• Use VNA communication etiquette standards, answering all calls within 4-rings and with a smile; thanking the caller, giving them your name, using hold carefully, and keeping them updated if they are on hold.
• Leave clear and detailed voicemail messages, including your name and your call back phone number.
• Never use voicemail to avoid calls.
• When necessary ask the caller, "May I place you on a brief hold?" Eliminating call transfers whenever possible.
• Adhere to communication messaging standards.

• Dana Farber has instituted a Mindfulness Based Practice Program. They train nursing staff in Mindfulness practices in a one day session and provide Mindfulness practices online at each shift change for those who have found this to be helpful. The focus is on self-care, providing an opportunity for staff to then more fully connect with patients and families.
• Dr. Daniel Willis, Chairman of the Nursing Department at Boston College, is leading meditation practice at The Women's Lunch Place in downtown Boston, a respite center for homeless women. He and one of his participants shared their experience of community, connection and freedom from self-limiting ideas as a result of their practice together. Dr. Willis is a theorist and an educational leader who is also committed to personally making nursing care real for others in need.
• Dr. Donna White is currently a nursing instructor at UMass Boston and the Institute for Health Professions at MGH. She works in the area of Addictions at the Lemeul Shattuck Hospital. Donna is teaching nurses how to work among the homeless population; changing the way that clinicians think of those who are suffering from addiction and enabling them to provide compassionate care. She speaks throughout the state on Compassion Fatigue and the value of meditation practice.
• Dr. Jeanette Ives Erickson is the Chief Nurse and Senior Vice President for Patient Care Services at MGH. Using the model of Caring Science, she has created a process in which the nurse-patient relationship drives infrastructure in the nursing department and is measured in the outcomes. Her goal is to protect that relationship in the current healthcare environment. The mission statement of the MGH nursing department states that "care is guided by knowledge, enabled by skill and motivated by compassion". Dr. Erickson has created several Innovation Units at MGH, where new ideas for patient centered nursing practice are piloted and evaluated. They have created the position of Attending Nurse on each floor. Just as the patient has an Attending Physician who manages their overall care, they also have an Attending Nurse who does their initial assessment and plan of care, oversees the nursing care providers and is available for questions and concerns. MGH also has Resiliency Rounds for nursing staff. These are conducted by the hospital chaplains and are designed to support care giving staff in their daily practice.

• Joint Visits
• Episode Management Meetings
• 1:1 Caseload Management Meetings

1. Medicare
2. Medicaid
3. Tufts

REMOVED FROM REQUIRED ELEMENTS FOR PLAN OF CARE: Medicare beneficiaries with Type II DM must include monitoring and reporting of intermittent HGAIC no less than every 120 days

REMOVED: Palmetto will maintain the quarterly HBAIC frequency for home health.

ADDED: physicians and home health agencies should consider the inclusion of HGAIC testing in the home care plan of care...this means that if your patient has type II DM, collaborate with MD to ask if HGAIC has been done and obtain results, if not ask if MD would like an order and please document in summary of clinical 485 and or MD order. 

(QA will not need to track this and SERS will not be generated for missing HGAIC)

Update on TUG: the MAHC 10 is our standardized tool of choice for assessing patient for fall risk. The TUG is an additional assessment tool that you can utilize, it is not mandatory for electronic documentation in Encore or McKesson

Rehab clinicians: If you choose not to administer the TUG, you may consider using another tool such as: Gait Speed, Berg, Tinetti, 30 Second Chair Stand Test, 2 Minute Step, to write or add to the individualized plan of care with goals.

• Go to Events in Clinician Explorer.  Events is the tab to the right of Notes
• Click Add
• Next to Event click search and select HZ HERPES ZOSTER SHINGLES VACCINE
• Under begin date enter the date of the vaccine. 

• If the person does not remember the exact date but remembers the month, enter the first date of the month such as 10/1/2015. If they remember the year but not the month or date, enter the first date of the year, 1/1/2015. If they remember that they received the vaccine, enter in Notes at the bottom of the screen received but unable to remember the date. This can be amended when the date is known.
• Click OK.

• In Clinical Explorer go to Profile
• In the tree on the left click on "User Defined Data"
• Click add
• If you helped the patient problem solve getting the vaccine meaning suggest a clinic or pharmacy or the MDs office you need to add this item under User Defined Data
  • HZV.C Offered: for patients whom the vaccination was offered plus add a capital Y to Text
• In Addition add the reason they did not get the vaccine as a separate entry:
• Using the drop down arrow next to Item: select from the following list.
• HZV.H Dec Contraind: for declined due to additional medical illnesses or contraindicated
• HZV.I Dec Religious: for declined due to spiritual and/or religious beliefs
• HZV.J Dec Financial: for declined due to financial reasons
• HZV.K Dec Access: for declined due to lack of access to the shingles vaccine
• HZV.L Dec No Reason: for declined without providing a reason
• HZV.M Dec Add Reason: for declined due to additional reasons
• Place a Y in the Text box. If you miss this step the computer will not recognize the reason the patient did not receive the vaccine.
• Click OK

• Add the HZ Event with date per directions above
• Go to Profile/User Defined data and delete the reason they did not have the vaccine

• An HZ Event under Events or:
• A reason the patient did not have the vaccine in Profile under User Defined Data