultant within Tameside enter RMP in the Identifier field and click Find now Internal Referrals (From within Tameside Trust) Page 12 of
If the referral is from an external organisation, type the name of the organisation that has referred the patient into the Name box and click External Referrals (Outside of Tameside Trust) Tip: The wildcard character % can be used when searching for organisations e.g. Salford% will display all organisations with Salford at the beginning of their name. 19. Select the organisation from the results by clicking the box to the left of the correct organisation name. Click OK 20. If the care provider is listed on the referral, type the name in the Care provider field. Page 13 of
21. On return to the Referral Details window, the right hand side of the screen will now need to be completed. Referral Creation Date is the date the referrer has created the referral. This is normally on the referral letter. For walk-in patients the referral creation date and time would be the day they presented themselves at appliance services. Referral Received Date is the date Appliance Services received the referral letter for written referrals. 22. If this referral is not from a Tameside consultant or service you may now proceed to step 28. For all other referrals continue on to the next step. 23. Linked Referrals Linking the appliance services referral to the original referrer s referral (e.g. the original outpatient Trauma referral) allows the patient s 18 week pathway to continue correctly. This step enables appliance services to stop the patient s 18 week pathway once they have been treated in the appliance service. 24. Click the Linked Referral details icon Page 14 of
25. The patient s active referrals are displayed. If there are no records displayed, click Cancel and proceed to step 28 26. The list should display all the patient s open referrals to Tameside Trust Locate the department that has sent the referral to appliance services by reviewing the Referred to name and Referred to Speciality columns. The column will not indicate the particular consultant but will display the speciality and team. The Referred to name should be Orthopaedic Clinics Pooled Consultant The Referred to Speciality should be Trauma and Orthopaedic Page 15 of
27. Select the box to the left of the correct row and click Select to return to the Referral details window. 28. The Referral to details section will now need to be completed. 29. In the Referred to type field click the drop down arrow and select Team All referrals are now received as a team referral 30. If you have previously created a referral to the Appliance team in Lorenzo click into the Team box and select the Surgical Appliances Team. Proceed to step 33 If you have never created an appliance service referral in Lorenzo, click the search icon at the end of the Team field. User has previously searched for the Appliance team User has never searched for the Appliance Team Page 16 of
31. In the name field type Appliance% and click The wildcard character % can be used if you don t know the full name of the Team. 32. Ensure the box to the left of the appliance team is highlighted in white and click to return to the Referral details window. 33. Click Next Page 17 of
34. No information needs to be entered on the RTT monitoring screen, so click Next This will take you to the Upload document section where the patient s referral can be scanned. 35. In the Upload ID field enter an ID for the scanned document. The ID Format to be used is: Source Speciality Date Speciality e.g. GP Paediatrics 04/07/2013 Click on the Scan icon to scan document 36. The Scan window opens. Select the Scanner name from the drop down field at the top of the window. Page 18 of
37. Put the referral in place on the scanner and once it is ready to be scanned, click Acquire. The document will be fed through the reader and appear on screen. Click OK. For guidance on scanning double sided documentation, see Appendix B - Scanning a Double Sided Document. The document has been scanned Click Finish 39. The Manage referral screen is displayed. Click Finish Page 19 of
40. The Book Appointment screen is displayed, this time with the newly created surgical appliance referral added. 41. Click Finish 42. Patient has now been walked into the clinic and should appear highlighted in blue. 43. The patient will still need to be departed and the treatment information also captured in an electronic note. Please refer to APS04 Recording Treatment Information in a Clinical Note and APS05 Depart a patient including Discharged, Follow up and DNA for further details on how to complete this patient s journey Page 20 of
Recording Walk-ins for Patients Collecting Appliances Due to the requirement of 18 weeks all patients who have been measured but not had a fitting, have not actually had treatment provided. The collection of the appliance can be classified as the first treatment making that visit the one eligible to stop the 18 week clock. The above scenario requires all collections to be captured correctly as a clinic visit within the system. Activity 1. Ensure the clinic view is showing slots for today. Additional Guidance Select the walk-in slot. It does not matter if there is already a patient booked into the slot as the slot is over bookable 2. Select Walk-in from the Clinics menu on the left hand side. Page 21 of
3. The Patient Search screen is displayed 4. If the patient s NHS number or Hospital number is available enter either in the Identifier field and proceed to step 5 Proceed to step 5 If the NHS Number or the hospital number is not available, enter the patient s demographics ensuring the minimum 3 items are entered: Surname Gender Date of birth Proceed to step 5 Proceed to step 5 5. Click Find to initiate a patient search on the system. Page 22 of
If the following screen appears after clicking Find refer to Appendix C PDS Trace screen The PDS Screen indicates that this patient is known across NHS organisations but potentially has no record with Tameside or they have some demographic details that have changed since they last presented themselves at the hospital. 6. If the correct patient is found click the box to the left of the search result and click Next If the correct patient is not found click the Search Criteria to return to the search criteria and return to step 4 Page 23 of
7. The Manage patient details screen is displayed This screen is used to make changes to the patient s demographics details. Clicking one of the links will open the relevant part of a patient s record and allow the user to change details. E.g. Manage address will allow the user to change the patient s home address. 8. Click Next to go to the Booking screen 9. Book Appointment screen is displayed Change the Appointment Type to Walk-in New Page 24 of
10. Change the Arrival time to reflect the arrival of the patient 11. Click the search icon at the end of the Referral Date field. As this patient has already been to Appliance services for measurement we should have a open referral for them. 12. Click Clear to remove any existing search criteria ensuring all referrals for the patient can be seen. Page 25 of
13. Click Find Now 14. Open referrals for the patient are displayed. Review the Referred to Name column and locate the referral to the Surgical appliance team. Page 26 of
15. Click the box to the left of the Surgical appliance Team. The selected referral should be highlighted in white. Click Select 16. The Book Appointment screen is displayed again but now the referral details will be populated with Surgical Appliances referral details. 17. Click Finish Page 27 of
18. The patient has now been walked into the clinic on Lorenzo and should appear highlighted in blue. 19. This patient still needs to be departed after their visit and the treatment information captured in an electronic note. For details on how to complete this patient s journey, please refer to APS04 Recording Treatment Information in a Clinical Note and APS05 Depart a patient including Discharged, Follow up and DNA Page 28 of
Appendix A: Scan Referral Letter 1. To scan: Activity Additional Guidance Enter the name of the Specialty in the Upload ID field Click on the Scan icon to scan document 2. The Scan window opens. Select the Scanner name from the drop down at the top of the window. 3. Once the document is in place on the scanner and ready to be scanned, click Acquire. The document will be fed through the reader and appear on screen. Click OK. For guidance on scanning double sided documentation, see Appendix B - Scanning a Double Sided Document 4. The document has been scanned Click Finish Return to the Manage Referral section of this SOP Page 29 of
Appendix B: Scanning Double Sided Documents Activity 1. To access the scanning screen, refer to Appendix A, Step 1. Additional Guidance 2. The Scan window opens Select a Scanner name from the drop down at the top of the window. To change the scanning settings to double sided scanning (duplex), select the Default user Interface icon at the top right of the window. 3. The scanner settings window appears. Click on Adjust the quality of the scanned picture. Page 30 of
4. Select the Feeder Setting tab. Ensure that the Enable Duplex box is selected. Once this has been done, place the document on the scanner ready for scanning. Click OK. 5. On return to the scanner settings window, click Scan. 6. The document will be fed through the reader and appear on screen. Click OK Page 31 of
7. The document has been scanned Click Finish Return to the Manage Referral section of this SOP Page 32 of
Appendix C: PDS Interaction The patient demographic spine (PDS) is an electronic database much like Lorenzo, and holds details of every patient who has an NHS number in England. It does not hold clinical details but does hold the most recent demographic details. If a patient has never been to Tameside the screen below may appear as although Tameside may not have any demographic information, another organisation may do. In this case the PDS can provide the user with the patient s NHS number and contact details. The purpose of the PDS is to ensure that if a patient changes their demographic details all NHS organisations will have access to that information. PDS may interact in two ways Patient not known to Tameside o Lorenzo will offer the patient s demographic details and NHS Number to the user to assist with the registration Patient is known to Tameside but there has been a change in their demographic details e.g. Home address. o Lorenzo will offer the patient s demographic details and highlight what has changed since they last presented themselves at Tameside. Activity 1. Click Ok to the message Additional Guidance This message indicates that information exists on the spine about a matching patient Page 33 of
2. A PDS Value and Lorenzo Value returned indicates that a discrepancy exists with the NHS number. Review key demographic fields and confirm any conflicts marked with the icon Conflicts are differences between patient details held on the PDS against the search values in Lorenzo Click on View full PDS Synchronisation report 3. Confirm the patient s address details by clicking on the expand node against the Usual Address 4. Cross check patient s address with the address on the referral The PDS Record column on the left is information provided by the referring organisation. The Lorenzo Record column indicates what Tameside knows about the patient. Click Ok Page 34 of
5. Click on Confirm Match only if you are sure this is the correct patient. For new patients ensure the Date of birth matches The GP details match The address matches. The surname matches If both records have a matching NHS Number and Date of Birth but the address or surname is different this maybe accurate as the patient may have moved locations or has had a name changed. Proceed to step 6 Alternatively if you are sure this is not the correct patient, click Cancel Patient returned is not correct Click Yes to the message box and try another search by returning to the section Recording a Patients Referral Details step 6 6. Click on Finish Page 35 of
7. Patient is registered locally on Lorenzo and a PAS ID (MRN) has been allocated Click Ok to the information message (this returns back to activity screen) Return to Recording a Patients Referral Details step 11 Page 36 of
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Document Control Version Number Date Document Status Author / Modifier / Reviewer Details Approved Signatory 0.1 12/07/2013 Draft Bilal Bham First draft 2.0 12/08/2013 Draft Monika Vorberg Updated with minor revisions 3.0 12/09/2013 Final Monika Vorberg Updated to Final