From Thousand Smiles Wiki
The purposes of the hub are:
- maintain charts of children being seen at the clinic
- route children through the screening process
- discharge patients once screening is done
Charts are delivered to the hub by the triage runner. Each chart is numbered, starting with number 26, the first 25 are saved for known surgery patients. The triage sheet is reviewed. Stickers for each station that triage has requested are placed on the back of the triage page. This page is folded up so that the stickers and number are visible when the charts are in the slots. The number help us keep track of how early in the day the patient arrived. We process the low numbers through the open stations. Once the patients have been through each station the charts are returned to the hub with the patient. The hub reviews the notes in the chart and gives the patient a slip stating when to return. The charts are then placed in the completed chart area. Divided by: Surgery Tomorrow - Important to note - Surgery with lab or Surgery Ear tubes only no lab Surgery in three months Return in three months Return in six months Return in nine months Return in one year No further care needed Error
The hub only receives charts, manila in color, for patients that have a history of cranio-maxillo-facial issues. Dental and orthodontic only patients have blue or yellow charts. These charts go directly to the dental desk located to the left of the stairs. If there is a manila chart that should be dental or orthodontic only have a new chart made at the dental desk. Make a note in the manila chart and place it in the error file in completed chart area so that the patient can be backed out of the computer.
The hub makes use of runners. Generally, there are one or two runners assigned to each station. The runners are the main communication link between each screening station and the hub. If screening stations are having any issues or closing down to take breaks the runner must communicate this to the hub.
The Door- one runner is at the door leading to the waiting area at all times. This runner will call the name on the chart. Only patients that have been called into the screening area are allowed in.
ENT screening- one or two runner(s). This station moves very quickly. Every cranio-maxillo-facial patient is sent to this station. This station has a waiting area and the runner will keep 4 or 5 patients in line at a time. These runners must confirm that "surgery tomorrow" charts are clearly marked and noted with "needs labs" or "tubes only no lab". These charts are kept at the hub in the "surgery tomorrow" file case at the end of the day or when the patient is completed.
Surgery screening- two runners. This station has 3-4 surgeons each reviewing cases for possible surgery. It is important to have a patient at each surgeon's screening area at all times. Very important for these runners to confirm the "surgery tomorrow" charts are clearly marked and kept at the hub in the "surgery tomorrow" file case.
Audio screening- one runner. This exam takes between ~30 minutes per patient and can only see one patient at a time, there is no waiting area. The runner needs to keep up on the charts that triage has noted this station as a priority.
Speech screening- one runner. This exam takes between 10-20 minutes per patient and can only see one patient at a time, there is no waiting area. The runner needs to keep up on the charts that triage has noted this station as a priority.
X-ray station- one runner. If x-rays are requested in the triage notes these must be done before the patient can go to dental or orthodontics. Type of x-ray should be in the notes. Clarification from the triage Dr. may be necessary. If triage has requested dental and or orthodontics and there are no x-rays in the patients chart or they are more than one year old, new x-rays may be needed. Clarification will be needed by the triage Dr. or a dentist.
Once the patient has visited each screening station the chart and patient are brought to the hub. The patient receives a return to the clinic in 3,6,9 or 12 months slip. These slips are kept at the hub. This is determined by reviewing the station notes in the chart. Each station notes when and if the patient should return. The charts are then placed in the completed chart area. Divided by: Surgery Tomorrow - Note - Surgery with lab or Surgery Ear tubes only no lab Surgery in three months Return in three months Return in six months Return in nine months Return in one year No further care needed Error
Common Issues and how to Resolve Them
Patients come to the hub to try to see where they are in line. We cannot help them. The patients are placed in numerical order relative to when their chart arrived at the HUB. However, if triage notes high importance or the patient will be having surgery on Saturday, these patients should have a low number and will be moved to the front of the line for each station. All patients and their families should be waiting outside. There is no reason for any of them to be around the hub. Kindly but firmly ask everyone to please wait outside. Find a translator to do this.
Owner and Alternates
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