Bereavement Best Practice

Topics: Documenting Initial Bereavement Assessment Changes to Evaluation Visits and Bereavement visits Adding a Contact to the Bereavement Console Bereavement Activity Console Updating the Care Plan/ Change in Risk Level Risk Assessing After Death Managing Bereavement

Documenting Initial Bereavement Assessment An initial assessment will be completed in the Physical Assessment for 00 and 01 visits to ensure the initial assessment is done within 5 days of the SOC This will take the place of the 72HA The Bereavement Risk Assessment should also be done at the contact level during initial visits The Bereavement Risk Assessment should be completed on all bereavement contacts by the responsible discipline

Start of Care and Add- On Evaluations Bereavement Risk Assessment will be renamed to Spiritual Assessment in 00s and 01s The Spiritual Assessment will be required to complete Because the Risk Assessment will be completed at the start of care and add- on evaluation visits, the number of questions in the Spiritual Assessment has been greatly reduced to save time

Bereavement Visits and Calls Bereavement Visits have had the number of questions reduced and now only require a narrative for different objective and subjective assessments

Adjustment to weighted values and Risk Level There have been adjustments to the weight value of the questions in the Risk Assessment to portray a more realistic risk level The risk levels now only include low, moderate and high Risk Levels are: Low Risk – 0-4 Moderate Risk – 5-9 High Risk 10 or above

Adding Contacts to the Bereavement Console There are 4 ways that a Bereavement Contact is added to the Bereavement Console in R2 Completion of Risk Assessment in PointCare or R2 Patient Death – Bereavement contacts only Pre –Bereavement via Referral Manually add contact within Bereavement console

Completing Risk Assessment in PointCare A patient will be added to the Bereavement Console when: The Risk Assessment is done at the contact level through PointCare Demographics Contacts Tap and Hold Contact Complete Risk Assessment Tap and Hold to review score Add Contacts if Necessary

Adding a Bereavement Contact in PointCare You may add a bereavement contact in PointCare through any visit type by accessing ‘Contacts’ in Demographics Edit Add Complete Required Fields Check ‘Bereavement’ Check Box

Completing a Risk Assessment in R2 Bereavement Console A patient will be added to the Bereavement Console when: The Risk Assessment is done through the Bereavement Console Bereavement Console  Activity Find Contact, double click Add Risk Assessment Complete Assessment A message displays the risk level of the contact and care plan associated Review Careplan

Patient Death A patient will be added to the Bereavement Console: At the time of death. Once the death workflow has been processed (88H), all contacts marked as ‘Bereavement’ will be added to the Bereavement Console Bereaved contacts will only be added at this time if they have not yet been assessed through either R2 or PointCare

Pre-Bereavement through Clinical Input A patient will be added to the Bereavement Console when: ‘Begin Bereavement’ is selected in R2 in Clinical Input This will begin any pre- bereavement activity

Manual Addition of Contact to Console A contact will be added to the Bereavement Console when: The contact is manually added to the Bereavement Console Hospice Community Self- Referral

Bereavement Activity Console Find Contact, double click Contact Details Contact Information Risk Assessment Careplan Calendar

Contact Information The contact’s information can be edited at anytime the contact is active in the system Areas to Edit: Contact Demographics Patient Demographics Referral Information General Bereavement Information Comments

Risk Assessment The Risk Assessment history is viewable in the Bereavement Console if the Bereavement Coordinator wishes to view it A Risk Assessment can be added here by selecting ‘Add Risk Assessment’ A Risk Assessment can be updated here the same way

Bereavement Plan of Care The system automatically creates a Bereavement Careplan based on the risk assessment score when the Bereavement Risk Assessment is completed This is viewable in Contact Details in the Careplan section This can be edited/ customized by selecting ‘Edit’ at the top left

Calendar The calendar will allow you to view any visits that have been plotted on the calendar for the contact Changes cannot be made to the calendar through the bereavement console Changes can be made through the scheduling console or in PointCare with a new order

Updating the Care Plan/ Change in Risk Level Contacts can be re-assessed as many times as needed This can be done through PointCare and R2 The history of all risk assessments will remain available in the Bereavement Console

Risk Assessing After Death Risk Assessments can be completed on all bereavement contacts at the time of patient death This Risk Assessment will replace the current one from the initial visit 13 month bereavement process will start at the time of death

Managing Bereavement Bereavement Activity Report Letters Visits/ Phone Calls Care Plans Bereavement Groups IDG

Bereavement Activity Report By selecting ‘Bereavement Activity Report’ at the bottom of the Bereavement Console, you can view activity that has been performed for each Contact including calls, letters and visits This will help ensure the careplan is being followed

Letters Initial Letter – 1st week (New) 4 week Letter 3 Month Letter 12 Month/ Anniversary Letter 13 Month Letter Removing Family Satisfaction Survey (Completed by 3rd Party)

Review New Bereavement Letters These letters should be reviewed and edited before they are batched and printed To review and edit the letters: Filter the letter status for ‘New’ Find the letter to be sent out Select Edit Verify that the letter is correct; make any changes as needed Click the status drop-down arrow; then click ‘Edited/ Reviewed’ A history of all of the changes will be stored in ‘View History’

Batch Print ‘Reviewed’ Bereavement Letters Once all of the letters for this time period have been edited and reviewed and the status has been updated, select ‘Batch Print Letters’ Apply the criteria values as necessary then ‘View/ Print’ Each letter will be displayed in a separate tab If you choose to generate the mailing labels, those will be displayed first

New Initial Letter A new letter has been added to the list of letters to be sent out This initial letter will generate within the first week following the patient’s death This letter will include a website that the contact can use to research additional bereavement resources bereavementresources.org

Visits / Phone Calls Visits and Phone calls can be scheduled to the contact after the death of the patient A phone visits (72HP) must be scheduled within 3 days of the patient death Visits can be added through the scheduling console by double clicking on the visit date 72H – Bereavement Visit 72HP – Bereavement Phone Visit

Completing the Schedule Bereavement Coordinator will plot/ schedule the initial phone call within 3 days of patient death (72HP) Once the visit is scheduled to the appropriate worker, that worker can then add visits through a physician verbal order in PointCare outside of a visit as the option to write a new order within a 72 visit is not available

Care Plans Contacts can be re-assessed as many times as needed as long as the contact is in an active status This can be done through R2 or PointCare in a Bereavement visit The history of all risk assessments will remain available in the Bereavement Console The careplan that is generated from the risk assessment can be edited or customized specifically for the contact

Bereavement Groups Bereavement groups can be tracked through the Bereavement console To add a Bereavement Group, select add and complete the required form You may enter in name, date, time, branch, attendees and additional details Past Group entries may be edited Bereavement Groups Report

Bereavement Groups Report The Bereavement Coordinator can view/ print a list of the groups that have been entered into HCHB Select Bereavement Groups Report at the bottom of the console and enter in the appropriate filter criteria The report will show the date, time, group name and leader and any details that may have been added upon entry It also calculates the hours and number of attendees

IDG During the admission IDG meeting, the Bereavement Coordinator will be responsible for addressing the initial risk assessment and verifying that the address and phone number are complete for this contact. Also that at least one contact is marked to receive the Satisfaction Survey and the address and phone number is completed for this person as well The Bereavement Coordinator may wish to discuss the plan of care that was generated based on the risk assessment that was completed for the contact. Any edits can be made at this time through the bereavement console

Ending Bereavement A bereavement contact will remain active in the bereavement console for 13 months If a contact chooses to end Bereavement early, you can select ‘End Bereavement’ at the bottom of the Bereavement Console You have the option to continue sending letters if you choose

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