Presentation on theme: "MOUNTAIN VISTA MEDICAL CENTER 1301 South Crismon Road Mesa, AZ 85209"— Presentation transcript:
1 MOUNTAIN VISTA MEDICAL CENTER 1301 South Crismon Road Mesa, AZ 85209 New Provider OrientationPhysicianAllied Health
2 Thank you for choosing Mountain Vista! Welcome to Mountain Vista Medical Center. This orientation packet will give you an overview of the hospital, leadership, services, policies and processes that are pertinent to practicing at our facility. If you have any questions about the information provided, please contact us.
3 Medical Staff Leadership 2014/2015 Chief of StaffSudhakar Reddy MDVice Chief of StaffCynthia Anneski MDSecretaryHani Shennib MDCredentials ChairRichard Dinsdale MDDepartment of Surgery ChairRafath Baig MDDepartment of Medicine ChairMonique Chang MDDepartment of OB/GYN ChairManisha Purohit MD
5 About MVMC 8 Years Old- Opened July 2007 178 beds & 20 Geropsych Unit Level III Trauma CenterdaVinci SI Surgical systemGeneral SurgeryOpen HeartObstetricsUrologyAggressive CodesStemiStrokeTrauma
6 More About MVMC Teaching program Residency Programs Students Primary affiliation with Midwestern UniversityAffiliation with 20+ schoolsResidency ProgramsInternal MedicineFamily PracticeGeneral SurgeryStudentsMedical, PA, NP & CRNA
7 Hospital Layout Patient Rooms in Center towers 1st Floor 2nd Floor ICU, Surgery, ER, Radiology, Cath Lab2nd FloorOrtho/Spine & Med Surg3rd FloorTelemetry & GeropsychUse center bank of elevators to access
11 Entrance/Parking 4 Main Entrances OutpatientCath LabER (Only entrance after 7:30pm)Main EntranceBe particularly careful not to leave valuables visible in your car
12 Physician ParkingPhysician covered parking is available off of Southern Avenue, east of Crismon Road. This provides easy access to the Emergency Room, ICU, and the Cath Lab.Be particularly careful not to leave valuables visible in your car
14 Medical Staff Meetings 2015 MEETING/TIMEJANFEBMARAPRMAYJUNJULAUGSEPOCTNOVDECCredentials :00 noon2nd Monday Monthly129131181014Education Comm :30 pm1st Monday Monthly5264137Executive :30pm2nd Thurs after 1st Mon Monthly22*161715PPRC :00pm4th Monday Monthly23272522242826Dept OB/GYN :00 noon1st Tuesday Bi-MonthlyDept Medicine :30amDept Surgery :00am1st Thursday MonthlyCardiology Section :30am1st Wednesday MonthlyCath Conference :00 am2nd Wednesday QuarterlyAdministrative MeetingsCritical Care :30 am2nd Wednesday Bi-MonthlyPharm/Therapeutics :30 am2nd Wednesday Bi-MonthlyInfection Control :00 amLast Monday Quarterly3130Quality Council :00 pm4th Wednesday Monthly28*29Service Line MeetingsOrtho rd Thurs 7:00am19211820Stroke th Wed 12:00noonTrauma th Thurs 7:00am29*TBD*Exception to rule
15 Electronic Medical Record COMPUTERIZED PHYSICIAN ORDER ENTRY: Credentialed practitioners must use the computerized physician order entry (CPOE) system whenever possible, including documenting physician orders in the electronic medical record. Each credentialed practitioner will complete and sign an acknowledgement that they have completed training to use the computerized physician order entry (CPOE) system.Each credentialed practitioner will sign an acknowledgement that they understand that:they will not share their computer password with anyone else,they will not allow any other practitioner to document physician orders in CPOE while logged in under their log-in/password.if it has been identified that they have knowingly allowed another practitioner to use their log-in/password (identifier) the facility may terminate their identifier immediately.Please contact Geri Camacho at for computer training in the electronic medical record.
16 Incomplete Medical Records DEFINITIONA patient’s medical record is considered incomplete/delinquent if deficiencies have not been completed within thirty (30) consecutive days after the patient’s discharge.NOTIFICATIONPractitioners will be notified, by mail, of incomplete and delinquent medical records on a biweekly basis by the Health Information Management Services Department.A certified notice, return receipt requested, will be mailed to the practitioner on the last Wednesday of the month on suspension for delinquent medical records.SUSPENSIONSuspension will be as outlined in the Bylaws for Automatic Suspension.The practitioner’s privileges will be suspended as follows:Admitting privilegesScheduling of elective surgical cases (already scheduled cases may proceed)The practitioner may not serve on the Emergency No-doc call schedule.Except OB practitioners whose patients present to the Hospital in laborUpon completion of delinquent medical records, the suspension will be removed.
20 Authentication & Abbreviations AUTHENTICATION: All clinical entries in the patient’s medical record shall be legible, accurately dated, timed and authenticated by written or electronic signature. The practitioner whose signature the electronic signature represents is the only one who possesses the password and he alone uses it. A signed confidential statement must be on file for each physician. Practitioners granted group signature rights may use electronic signature utilizing their own passwords only.ABBREVIATIONS: The Medical Executive Committee approved the Hospital list of “Do Not Use” abbreviations. An official record of the sanctioned unapproved abbreviations is kept on file in the Health Information Management Services Department and is available at all nursing stations. Orders with unapproved abbreviations must be clarified and rewritten; failure to use proper abbreviations and use of prohibited abbreviations may result in medical staff action.
21 Operative ReportsA comprehensive operative progress note must be entered in the medical record immediately after a surgery or procedure to provide pertinent information for use by any individual who is required to attend to the patient. Operative Reports may be dictated or written in the medical record immediately following surgery. The Operative Progress Note Form may be used. In addition to the immediate written post-procedure note, all operative or procedure reports must be dictated within 24 hours of the procedure.All dictated or written Operative Reports shall include:Description of findingsTechnical procedures usedSpecimens removedPostoperative diagnosisEstimated blood lossName of primary surgeon and any assistants and/or anesthesiologists
22 Progress NotesProgress notes shall be written at least daily on all patients. Dated progress notes shall be recorded at the time of observation, sufficient to permit continuity of care and transferability. Patient’s clinical problems should be clearly identified in the progress notes and correlated with specific orders and test and treatment results as appropriate. Progress notes will not be required on the day of a patient’s discharge as long as the patient meets the pre-established discharge criteria set by that department. Physicians will be notified if their patients fail to meet criteria on discharge day and will then be responsible for progress note(s).
23 Consultation Reports Consultation reports shall contain: evidence of a review of the patient’s record by the consultantpertinent findings on examination of the patientthe consultants opinion, and recommendationThe attending practitioner shall be responsible for reviewing consultant’s opinions prior to surgery or invasive procedures, as appropriate.
24 Emergency CodesHave been standardized and are the same through out the valley. The codes are listed on the back of your badge.Code Red: FireCode Blue: Adult Cardiac ArrestCode Blue Pediatric: Pediatric Cardiac ArrestCode STEMI: Active Heart AttackCode Gray: Combative PersonCode Silver: Combative Person with WeaponCode Pink – Infant/Child AbductionCode Brown: EvacuationCode Green: Wandering PatientCode Orange: Hazardous SpillCode Yellow: Bomb ThreatCode Triage: DisasterCode 2000: Fire Alarm System Down
25 Safety Information MSDS RACE PASS Available in each unit RescueAlarmContainExtinguish/EvacuatePASSPullAimSqueezeSweepMSDSAvailable in each unitAvailable online
26 Safety Tips Do not leave valuables in nurse’s stations Do not leave anything visible in your vehicleReport all suspicious behavior (Ext 44)Look for badges!
27 Non Smoking Please! Mountain Vista is a Tobacco Free Facility No Smoking in the Break RoomsNo Smoking in the Parking LotsSmoking allowed on public sidewalks off MVMC property
28 Patient Evacuation Horizontal Evacuation Go through fire doors on other end of same floorVertical EvacuationTransport the patients to another floor
29 Electrical Safety Always use three prong power plug To remove, pull from plug, not from cordRed plugs are for Emergency PowerEquipment Failure/DamagedContact Nursing Dept for that floor
30 Infection Control Infection Prevention: Wash Hands Before seeing patientsAfter seeing patients (even if wearing gloves)The best way to protect your patients and yourself is to wash your hands frequently. Hands must be washed after removing gloves. Hands can be washed with soap and water but if not contaminated you may use the instant hand sanitizer which must remain wet for 20 seconds to be effective.
31 Staff Isolation Precautions A mask is requiredHand hygiene is requiredLimit pt transport to essential tests/proceduresNotify receiving area of necessary precautions if test/procedure is requiredPatient must be masked when out of room.No flowers or plantsThe patient’s door must remain closed at all times!
32 Isolation Precautions There are three types of isolation precautionsContact – Identified by an orange sign you must wear gloves upon entering the patient room. You must wear a gown if you anticipate direct contact with the patient or their environment.Droplet – Identified by a pink sign. You must wear a surgical mask with face shield upon entering the patient’s roomAirborne – Identified by a green sign. You must a N-95 respirator mask, the door to the patient’s room must remain closed at all times and the patient’s visitors should wear a N-95 respirator mask while in the patient’s room.Follow all posted precautionsUse appropriate Personal Protective Equipment (PPE)
33 National Pt Safety Goals Identify Patients CorrectlyUse at least 2 ways to identify patientsStaff CommunicationReport information correctly & efficientlyPrevent InfectionFollow hand cleaning guidelinesFollow proven guidelinesTime OutIs this the correct patient? Procedure? Location?
34 Patient Fall Prevention Patient fall risk assessment is done on:AdmissionWhen there is a change in status or conditionOn transfer to another unit
35 Restraints, Non-Violent AssessmentPatient exhibits clinical justified application criteriaNon-Violent/Non-Self DestructivePulling at or interfering with Invasive tubes/linesPatient Safety- Attempting to crawl our of bed and/or exhibiting disorientated/confused behavior resulting in potential injury to selfSurgical/Wound Maintenance (picking at site, in manner that hinders healing process)Try Alternate Interventions, per policyUse Alternative, DO NOT RESTRAINNoAlternativeFailed?YesObtain Order & initiateObtain orders from LIP or authorized designee (NP, PA, Resident)Initial order must not exceed 24 hours, renewed orders must not exceed one calendar dayRN may initiate restraint if LIP not available and the patient is at immediate risk, but must obtain an order within 12 hoursNotify the treating physician ASAP if the treating physician did not provide the orderPatient/familyNotify Patient/family as soon as possible in the process and prove them restraint Education MaterialMonitor, Reassess & ReleaseReassess at least every 2 hours if greater than 18 years of age & every 1 hour if less than 18 years of age using all appropriate parameters per policyRelease patient if application criteria no longer existsApplicationApply least restrictive restraint using appropriate technique
36 Restraints, Violent No Yes Assessment Patient exhibits clinical justified application criteriaViolent/Self DestructiveA situation in which there is an imminent risk of the patient physically harming himself or herself, staff, or others and non-physical intervention would not be effectiveTry Alternate Interventions, per policyUse Alternative, DO NOT RESTRAINAlternativeFailed?NoYesPatient/familyNotify Patient/family as soon as possible in the process and prove them restraint Education Material (as allowed. See G6)Obtain Order & initiateCompetent RN may initiate use based on assessmentObtain order from LIP or authorized designee. A FACE-TO-FACE ASSESSMENT MUST BE COMPLETED BY THE LIP OR AUTHORIZED DESIGNEE WITHIN 1 HOUR OF APPLICATION.Timeframes that the order cannot exceed are age specific: > 18 years = 4 hours; 9-17 yr = 2 hours; <9yrs = 1 hourNotify the treating physician ASAP if the treating physician did not provide the orderMonitor, Reassess & ReleaseReassess at least every 15 minutes using all appropriate parameters per policyRelease patient if application criteria no longer existsDebrief (BHU ONLY)Conduct a debriefing within 24 hours as per policyApplication & StaffingApply least restrictive restraint using appropriate technique1:1 staffing adjustment required
37 Personal Electronic Equipment CELL PHONE USE – TEXTING & PHOTOGRAPHING PATIENTS - The sending of text messages that contain hospital or patient- related health information is strictly prohibited. It is prohibited to use a cell phone camera to photograph patients.
38 EMTALA EMTALA – Emergency Medical Treatment and Active Labor Act EMTALA – Requires a hospital with a dedicated Emergency Department to provide a medical screening and determine whether or not the individual has an emergency medical condition which if present must be treated or stabilized.
39 HIPAAHIPAA – Health Insurance Portability and Accountability Act was passed by congress inThe purpose of HIPAA was to create national standards to protect a person’s health information
40 STAR Standards Star Stands for S – SERVICE T – TEAMWORK A – ATTITUDE AND ACCOUNTABILITYR - RESPONSIVENESS
41 ALERT LINEThe Alert Line is a “totally confidential 24/7 line to report violations of IASIS Code of Conduct”. If you witness anything unethical or illegal please Sheryl Caracciolo at You may also call
42 Medical Staff Services Sandy Elcock, Director Tina Deddo, Medical Staff Assistant Vickie Rockwell, Credentials Coordinator
43 I acknowledge that I have received and reviewed the orientation packet provided to me by Mountain Vista Medical Center.Print NameSignature Date