Patient Screening and Workflow Process Optimization

 
Flowchart Template: Review Link to Learn How
Start
Process
Process
Process
Decision
 
Yes
 
 
No
End
 
Identifying Patients for Screening
 
Describes process around identifying eligible patients,
noting patients due for screening, notifying patients due
for screening, and flagging files for providers
Nurse reviews patient
chart
Nurse puts note on chart
for provider stating the
need for home stool test
Nurse calls or sends a
letter to patient notifying
patient of due screening
and need to schedule
appointment
Patient calls clinic to
schedule
appointment for
screening
Hx of Crohn’s
Dx or Colitis?
 
Yes
 
No
Leave note on chart
for provider to discuss
scheduling a
colonoscopy
Patient is considered
high risk and does not
qualify for take home
test
Nurse pulls list of
patients aged 45-75
Has patient
had a
colonoscopy
within the last
10 years?
 
No
Has patient
done a home
stool test for
CRC this
year?
Hx of polyps
or CRC?
Fam Hx of
polyps or CRC
in fam <60
y.o.?
Go to next patient
 
Yes
 
No
 
No
 
No
 
Yes
 
Yes
 
Yes
 
Patient Flow During Visit
 
Include:
Physical spaces and processes that take place for each
Identify the availability of educational materials at each step
Identify when and how CRC screening is discussed
Identify staff responsibilities for ordering tests and for educating patient on how to complete the tests
Patient checks in with
registration staff
Provider schedules
patient for a colonoscopy
and provides education
for next steps
Provider utilizes Exact
Sciences Screening
Option tear-off sheet to
facilitate shared decision
on the best test for the
patient.
Provider provides a
home stool test with
instructions and places
an order in the chart
Nurse ensures patient
does not have any
other questions prior
to leaving
Does patient
require a
colonoscopy?
 
Yes
 
No
Registration staff
update patient contact
information and hand
patient paperwork to
complete
Nurse rooms patient,
completes health
maintenance items
and sees note for CRC
test
Provider conducts
clinic visit with patient
Provider notifies
patient they are due
for their home stool
test/colonoscopy
Nurse ensures a note is on
the chart to alert provider
and lets provider know
patient is ready and verbally
confirms need for home
stool test or colonoscopy
Patient arrives for
visit
Nurse utilizes
CRC
screening
algorithm to
determine
risk level
End
Provider notifies the
nurse the patient will
complete the stool
test at home
 
Yes
 
No
 
Screening and Results Tracking
 
Include:
Staff responsible for determining when a screening test has been completed or if a screening test is
incomplete.
How results are documented
How patients are informed of results
Provider or nurse puts
order in chart for CRC
screening test and makes
appropriate referrals
Test has been completed
and resulted in the EHR
Nurse reviews results
Nurse sends letter to patient
stating the test was negative
and to follow up as usual with
primary care provider
Provider/nurse calls patient
with results and schedules
follow-up appointment to
discuss colonoscopy
Nurse notifies the
provider of positive
results
Was the test
negative?
 
Yes
 
No
 
Workflow for Follow-up Colonoscopy
(following positive stool test)
 
Include:
Staff responsible for scheduling the follow-up colonoscopy
Staff who reviews prep instructions with the patient
What happens when patients are uninsured or underinsured
Specialist provider referral processes
Estimated wait times
Reception staff
confirm patient
information
Patient, nurse, and
schedulers work together
to schedule colonoscopy
test and estimate wait
time for appointment
Nurse reviews prep
instructions with
patient
Referrals sent to
appropriate locations
Patient
completes visit
Does
patient
need to be
referred
out for
test?
 
Yes
 
No
Patient has positive
CRC home stool test
and arrives for
follow-up
appointment
Nursing team rooms
patient and completes
health maintenance
items
Nurse asks patient if
anything has changed
related to stool health
since last visit and
documents
Provider answers any
questions patient may
have
Provider places
referral for
colonoscopy and
communicates new
order to nurse
Provider reviews stool
test results and
educates patient on
next steps
Nurse notifies provider
patient is ready and
communicates any
changes
Nurse
determines
if patient
qualifies for
NDCRCSI
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The flowcharts and descriptions detail the steps involved in identifying eligible patients for screening, managing patient flow during visits, and tracking screening results. The process includes reviewing patient charts, determining screening eligibility, discussing screening options with patients, and ensuring proper follow-up for screening tests. The goal is to streamline the workflow for efficient patient care.


Uploaded on Apr 03, 2024 | 2 Views


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  1. Flowchart Template: Review Link to Learn How Start Process Process Decision No Yes Process End https://www.youtube.com/watch?v=GsfZD4oU7l0

  2. Identifying Patients for Screening Nurse pulls list of patients aged 45-75 Describes process around identifying eligible patients, noting patients due for screening, notifying patients due for screening, and flagging files for providers Nurse reviews patient chart Has patient had a colonoscopy within the last 10 years? Yes Go to next patient No Has patient done a home stool test for CRC this year? Yes No Patient is considered high risk and does not qualify for take home test Leave note on chart for provider to discuss scheduling a colonoscopy Yes Hx of Crohn s Dx or Colitis? No Hx of polyps or CRC? Yes No Fam Hx of polyps or CRC in fam <60 y.o.? Yes No Nurse calls or sends a letter to patient notifying patient of due screening and need to schedule appointment Patient calls clinic to schedule appointment for screening Nurse puts note on chart for provider stating the need for home stool test

  3. Patient Flow During Visit Include: Physical spaces and processes that take place for each Identify the availability of educational materials at each step Identify when and how CRC screening is discussed Identify staff responsibilities for ordering tests and for educating patient on how to complete the tests Registration staff update patient contact information and hand patient paperwork to complete Nurse rooms patient, completes health maintenance items and sees note for CRC test Patient arrives for visit Patient checks in with registration staff Nurse utilizes CRC screening algorithm to determine risk level Nurse ensures a note is on the chart to alert provider and lets provider know patient is ready and verbally confirms need for home stool test or colonoscopy Provider notifies patient they are due for their home stool test/colonoscopy Yes Provider conducts clinic visit with patient No Provider utilizes Exact Sciences Screening Option tear-off sheet to facilitate shared decision on the best test for the patient. Provider schedules patient for a colonoscopy and provides education for next steps Does patient require a colonoscopy? Yes End Nurse ensures patient does not have any other questions prior to leaving No Provider provides a home stool test with instructions and places an order in the chart Provider notifies the nurse the patient will complete the stool test at home

  4. Screening and Results Tracking Include: Staff responsible for determining when a screening test has been completed or if a screening test is incomplete. How results are documented How patients are informed of results Provider or nurse puts order in chart for CRC screening test and makes appropriate referrals Test has been completed and resulted in the EHR Nurse sends letter to patient stating the test was negative and to follow up as usual with primary care provider Yes Was the test negative? Nurse reviews results No Provider/nurse calls patient with results and schedules follow-up appointment to discuss colonoscopy Nurse notifies the provider of positive results

  5. Workflow for Follow-up Colonoscopy (following positive stool test) Include: Staff responsible for scheduling the follow-up colonoscopy Staff who reviews prep instructions with the patient What happens when patients are uninsured or underinsured Specialist provider referral processes Estimated wait times Patient has positive CRC home stool test and arrives for follow-up appointment Nurse asks patient if anything has changed related to stool health since last visit and documents Nursing team rooms patient and completes health maintenance items Reception staff confirm patient information Provider places referral for colonoscopy and communicates new order to nurse Nurse notifies provider patient is ready and communicates any changes Provider reviews stool test results and educates patient on next steps Provider answers any questions patient may have Does patient need to be referred out for test? Nurse determines if patient qualifies for NDCRCSI Referrals sent to appropriate locations Nurse reviews prep instructions with patient Yes No Patient, nurse, and schedulers work together to schedule colonoscopy test and estimate wait time for appointment Patient completes visit

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