PtEd Doc PCC Protocols

PCC Patient Education Protocols: 

PCC Patient Education Protocols Why won’t they just write it down?

Why do we educate patients?: 

Why do we educate patients?

Patients do what they perceive as important.: 

Patients do what they perceive as important.

What is the Task of patient education?: 

What is the Task of patient education?

The task of patient education is to bring the patient to an understanding of his or her disease process and its management as important.: 

The task of patient education is to bring the patient to an understanding of his or her disease process and its management as important.

The task of patient education is to bring the patient to an understanding of his or her disease process and its management as important.: 

The task of patient education is to bring the patient to an understanding of his or her disease process and its management as important.

Do providers understand this concept?: 

Do providers understand this concept?

Do providers educate patients?: 

Do providers educate patients?

WHY WON’T THEY JUST WRITE IT DOWN?!!: 

WHY WON’T THEY JUST WRITE IT DOWN?!!

I discussed with Ms. Jones that her obesity puts her at increased risk for diabetes, heart disease, gallstones, back and knee problems, and infertility. I discussed the relationship among obesity, caloric intake and exercise. I explained that she likely has a genetic predisposition to obesity and that she will have to work harder to lose weight. I explained that she could lose weight through a plan including regular exercise and dietary modification/restriction. I advised her to talk to a physician before she began any diet, especially fad diets. I emphasized the importance of good hygiene. We discussed some components of a healthy eating plan including regular meal times, eliminating or limiting snack foods and fatty foods, reducing sodium consumption and adding more fresh fruits and vegetables and fiber to the diet. We discussed that the most healthy fluid for the body is water and that colas and alcohol contain many hidden calories. We discussed that healthy eating plans begin at the grocery store and discussed techniques for shopping for a healthier body. : 

I discussed with Ms. Jones that her obesity puts her at increased risk for diabetes, heart disease, gallstones, back and knee problems, and infertility. I discussed the relationship among obesity, caloric intake and exercise. I explained that she likely has a genetic predisposition to obesity and that she will have to work harder to lose weight. I explained that she could lose weight through a plan including regular exercise and dietary modification/restriction. I advised her to talk to a physician before she began any diet, especially fad diets. I emphasized the importance of good hygiene. We discussed some components of a healthy eating plan including regular meal times, eliminating or limiting snack foods and fatty foods, reducing sodium consumption and adding more fresh fruits and vegetables and fiber to the diet. We discussed that the most healthy fluid for the body is water and that colas and alcohol contain many hidden calories. We discussed that healthy eating plans begin at the grocery store and discussed techniques for shopping for a healthier body.

WHY WON’T THEY JUST WRITE IT DOWN?!!: 

WHY WON’T THEY JUST WRITE IT DOWN?!!

TIME: 

TIME

So, what’s the answer?: 

So, what’s the answer?

PCC Patient Education Protocols: 

PCC Patient Education Protocols

What are Pt. Ed. Protocols?: 

What are Pt. Ed. Protocols? 4-part mnemonics that are a short-cut for documenting patient/family education encounters. They are entered in the Patient Education Section of the PCC. They result in an entry on the health summary for future reference.

What are the 4 parts?: 

What are the 4 parts? Disease state, condition or system being addressed. Specific education topic Level of patient/family understanding of the material Initials of the provider who did the education

1st letter condition, system, or disease process: 

1st letter condition, system, or disease process BT - Baby Bottle Tooth Decay BH - Behavioral Health BF - Breast-feeding CVA - Cerebrovascular Disease CD - Chemical Dependency CHN - Child Health Newborn CHI - Child Health Infant CHT - Child Health Toddler CHP - Child Health Preschool CHS - Child Health School Age CHA - Child Health Adolescent CDC - Communicable Diseases CAD - Coronary Artery Disease DM - Diabetes Mellitus DP - Disease Process DV - Domestic Violence LIP - Dyslipidemia DYS - Dysrhythmia FP - Family Planning GER - Gastroesophageal Reflux Disease GL - Glaucoma HTN - Hypertension

Slide18: 

IM - Immunizations INJ - Injuries M - Medications MH - Men’s Health ND - Neurologic Disorder OBS - Obesity OC - Ocular Condition ODM - Ocular Diabetes Mellitus OM - Otitis Media PVD - Peripheral Vascular Disease PN - Prenatal PP - Postpartum PL - Pulmonary RD - Rheumatic Disease STD - Sexually Transmitted Diseases SPE - Surgical Procedure and Endoscopy TO - Tobacco Use TB - Tuberculosis WL - Wellness WH - Women’s Health

Pediatric Codes : 

Pediatric Codes BT - Baby Bottle Tooth Decay BF - Breast-feeding CHN through CHA CDC - Communicable Disease DP - Disease Process DV - Domestic Violence IM- Immunizations OBS - Obesity OM - Otitis Media PL - Pulmonary Disease TO - Tobacco Use

OB/Gyn codes: 

OB/Gyn codes BF - Breast-feeding DM - Diabetes Mellitus DP - Disease Process DV - Domestic Violence FP - Family Planning OBS - Obesity PN - Prenatal PP - Postpartum STD - Sexually Transmitted Disease SPE - Surgical Procedure and Endoscopy WL - Wellness WH - Women’s Health

Surgery Codes: 

Surgery Codes DM - Diabetes Mellitus DP - Disease Process GER - Gastroesophageal Reflux INJ - Injuries OBS - Obesity PVD - Peripheral Vascular Disease SPE - Surgical Procedures and Endoscopy TO - Tobacco Use WL - Wellness

Adult Medicine Codes: 

Adult Medicine Codes BH - Behavioral Health CVA - Cerebrovascular Disease CD- Chemical Dependency CDC - Communicable Diseases CHF - Congestive Heart Failure CAD - Coronary Artery Disease DM - Diabetes Mellitus DP - Disease Process LIP - Dyslipidemia DYS - Dysrhythmia GER - Gastroesophageal Reflux Disease HTN - Hypertension MH - Men’s Health ND - Neurologic Disorder OBS - Obesity PVD - Peripheral Vascular Disease PL - Pulmonary Disease RD - Rheumatic Disease TO - Tobacco Use TB - Tuberculosis WL - Wellness WH - Women’s Health

2nd letter - specific topicSome common examples: 

2nd letter - specific topic Some common examples DP - Disease Process C - Complications LA - Lifestyle Adaptations M - Medications N - Nutrition FU - Follow up L - Patient Information Literature P - Prevention S - Safety TX - Treatment TE - Tests

3rd letter - level of understanding: 

3rd letter - level of understanding G - Good F - Fair P - Poor R - Refused GP - Group

4th letter - initials of provider: 

4th letter - initials of provider

I discussed with Ms. Jones that her obesity puts her at increased risk for diabetes, heart disease, gallstones, back and knee problems, and infertility. I discussed the relationship among obesity, caloric intake and exercise. I explained that she likely has a genetic predisposition to obesity and that she will have to work harder to lose weight. I explained that she could lose weight through a plan including regular exercise and dietary modification/restriction. I advised her to talk to a physician before she began any diet especially fad diets. I emphasized the importance of good hygiene. We discussed some components of a healthy eating plan including regular meal times, eliminating or limiting snack foods and fatty foods, reducing sodium consumption and adding more fresh fruits and vegetables and fiber to the diet. We discussed that the most healthy fluid for the body is water and that colas and alcohol contain many hidden calories. We discussed that healthy eating plans begin at the grocery store and discussed techniques for shopping for a healthier body.: 

I discussed with Ms. Jones that her obesity puts her at increased risk for diabetes, heart disease, gallstones, back and knee problems, and infertility. I discussed the relationship among obesity, caloric intake and exercise. I explained that she likely has a genetic predisposition to obesity and that she will have to work harder to lose weight. I explained that she could lose weight through a plan including regular exercise and dietary modification/restriction. I advised her to talk to a physician before she began any diet especially fad diets. I emphasized the importance of good hygiene. We discussed some components of a healthy eating plan including regular meal times, eliminating or limiting snack foods and fatty foods, reducing sodium consumption and adding more fresh fruits and vegetables and fiber to the diet. We discussed that the most healthy fluid for the body is water and that colas and alcohol contain many hidden calories. We discussed that healthy eating plans begin at the grocery store and discussed techniques for shopping for a healthier body.

OBS-C,LA,EX,N-G-MR: 

OBS-C,LA,EX,N-G-MR

OBS - Obesity: 

OBS - Obesity DP - Disease Process C - Complications LA - Lifestyle adaptations N - Nutrition EX - Exercise FU - Follow up P - Prevention L - Patient information Literature

How were these codes developed? A multidisciplinary team consisting of 2 doctors, 6 nurses, a pharmacist and a dietician from across I.H.S. met and revised and added to existing codes that were initially developed out of the Tucson area under Liz Dickey’s direction.: 

How were these codes developed? A multidisciplinary team consisting of 2 doctors, 6 nurses, a pharmacist and a dietician from across I.H.S. met and revised and added to existing codes that were initially developed out of the Tucson area under Liz Dickey’s direction.

Who can use these codes: 

Who can use these codes Doctors Physician Assistants and Nurse Practitioners Nurses Pharmacists Respiratory Therapists Patient Educators Other health care providers

Slide31: 

“That’s great, Dr. Ratzlaff, but the doctors at my service unit won’t do this!”: 

'That’s great, Dr. Ratzlaff, but the doctors at my service unit won’t do this!'

Providers do what they perceive as important.: 

Providers do what they perceive as important.

How to motivate people : 

How to motivate people Find out what they want. Find out who they are afraid of. Find out who they want to like them. Find out what they want to avoid.

Find out what they want: 

Find out what they want Nearly all doctors want to get credit for what they do. They all know that they are educating their patients. If you show them that they can get recognized for this it will be a motivator. Send a list of people who have more than 50 documented education encounters to supervisors.

Find out who they are afraid of: 

Find out who they are afraid of Whether they will admit it or not, doctors are typically afraid of JCAHO and HCFA. Be sure they understand that this is the way I.H.S. has chosen to comply with the JCAHO requirement for patient and family education. If it isn’t documented it didn’t happen.

Find out who they want to like them: 

Find out who they want to like them Most doctors want their patients to like them. Patients will like them more if the patient feels like the doctor cares about him/her. Written coordination of patient education makes it clear that the doctor is the leader of the health care team.

Find out what they want to avoid: 

Find out what they want to avoid Doctors want to avoid more writing in the chart than they are already doing. Since they can’t avoid the JCAHO requirement for documentation of patient education, help them understand that they can beat JCAHO’s game with a few simple letters on the PCC.

Slide39: 

I discussed with Ms. Jones the correct technique for obtaining peak flow measurements. I further discussed the importance of doing twice daily peak flows and how this can prevent ER visits and hospitalizations. We then discussed how the use of a spacer could result in improved delivery of her inhaled medicines. I explained the proper use and care of a spacer. We reviewed her current asthma medications including the name dose and timing of administration. I reinforced which medicines are for quick relief and which ones are anti-inflammatory medicines. We discussed that correct use of her medicines could result in improved life-style. I reminded her to consult with her physician before using any over the counter medicines for asthma.: 

I discussed with Ms. Jones the correct technique for obtaining peak flow measurements. I further discussed the importance of doing twice daily peak flows and how this can prevent ER visits and hospitalizations. We then discussed how the use of a spacer could result in improved delivery of her inhaled medicines. I explained the proper use and care of a spacer. We reviewed her current asthma medications including the name dose and timing of administration. I reinforced which medicines are for quick relief and which ones are anti-inflammatory medicines. We discussed that correct use of her medicines could result in improved life-style. I reminded her to consult with her physician before using any over the counter medicines for asthma.

PL-PF,SPA,M-G-MR: 

PL-PF,SPA,M-G-MR