Bounceback prevention: Difference between revisions
Neil.m.young (talk | contribs) (Text replacement - "==Source==" to "==References== <references/>") |
Neil.m.young (talk | contribs) (Text replacement - " pt " to " patient ") |
||
| Line 3: | Line 3: | ||
*High risk complaint without definitive diagnosis on discharge (eg [[Abdominal Pain]], [[Chest Pain (DDx)|Chest Pain]], [[Headache]], [[Fever]]) | *High risk complaint without definitive diagnosis on discharge (eg [[Abdominal Pain]], [[Chest Pain (DDx)|Chest Pain]], [[Headache]], [[Fever]]) | ||
*Abnl VS | *Abnl VS | ||
*Condition making it less likely | *Condition making it less likely patient will return for worsening symptoms (mental/psych/substance abuse) | ||
*Chronic dz with decompensation | *Chronic dz with decompensation | ||
*Difficulty obtaining accurate data (language, dementia, inebriation, etc) | *Difficulty obtaining accurate data (language, dementia, inebriation, etc) | ||
*Advanced age | *Advanced age | ||
*Upset pt | *Upset pt | ||
*Unmet | *Unmet patient expectations | ||
*Bouncebacks (a | *Bouncebacks (a patient return, us within 72h) | ||
OVERALL: a | OVERALL: a patient you will worry about after your shift | ||
==Step 2== | ==Step 2== | ||
| Line 21: | Line 21: | ||
*Write a progress note explaining medical decision-making process (if unclear in H&P) | *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 | *Assure that aftercare instructions are specific and f/u is timely and available | ||
*Confirm that | *Confirm that patient understands and is comfortable with the plan | ||
OVERALL: Complete a medically and legally defensible eval which is reflected in the documentation on the chart | OVERALL: Complete a medically and legally defensible eval which is reflected in the documentation on the chart | ||
Revision as of 12:27, 2 July 2016
Step 1
Identify High Risk patients:
- High risk complaint without definitive diagnosis on discharge (eg Abdominal Pain, Chest Pain, Headache, Fever)
- Abnl VS
- Condition making it less likely patient 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 patient expectations
- Bouncebacks (a patient return, us within 72h)
OVERALL: a patient you will worry about after your shift
Step 2
Review your evaluation prior to discharge:
- 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 patient understands and is comfortable with the plan
OVERALL: Complete a medically and legally defensible eval which is reflected in the documentation on the chart
References
"Bouncebacks" (Weinstock, Longstreth)