Home Forums Discussions General Discussion How do I track nurses following up on messages?

Scenario: I have a patient who has an abnormal lab result that needs follow up. I send a message to a staff member stating I want this patient to come in for a follow up lab test.

Is there a way to track that the message has been received and followed up on without having to:

1) Set a reminder for myself to check
2) Look at the patients chart in AC and look for an addendum/message that patient has follow up appointment

As far as I know, I cannot look and see what messages are in that particular staff members inbox without using their user ID & password.

Any suggestions would be appreciated.

thanks

Marty,
If I want to know that the staffer contacted the patient and told them to have the test, lab, visit, etc., then I send the message to the patient and cc it to myself. I save the one that comes to me to the chart (which documents that it was ordered). The staffer is instructed to reply to me by hitting "task complete" when they have spoken to the patient.

On the other hand, if you want to document that the patient actually had the lab or test, and you have seen the result, I think that generating a reminder is the only way to do that.

I am interested to hear if others have better ways of doing this.

You can look in Outbox to see if the message you sent is still in their box. I send these out and have my staff send the message back when completed.

Jon,

How do you generate a "task complete" message?

When you read a message, above the message box on the right there is a task complete check box,when checked, it asks do you want to send message (to sender) that task is complete, and when you say yes, it sends the message back with task completed in the title.

Here is what we have been doing with messages where a lab test (or something else) needs to be done. A good example is UTI symptoms. A patient will call, and my staff send me the message, I send back a note to give a urine sample and I send a prescription to be started afterward. The staff call the patient and order the testing and send message back to me. I hold it in my box until the next day when I add a note about the U/A, then I continue to hold it until I receive the urine culture and note that. When all of this is done, I save the message to the chart. Each step is documented in the message with the writer and the time of the action, but the message is not saved until everything is complete.

I am now changing the message color to blue when it is in a holding pattern, and add a date to the beginning of the title when a test is to be done, so I know when the message is to be acted upon again.

John,
Also be aware that in "Miscellaneous Preferences" in the Admin section, you need to check the box that says "Show 'task complete' text box for messages" in order to see the box in the first place. Maybe you don't have the preference checked, which is why you have never seen the box.

Donna,
Though we considered that system, I didn't want to clutter my inbox with those messages like that. We have recently started to try to utilize colored messages and as you say, that might be a way to make that work more smoothly.

I didn't know about the TASK COMPLETED box. That's going to be useful. Jon's method works for what I want to do. It documents to the chart if you want as well.

Thanks Jon!

Good point, Jon.
I forgot that you have to activate the task completed option.

Thanks Jon, I have used AC for 5 years but I never have used the Task completed!

Thanks for the Task Completed tip. I added it and we are going to start using it.

Awesome, I am going to play with the 'task completed' button this weekend. Does it allow you to document this?

I have tried many work arounds, (some are not 'meaningful enough' if you know what I mean) and currently I can best get the job done by writing and order:
"Stephanie, please call this patient and send her to the lab, then start her on this Rx for Cipro.."

After I write the order, I copy it (Ctrl C) send it, then make and addendum titled, 'Stephanie is taking care of this UTI'
then I paste, "Ctrl V" and sent to Stephanie, 1-6-12. mts.

I have come to realize, that as soon as my staff are really clear on what I want them to do, and what they will be held accountable for taking care of, our success rate approaches 100%.

So 'Task Completed' sends the message but doesn't leave any documentation in the record with respect to what was done or by whom? mts

Yes, it simply notifies the sender of the original message.
You can then save it to the chart if desired.

Martin, I was too tired last night to bring that up. First, Jon's discovery is brilliant. Never noticed it. But, I agree with you that it doesn't allow the recipient to document other stuff.

Example:


Bert: Please order a TSH on Thursday for this patient.
Brianna: Task completed.

So, it documents it was done, but what she would normally document it like this.

Brianna: Sent reqs for TSH to both labs. Mom informed.

Now, with our labs, you have to document it, because there is a 30% chance, the won't have it. It is also important to state that you talked to mom or left a message, etc.

Otherwise, the sender has to do all the documenting, e.g. Please send TSH to both labs and inform mom. Then the task completed does this.

Once she receives the message, she can't write in it without hitting reply, and then the Task Complete check box is gone.

Now she could hit task completed then hit reply, document more and save to chart. So, due to all this, I agree with Boondoc and nothing against Jon's discovery or what he uses

I also have found (probably am wrong) that if I send a message to Brianna, it doesn't automatically document who I sent it to unless I specifically put it in or copy the message. Sure, it is in the outbox, but that is lame documentation. If she saves it to the chart, her name is there, but if she were to delete it, then there is no way of telling where it went since it would then be out of your inbox. Like our IM and like Yahoo, etc. all messages should be recorded in a text file in the AC folder or a separate folder with permissions only for the admin. This takes up very little space.

As many have said, the entire messaging system, while somewhat well thought out, leaves a lot of room for improvement. Less is more therefore I don't need Bert's message, I just need Bert. Please correct me if I am wrong, but can I get rid of the >> before replies? Also, unlike emails which can be changed in preferences, I think the descending messages as you see in Yahoo are easier to follow. Maybe even have a line for dates so that anything below that line is considered on that date so: (In next post)

Bert sends message to Brianna on 7/1112 @ 1005 am

7/11/12

Bert 1005
Please send TSH

Brianna 1056
Sent TSH to both labs for Thursday 7/14/12. Mom aware. Mom will call us to ask for a new req because, as you know, the rate that the labs lose these is 82%

Bert 1145
Please have appt with mom on following day

Brianna forwards message to Brittany @ 1232

Brianna 1232
Please set up apt per above

Brittany 1346
Appointment made for 0745 on 7/15/12. Mom aware

TASK COMPLETED (automatically saved to chart and copies sent to all others in message)

Originator of message can save write addendum to message and save or send to anyone and the process would start all over again.

In general, from my vantage point the messages just look sloppy.

Last thought, it would be nice to have a way to message either in the message or outside of the message with a feature called WP or work product. Just like the confidential tab, there are just some things that shouldn't be in the record. Currently, we have to do things like DELETE THIS>blah, blah, blah.
Because of this, we NEVER include messages when we send records. They are there for litigation or if someone absolutely needs them, but this has never happened.

The problem for me is I can't save it to the chart unless I pull up the patient and attach it to the message. So, for me, it is not that helpful.

I send tasks that need tracking as ORDERS. Orders are able to be tracked and when they are completed, they are saved in the record in the orders section, not the messages. You can see which orders are not completed.