Hospice Survey Flashcards
DURING ORIENTATION, DID YOU RECEIVE INFORMATION ABOUT A CONFLICT OF INTEREST POLICY?
• Yes! We received information and signed a conflict of interest form. Human Resources reviewed our agency policy with us and we received a copy in our employee notebook.
- The conflict of interest policy is designed to identify situations that present potential conflicts of interest and to provide employees the procedures for making the appropriate disclosure.
- Example: You work at your church as a congregational nurse and you also work at HPCG as a nurse (this could be a conflict of interest if you are acting in both roles with the patient).
CAN YOU TELL ME 3 OR 4 PATIENT RIGHTS? **KNOW THESE!**
- to receive effective pain and symptom management;
- to be involved in developing their plan of care and the updates to the POC;
- confidentiality and privacy of their health information;
- to be informed, both orally and in writing, in advance of care being provided, of the charges, including payment for the service/care expected from third parties and any charges for which the patient will be responsible;
- to refuse treatment after knowing consequences;
- to be able to identify staff through nametags;
- to choose their healthcare provider, including attending physician
- to have their property and person treatment with respect, consideration, and recognition of their dignity and individuality
HOW DOES HPCG INFORM PATIENTS OF THEIR RIGHTS & RESPONSIBILITIES?
- HPCG provides all new patients on admission with a notebook – HPCG’s Patient Care Notebook – A Guide for Patients and Families - containing lots of information including our Patient’s Rights and Responsibilities.
- Patients or their caregivers initial off on the patient consent form (this is part of informed consent, which is a right!) that they have been provided and understand these rights in a manner or language they can understand.
TO WHOM WOULD YOU REPORT SUSPECTED VIOLATIONS INVOLVING MISTREATMENT, NEGLECT, OR ABUSE OF THE PATIENT? WHAT IS THE TIMEFRAME FOR DOING THIS?
- Any suspicion of abuse, neglect and/or exploitation by anyone (including HPCG staff) is brought to the attention of Marta or her designee immediately. Communication must be direct – do not leave a voicemail. If Marta is unavailable speak with Risa or another clinical manager. An investigation is conducted and DSS is notified if suspicion is confirmed.
- In LTC, Donna notifies the facility’s Director of Nursing or Administrator and requests assistance in evaluating and taking necessary steps to correct the problem.
- During on-call hours, communicate with Clinical Resource.
- HPCG follows all Federal and State requirements regarding reporting suspected abuse, neglect or exploitation of a juvenile or disabled adult. The patient has the right to be free of mistreatment, neglect or verbal, mental, sexual, and physical abuse, including injuries of unknown source, and misappropriation of patient property.
TELL ME ABOUT YOUR AGENCY POLICY FOR HANDLING A COMPLAINT FROM A PATIENT? WHO DO YOU REPORT IT TO AND HOW IS IT DOCUMENTED?
- Anyone can make a complaint.
- All complaints, including those after-hours, get written up on a consumer complaint form and sent to Sue S. as the VP of Quality and Compliance.
- Complaints are then followed up and investigated with feedback given back to the consumer. We track for trends. Complaints help us think about ways to improve our services.
HOW DOES HPCG KEEP PATIENT INFORMATION CONFIDENTIAL?
Hospice and Palliative Care of Greensboro (HPCG) trains all employees at orientation and yearly about HIPAA and patient confidentiality. We sign a form agreeing to keep patient information private. Violations of the confidentiality policy may result in disciplinary action up to and including termination.
- If e-mail with patient information is sent outside HPCG, it is encrypted
- All trash containing patient information is placed in shred-it bins
- Do not leave patient information visible and unattended
ARE PATIENTS PROVIDED INFORMATION ABOUT ADVANCE CARE DIRECTIVES AT THE START OF CARE? HOW IS THIS DOCUMENTED?
- Yes. Information about Advance Care Directives is in our Patient Care Notebook given to patients and family members on admission to HPCG.
- Team members – especially the Social Workers – then review this information with the patient as care continues.
- Updates are shared with other team members by voicemail/email, in the Interdisciplinary Group (IDG) meetings, shift reports and changes are reflected in the chart as well as on the IDG meeting menu.
WHAT ARE HPCG’S RESUSCITATIVE GUIDELINES AND WHO DOES WHAT?
- When a patient / representative expresses the desire for a DNR, the RN gets a verbal order and the Social Worker obtains two out-of-facility DNR’s or facilitates the completion of a MOST form.
- In the event of transportation by ambulance, a signed Out-of-Facility DRN and / or MOST form must be in the patient’s home or facility to prevent CPR if a cardiac or respiratory arrest occurs.
HOW DOES HPCG GO ABOUT HANDLING ETHICAL ISSUES? HOW ARE THEY REPORTED, DOCUMENTED, AND RESOLVED?
- We use team conference, clinical managers’ meetings (scheduled or called), our Professional Advisory Committee, Cone Health Ethics Committee, or others as needed to discuss these ethical concerns. We can also meet with the patient and family to discuss concerns.
- Marta, the Director of Support Services / Risa, VP of Clinical Services, collects information and coordinates these discussions. Risa reports to the Board quarterly.
- Example: A patient lives alone, does not have a caregiver, and is very unsafe. The patient is slightly confused at times but is adamant that he wants to remain at home. Staff want to ensure the patient’s well-being (beneficence/do good) but also want to respect the patient’s self-determination (autonomy).
CULTURAL DIVERSITY – WHAT DOES HPCG DO WHEN A PATIENT IS ADMITTED WHO IS FROM A DIFFERENT CULTURE? HOW DO WE HANDLE SITUATIONS INVOLVING COMMUNICATION AND LANGUAGE BARRIERS?
**We utilize interpreters or the AT&T Language Line for situations involving communication/language barriers.**
IF YOU SUSPECTED FRAUD & ABUSE IN THE AGENCY, WHO WOULD YOU REPORT IT TO?
- informing a manager: supervisor, the Compliance Officer (Sue Sciabbarrasi), or a member of the Compliance Committee (Sue S, Pat Soenksen, Marion Taylor, Clay Smith, Tab Haigler, Pat Gibbons, Risa Hanau, Susan Cox, Maggie Conklin, Chip Reklis, and Dr. Carlos Monguilod)
- or by leaving a message in the confidential Compliance voicemail (x2425).
• Everyone in the organization is responsible for compliance!
HOW DOES HPCG INTRODUCE THE AVAILABILITY OF SPIRITUAL COUNSELING?
• AN RN completes an initial assessment to determine the patient’s immediate care and support needs within 48 hours of the patient’s election of hospice care. She provides education on HPCG’s services, including chaplain services. If spiritual issues are identified at that time, the RN communicates this to the hospice interdisciplinary group (IDG).
- The IDG conducts and documents a patient-specific comprehensive assessment within 5 days of election that identifies the patient’s need for hospice care, including medical, nursing, psychosocial, emotional and spiritual care.
- Social Workers regularly assess for spiritual needs when updating the comprehensive assessment and plan of care. All non-LTC patients receive a call from the Chaplain to introduce services.
HOW WOULD YOU HANDLE A PATIENT WITH SPECIFIC DIETARY NEEDS?
- The patient’s nutritional status is assessed by the hospice RN during the comprehensive assessment and subsequent reassessments. These interventions are part of the plan of care and education is provided to patients and families as needed.
- When the IDG or attending physician identify nutritional needs or problems that exceed the expertise of the RN Case Manager or other members of the IDG, an appropriately trained individual (typically the dietician) is retained to provide more specialized interventions.
WHEN MORE THAN ONE ORGANIZATION IS PROVIDING SERVICES TO A PATIENT, HOW ARE SERVICES COORDINATED?
• The RN Case Manager coordinates the patient’s plan of care and facilitates the ongoing sharing of information with the attending physician, contracted facilities, vendors, other members of the IDG, and non-hospice healthcare providers furnishing services to the patient (for conditions related and not related to the terminal illness).
• Communication mechanisms include, but are not limited to:
o IDG meetings
o ad hoc case conferences when needed
o family meetings as appropriate
o discharge and/or transfer summaries as needed
o telephone communications and voice mail
o reports from and to on-call staff
o documentation in the patients’ records
• The IDG meets weekly to provide care planning for the hospice’s patients/caregivers. Each patient/caregiver is discussed, at a minimum, every 15 days, and when changes occur.
HOW ARE CHARGES FOR CARE CONVEYED TO PATIENTS?
- Admission staff discuss with patients and caregivers on admission what is covered and not covered.
- Susan Walters works with our private insurance patients.
- Patients are admitted to HPCG services regardless of their ability to pay.
- Social Workers also talk about charges as it relates to patients going to Beacon Place.
- Medication coverage is reviewed with patients and caregivers on an ongoing basis.
- Medicare/Medicaid reimburses HPCG for most of the care we provide.
DID YOU RECEIVE A JOB DESCRIPTION UPON HIRE? DESCRIBE IT.
Yes! I received and signed a job description upon hire. In addition, I receive an updated job description, which I sign annually, as part of the annual evaluation process.
DESCRIBE YOUR ORIENTATION.
- HPCG has an agency orientation that covers all kinds of agency information including mission statement, conflict of interest, patient rights, information about abuse and neglect, cultural diversity, infection control, Conditions of Participation, services our agency provides, and many other things.
- Then we each go through a job-specific orientation.
DID YOU RECEIVE AN ANNUAL EVALUATION? HOW WAS IT DONE?
Yes! Evaluations are completed yearly by your supervisor based on your job description. Both you and your supervisor have input in your evaluation and sign off on it electronically.
HOW MANY CONTINUING EDUCATION HOURS ARE NEEDED EVERY 12 MONTHS?
- Clinical staff are required to have 12 hours yearly; administrative staff 8 hours a year.
- HPCG offers regular in-service training for its staff. We utilize the Hospice Education Network via the computer as well as other opportunities both on-site and off-site.
