Bounceback prevention: Difference between revisions

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STEP 1
==Step 1==
 
Identify High Risk patients:
Identify High Risk patients:
#High risk complaint without definitive diagnosis on d/c (eg A/P, C/P, H/A, F)
#Abnl VS
#Condition making it less likely pt will return for worsening symptoms (mental/psych/substance abuse)
#Chronic dz with decompensation
#Difficulty obtaining accurate data (language, dementia, inebriation, etc)
#Advanced age
#Upset pt
#Unmet pt expectations
#Bouncebacks (a pt return, us within 72h)


-High risk complaint without definitive diagnosis on d/c (eg A/P, C/P, H/A, F)
OVERALL: a pt you will worry about after your shift
 
-Abnl VS
 
-Condition making it less likely pt will return for worsening symptoms (mental/psych/substance abuse)
 
-Chronic dz with decompensation
 
-Difficulty obtaining accurate data (language, dementia, inebriation, etc)
 
-Advanced age
 
-Upset pt
 
-Unmet pt expectations
 
-Bouncebacks (a pt return, us within 72h)
 
-OVERALL: a pt you will worry about after your shift
 
 
STEP 2


==Step 2==
Review your evaluation prior to d/c:
Review your evaluation prior to d/c:
#Address ALL documented complaints in H&P
#Confirm hx is accurate
#Consider potentially serious dx
#Explore abnl findings
#Write a progress note explaining medical decision-making process (if unclear in H&P)
#Assure that aftercare instructions are specific and f/u is timely and available
#Confirm that pt understands and is comfortable with the plan


-Address ALL documented complaints in H&P
OVERALL: Complete a medically and legally defensible eval which is reflected in the documentation on the chart
 
-Confirm hx is accurate
 
-Consider potentially serious dx
 
-Explore abnl findings
 
-Write a progress note explaining medical decision-making process (if unclear in H&P)
 
-Assure that aftercare instructions are specific and f/u is timely and available
 
-Confirm that pt understands and is comfortable with the plan
 
-OVERALL: Complete a medically and legally defensible eval which is reflected in the documentation on the chart
 
 
Source


==Source==
"Bouncebacks" (Weinstock, Longstreth)
"Bouncebacks" (Weinstock, Longstreth)


[[Category:Policy]]
[[Category:Policy]]

Revision as of 05:07, 9 June 2011

Step 1

Identify High Risk patients:

  1. High risk complaint without definitive diagnosis on d/c (eg A/P, C/P, H/A, F)
  2. Abnl VS
  3. Condition making it less likely pt will return for worsening symptoms (mental/psych/substance abuse)
  4. Chronic dz with decompensation
  5. Difficulty obtaining accurate data (language, dementia, inebriation, etc)
  6. Advanced age
  7. Upset pt
  8. Unmet pt expectations
  9. Bouncebacks (a pt return, us within 72h)

OVERALL: a pt you will worry about after your shift

Step 2

Review your evaluation prior to d/c:

  1. Address ALL documented complaints in H&P
  2. Confirm hx is accurate
  3. Consider potentially serious dx
  4. Explore abnl findings
  5. Write a progress note explaining medical decision-making process (if unclear in H&P)
  6. Assure that aftercare instructions are specific and f/u is timely and available
  7. Confirm that pt understands and is comfortable with the plan

OVERALL: Complete a medically and legally defensible eval which is reflected in the documentation on the chart

Source

"Bouncebacks" (Weinstock, Longstreth)

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