1. PENNY GEORGE INSTITUTE FOR HEALTH AND HEALING The Environment of Practice: Working in the Acute Care Setting Presented by Wendy Farrar, BA, NCTMB Mollie O’Brien, MA, NCTMB Jeremy Miller, BS, LMT, NCTMB

2. PENNY GEORGE INSTITUTE FOR HEALTH AND HEALING Clinical Care Clinical Care Education Education Research Research

3. PENNY GEORGE INSTITUTE FOR HEALTH AND HEALING Direct/Indirect Patient Care

4. PENNY GEORGE INSTITUTE FOR HEALTH AND HEALING Morning Rounds Blessing Blessing Patient Care Coordination Patient Care Coordination

5. PENNY GEORGE INSTITUTE FOR HEALTH AND HEALING Patient Care Coordination Prioritize & assign ongoing patients Prioritize & assign ongoing patients Triage new referrals Triage new referrals Staffing Staffing

6. PENNY GEORGE INSTITUTE FOR HEALTH AND HEALING Referral Criteria Pain Pain Anxiety Anxiety Nausea Nausea Constipation Constipation Difficulty sleeping Difficulty sleeping Maintaining/prolonging pregnancy Maintaining/prolonging pregnancy Coping with changes in health Coping with changes in health

7. PENNY GEORGE INSTITUTE FOR HEALTH AND HEALING Holistic Patient Assessment Diagnoses Diagnoses Level of acuity & alertness Level of acuity & alertness Precautions Precautions Medications & lab/imaging results Medications & lab/imaging results General health history General health history Mental, emotional, social, spiritual and psychological well-being Mental, emotional, social, spiritual and psychological well-being Interest/understanding Interest/understanding

8. PENNY GEORGE INSTITUTE FOR HEALTH AND HEALING Holistic Patient Assessment Chart review Chart review Communication with other care providers Communication with other care providers Patient interaction/observation Patient interaction/observation

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10. PENNY GEORGE INSTITUTE FOR HEALTH AND HEALING Making a Treatment Plan Factors for consideration Factors for consideration Consent Consent

11. PENNY GEORGE INSTITUTE FOR HEALTH AND HEALING Holistic Treatment/Intervention

12. PENNY GEORGE INSTITUTE FOR HEALTH AND HEALING Holistic Treatment/Intervention Acupressure Acupressure Aromatherapy Aromatherapy Art Care Art Care Education Education Energy work Energy work Guided imagery Guided imagery Korean Hand Therapy Korean Hand Therapy Reflective Listening Reflective Listening Relaxation Techniques Relaxation Techniques

13. PENNY GEORGE INSTITUTE FOR HEALTH AND HEALING Holistic Treatment/Intervention Traditional Asian Medicine: Acupuncture, Acupressure, Shiatsu, Tui Na, Qi Gong Traditional Asian Medicine: Acupuncture, Acupressure, Shiatsu, Tui Na, Qi Gong Therapeutic Massage Therapeutic Massage Music Therapy Music Therapy

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16. Discharge Criteria Goals met Goals met No progress No progress No investment No investment Lack of cognition Lack of cognition State of consciousness State of consciousness No interest/refusal No interest/refusal

17. PENNY GEORGE INSTITUTE FOR HEALTH AND HEALING Documentation: 3 Goals Met By 3 Types Types of Documentation Electronic Medical Record - Epic/ Excellian Electronic Medical Record - Epic/ Excellian Departmental database - Microsoft Access Departmental database - Microsoft Access Practitioner visit sheets Practitioner visit sheets Goals of Documentation Clinical Clinical Operational Operational Research Research

18. PENNY GEORGE INSTITUTE FOR HEALTH AND HEALING Documentation: Goals Clinical Goals Clinical Goals – Checking Chart prior to seeing Patient – Progress Notes (part of Patient’s EMR) Operational Goals Operational Goals – Care Coordination – Productivity and Staffing Research Goals Research Goals – Our results in context of Pt’s entire stay

19. PENNY GEORGE INSTITUTE FOR HEALTH AND HEALING Documentation: Recording Raw Data Immediately after session, flow sheet Immediately after session, flow sheet – Time in/Time Out – Last session results – Session goal – Pre/Post ratings – Session results – ? Discharge

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21. When ‘File’ Button is clicked, Raw Data goes… Access Database Progress note Progress note

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23. Documentation: Practitioner Visit Sheets Record of treatments,results,Day-to-DayCareCoordination and as a back-up for ‘downtime’

24. PENNY GEORGE INSTITUTE FOR HEALTH AND HEALING Practitioner Resilience Self care Self care Boundaries Boundaries Team work Team work Self awareness Self awareness Personal growth and healing Personal growth and healing Professional growth Professional growth

25. PENNY GEORGE INSTITUTE FOR HEALTH AND HEALING Indirect Patient Care Program development initiatives Program development initiatives Patient safety and compliance Patient safety and compliance Professional growth & development Professional growth & development Education Education Research Research

26. Q&A 1)Write question on the note card in your folder. 2)Note category of question at top of card. Categories – Business Operations – Clinical Care – Education – Research – Documentation / Ethics / Legal – Self Care/Resilience 3) Place card in basket. 4) Take a 10 minute break.