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CHIUS Three Bridges (3B) Student Clinic 2
TableofContents
ABOUTUS 3
CLINICOBJECTIVES 3
STUDENTS 4
STUDENTELIGIBILITY 4 STUDENTEXPECTATIONS 4 SHIFTSUPERVISORDUTIES 5
PRECEPTORS ERROR! BOOKMARK NOT DEFINED.
PRECEPTORELIGIBILITY 6 PRECEPTOREXPECTATIONS 6
CLINICORIENTATION 7
ORIENTATIONCHECKLIST–FORSTUDENTS 7
CLINICWORKFLOW 9
GENERALOVERVIEW 9 CLINICPREPARATION 9 CLINICDAYS–WORKFLOW 11
APPENDIX 18
A.EXAMPLEOFCLINICDAYSCHEDULE 18 B.WELCOMEINFORMATIONFORM-FORSTUDENTSANDPRECEPTORS 19 C.DOCUMENTSANDFORMS 20 QUEENSLANDPATIENTINTAKEFORM 20 PRECEPTORINVITATIONFORM 20 CERTIFICATEOFAPPRECIATION–FORPATIENTS 20 TEMPLATEFORCLINICSCHEDULE 20 TEMPLATEFORCLINICCALENDER 20 ORIENTATIONCHECKLIST–FORSTUDENTS 20
CHIUS Three Bridges (3B) Student Clinic 3
ABOUTUSTheCommunityHealthInitiativebyUniversityStudents(CHIUS)organizationisaUniversityofBritishColumbia(UBC)interdisciplinarystudentteamthatdevelopsandofferscommunity-basedclinicalandsocialinitiativestomeetthehealthcareneedsofmarginalizedpopulationswithintheVancouverinnercitycommunity.TheThreeBridges(3B)StudentRunClinicaddressesthismandatebyprovidinglearningandteachingexperiencesforstudentsandpreceptors,creatingmeaningfulopportunitiesforhealthcareprofessionalstudentstohelpthoseinneedintheircommunity.Studentslearnwithandaboutotherhealthcareprofessionals,includingtherolesthattheyplayoncontemporaryhealthcareteams,aswellastheimportanceofcivicduty,advocacy,servicetoothers,andthetenetsofprofessionalism.Underthesupervisionofpreceptorsandstaff,studentsinterviewpatientswithchronichealthconditions,andthroughaunique,team-basedapproach,provideappropriatecounsellinganddeliverinterventions.TheclinicoperatesoutoftheThreeBridgesCommunityHealthCentre,locatedat1292HornbyStreet,Vancouver,B.C.Regularservicesprovidedbythisclinicincludeaccesstoyouthdrop-inhealthclinics,publicandcommunitynurses,mentalhealthandaddictioncounsellors,dentalclinicsforchildren,speechtherapists,andnutritionists.ThestaffmembersattheThreeBridgesCentregenerouslysupportourclinicservice.Linktothe3Bclinicwebsite:http://www.vch.ca/locations-and-services/find-locations/find-locations?site_id=161ForanyquestionsabouttheCHIUSclinic,pleasecontactusat:chius.clinic@gmail.com
CLINICOBJECTIVES1. AddressthegapsinchronicdiseasemanagementinVancouver’svulnerablepopulation,witha
focusondiabetesandpainmanagement2. ProvideaninterdisciplinaryclinicexperienceforHealthSciencesstudentsatUBCandthe
opportunitytolearnanddevelopclinicalexpertisealongsideotherhealthprofessionalstudents3. Promotedevelopmentofcommunicationandcollaborationskillsbyinteractingwithother
membersoftheinterprofessionalteam4. Providetheopportunitytopracticeprofessionalclinicalskillsunderthesupervisionofmentors5. Fosterasenseofcivicandsocialaccountability6. Broadenworldviewsandexposestudentstotheimpactofsocialdeterminantsonhealth
CHIUS Three Bridges (3B) Student Clinic 4
STUDENTSAsastudentattheclinic,yourrolesandresponsibilitieswouldinclude:-Reviewingpatientinformationpriortoclinicdaysandfamiliarizingyourselfwithrelevantmedicaltopics-Conductingpatientinterviewsinateam-basedformatusingastandardizedintakeform-Participatingincaseconferenceswithpreceptorstodevelopcareplansforpatients-Deliveringinterventionstopatientsasneeded(e.g.pharmacystudentperformingamedicationreview)-Documentpatientinformationontoanelectronicmedicalrecord-DebriefingattheendofthedaywithyourteamandpreceptorsPleaserefertotheClinicWorkflowsectionforamoredetaileddescriptionofstudentduties
STUDENTELIGIBILITYThefollowingoutlinesthestudentrequirementsforparticipatingintheCHIUS3Bclinic:
Faculty EligibleyearsofstudyMedicine 1or2Pharmacy 3or4Nursing StudentswhohavecompletedTerm3PhysicalTherapy 2OccupationalTherapy 1or2SocialWork Any
STUDENTEXPECTATIONSStudentsareexpected:
• Tomaintainprofessionalbehaviorandappropriateboundarieswithpatients,preceptors,andstaff• Tomaintainappropriatepersonalpresentation(dressshouldalwaysbeappropriatetoa
professionalsetting)• Toseektodevelopfriendlyworkingrelationshipswithpeers,professionalcolleagues,andlearn
abouttherolethateachteammemberhaswithintheteam• Totakeadvantageofanylearningopportunitiesavailable• Toreflectontheirpracticeandadaptaccordingly• Toplanandprepareappropriatelyforassessment/treatmentsessions• Tomaintainopencommunicationschannels–clarifyingissues,debriefing,anddiscussingthoughts
orreactionstoanythingyoumayfinddifficultorupsetting,sothatissuescanbedealtwithconstructively
CHIUS Three Bridges (3B) Student Clinic 5
• Toadheretodocumentationguidelines,andcompleteinatimelymanner• Torespectandmaintaintheconfidentialityofpatientandworkplaceinformation• Toadheretoworkplacepoliciesandprocedures• Toutilizenonclientcontacttimeconstructively• Togiveactiveandconstructivefeedbacktowardsstaff,faculty,andothercolleaguestoimprovethe
CHIUSprogram
SHIFTSUPERVISORDUTIESTheshiftsupervisorwillbethestudentinchargeoforganizingandfacilitatingclinicoperations.ThispositionmaybefilledbyastudentfromanyhealthcarefacultyatUBC,withaminimumcommitmentperiodofoneschoolsemester:
• SeptembertoDecember–Twoblocksduration• JanuarytoApril–Twoblocksduration
Theshiftsupervisorwillbechargedwiththefollowingduties:Pre-clinicpreparation
• Thecreationofworkflowschedulesforeachclinicday• Thedistributionofawelcomeinformationformtostudentsandpreceptorsbeforeeachclinicblock• Thecreationofshortsummariesforpatientsreferredtotheclinicanddistributionofpatient
informationpriortothestartofeachshift.Theshiftsupervisormustusetheirdiscretioninsharingconfidentialinformationsothatidentifyingpatientinformationisremoved
• Tocallfollow-uppatientsthedaybeforetheirscheduledclinicvisittoremindthemoftheirappointment
• Tofunctionasthemainliaisonbetweenstudents,preceptors,andclinicstaffmemberswithregardstocommunication
• Checktheclinicemail(chius.clinic@gmail.com)andreplytoanyinquiriesDuringclinic
• PurchasecartonofStarbucksCoffeeforpreceptorsandstudents(canbepurchasedrightacrossthestreetfromtheclinic)
• Arriveatclinic30minutesbeforestarttimetohelpwithsettingupfortheclinicday(thepreparationinformationisdetailedlateroninthispackage)
• Tobepresentforthedurationofeachclinicshifttohelpwithlogisticsandtrouble-shooting• Toleadthedebriefsessionattheendofeachday,aswellasatthecompletionofeachclinicblock• Assistwithcleanupattheendoftheday• Attheendofeachclinicblock,remindstudentsandpreceptorstofillouttheonlinequestionnaire
regardingclinicfeedbackPleaserefertotheClinicWorkflowsectionforamoredetaileddescriptionofshiftsupervisorduties
CHIUS Three Bridges (3B) Student Clinic 6
PRECEPTORSAsapreceptorattheclinic,yourrolesandresponsibilitieswillinvolve:-Supervisingstudentsthroughouttheprocessofinterviewingpatients,participatingincareconferences,anddeliveringinterventions-ProvidingfeedbacktostudentsonimprovingtheirinterviewingandclinicalskillsPleaserefertotheClinicWorkflowsectionforamoredetaileddescriptionofpreceptorduties
PRECEPTORELIGIBILITYToparticipateintheclinic,apreceptormusthavethefollowingqualifications:
1. Beoneofthefollowing:a. VancouverCoastalHealth(VCH)staffonpaidtimeb. UBCfacultyc. ApersonwithaUBCappointment*
2. Anup-to-datelicensewiththeirprofessionalcollege3. Malpracticeinsurance
*IfyouarenotVCHstaffonpaidtimeorhaveanyaffiliationwithUBC,thesubmissionofanapplicationforaUBCappointmentcanbearranged.Pleasecontactusaschius.clinic@gmail.comformoreinformationonthisprocess.
PRECEPTOREXPECTATIONSPreceptorsareexpected:
• Tomodelappropriateprofessionalbehaviorsandboundaries,exemplifyingappropriateworkingrelationshipswithallmembersofthemultidisciplinaryteam
• Tobeapproachableandavailableforquestionsandencouragestudentstotakeadvantageofanylearningopportunities
• Tomaintainopenchannelsofcommunications,facilitatingclarifications,debriefing,andgivingtimelyandconstructivefeedback
• Tomodeltimemanagementskillsandsupportstudentstodevelopskillsandstrategiesinthisarea• Toprovideinformationregardingdocumentationstandards,andgivetimely,consistentand
constructivefeedbackwithregardstodocumentation
CHIUS Three Bridges (3B) Student Clinic 7
CLINICORIENTATIONSiteorientationforbothstudentsandpreceptorswillbedonetwiceperschoolterm,atthebeginningofeachsemester(SeptemberandJanuary).Theorientationwillconsistofaclinicstaffmembergivingabrieftourofthefacilityandit’sequipment,aswellasabriefexplanationoftheclinicmodel,intakeprocess,andoverallworkflow.Orientationtotheuseoftheelectronicmedicalrecords(EMR)systemwillbeavailableasarecordingonline,whichshouldbeviewedpriortoastudent’sstartdate.ArequisitionformtoapplyforanEMRloginnameandpasswordshouldbefilledoutamonthinadvanceofthestartdateaswell.The‘StudentExpectations’and‘Workflow’sectionsofthismanualshouldbereviewedbyallstudents(andpreceptors)beforetheirfirstclinicshift.ForstudentswithlittleornoexperiencewithwritingSOAP(subjective/objective/assessment/plan)notes,thefollowingisausefulresourcethatexplainsthebasicsofaSOAPnote:www.wikihow.com/write-a-soap-note.StudentsarealsohighlyencouragedtoparticipateinthegeneralCHIUSorientationinSeptember,whichintroducesstudentstostrategiesinworkingwithsensitivepopulations.Forsomestudents,theCHIUS3Bclinicmaybetheirfirsttimeworkingwithmarginalizedpopulations,andthissessionwillhelppreparethemtobetterhandlechallengingsituationsthatmayariseduringtheirtimeattheclinic.ThisorientationisheldannuallyinSeptemberandisopentoallhealthcarestudentsatUBC.
ORIENTATIONCHECKLIST–FORSTUDENTSThefollowingitemsmustbecompletedpriortothestartofeachclinicblock:Forms:**onlyifyoudidnotfilltheseoutandhandtheminattheCHIUSgeneralorientation
o EMRloginrequisitionform
o VancouverCoastalHealth(VCH)confidentialityform
• Pleasebringthecompletedformwithyouonyourfirstclinicday
• Availableat:http://studentpractice.vch.ca/orient.htm
Modulesandvideos:
o StudentPracticeEducationCoreOrientation(SPECO)module
• Availableat:http://studentpractice.vch.ca/orient.htm
o EMRtrainingvideos
• Video#1(2min,19sec):https://www.youtube.com/watch?v=3kfzD2Gse8Y&list=PLb-
I3FkiTnJhhtuLfrIY9AWG3tXaq2n35&index=1
CHIUS Three Bridges (3B) Student Clinic 8
• Video#2(51min,52sec):
http://www.screencast.com/users/PCCEMR/folders/EMR%20HELP%20VIDEOS/media/bb368b8a-1d40-4f79-8e84-f7ec74f4eaf9
Readings:
o Reviewofthe‘StudentExpectations’and‘Workflow’sectionsoftheClinicManual
• Availableat:http://www.chius.ubc.ca/chius-clinic/chius-interdisciplinary-clinic/
o SOAPnotetutorial(optional)
• Availableat:www.wikihow.com/write-a-soap-note
Theabovechecklistalongwithlinkstodocumentsandvideoscanbefoundat:http://www.chius.ubc.ca/chius-clinic/chius-interdisciplinary-clinic/
CHIUS Three Bridges (3B) Student Clinic 9
CLINICWORKFLOW
GENERALOVERVIEW• Therewillbe4clinicblocksscheduledduringeachacademicyear(seeappendixforexampleof
cliniccalendar)o Firstsemester–2clinicblockso Secondsemester–2clinicblocks
• Studentswillberequiredtocommittoanentireclinicblockforcontinuityofpatientcare• Eachclinicblockwillconsistof3clinicdays(Days1,2,and3)biweeklyonSaturdays(from9:30am
-1:00pm)overaperiodof5weeks• Eachclinicdaywillbescheduleddependingonthenumberofnewpatientsandreturningpatients
beingseen• Studentswillbesplitintotwoteams(Team#1and#2),eachconsistingofonestudentfromeach
ofthefollowinghealthdisciplines:o Medicineo Pharmacyo Nursingo Physicaltherapyo Occupationaltherapyo Socialwork
• Eachteamwillworkindependentlyofeachotherwithsupportfromstaffandpreceptors• Oneachclinicday,eachteamwillconducteitherONEnewpatientintakeorONEtoTWOpatient
follow-ups• Eligiblepatientswillbereferredtotheclinicbytheirfamilyphysicianat3B–thereferralform(see
appendix)mustbefilledoutandsenttotheShiftSupervisoratleastoneweekinadvanceoftheirscheduledappointmenttime
CLINICPREPARATIONClinicDay1–thefollowingtobedone1weekprior1.TeamassignmentsShiftSupervisorResponsibilities:
• ShiftsupervisorwillreviewrosterofincomingstudentsandassignstudentstoeitherTeam#1orTeam#2whiletakingstudentexperienceandyearsofstudyintoaccount.Teamassignmentswillbedistributedtostudentsviaemail
StudentResponsibilities:• None
CHIUS Three Bridges (3B) Student Clinic 10
2.PatientpreparationShiftSupervisorResponsibilities:
• Shiftsupervisorwillreviewreferralformsforallnewandreturningpatientsscheduledandsummarizemainissuesinemailform,tobedistributedtostudentsforresearchandpreparationpurposes.Medicationlistshouldbeincludedintheinformationdistributed.Abriefdescriptionofthetypeofdwellingthepatientresidesin,andwhatcitytheycallhomeshouldalsobeincluded.Onenewpatient,ORonetotwofollow-uppatientswillbeassignedtoeachinterdisciplinaryteam
• Shiftsupervisorshouldbepreparedtogiveabrieforalsummary(<1minutes)ofeachpatient’sprimaryissuesatthebeginningoftheclinicshift
StudentResponsibilities:• Studentsshouldusetheweekbeforetheclinicdaytoreviewpatientinformationandconduct
preliminaryresearch(ifnecessary)onrelevanttopicsinpreparationfortheclinicday3.SchedulepreparationShiftSupervisorResponsibilities:
• Shiftsupervisorwilldraftascheduleforeachteamthatbalancestimeforpatientfollow-upaswellasassessmentofnewpatients.Thescheduleshouldavoidhavingpatientsarriveatthesametime,andattempttospreadoutthetimesthatpreceptorswillbeneededbyeachteam(inparticularthestudent/preceptordiscussiontimeandteamdiscussiontime).Thisschedulewillbedistributedtoclinicstaff,preceptors,andstudentsviaemail.(Seeappendixforexampleofclinicschedule)
StudentResponsibilities:• Studentsshouldbeawareoftheirschedulefortheday
ClinicDays2and3–thefollowingtobedone1weekprior1.Returningpatientpreparation(**thismaybedoneatendofpreviousclinicshift)ShiftSupervisorResponsibilities:
• ShiftsupervisorwillreviewSOAPnotesrecordedontheEMRsforreturningpatientsfrompreviousclinicdays.Theywillmakenoteofanyplannedfollow-upinterventionsanddeterminethetotalamountoftimethatwillbeallottedforfollow-upforeachpatient(SOAPnotesshouldincludeabriefdescriptionofplannedinterventionsaswellasanestimationoftimeneededfordelivery–e.g.“Pharmacy-reviewofbloodglucoselogbookandcounsellingonstrategiesforimprovingmanagement;15minutes”)
StudentResponsibilities:• Studentsshouldpreparefordeliveryoffollow-upinterventionsbydoingresearchingapplicable
resources2.Patientpreparation
• ThisstepsameasDay13.Schedulepreparation
• ThisstepsameasDay1
CHIUS Three Bridges (3B) Student Clinic 11
CLINICDAYS–WORKFLOWCLINICDAY1EXAMPLE
• Shiftsupervisorwillarriveat8:45amatthe3Bclinictosetupforthedayo Connectwithsecurityguards,unlockconferenceandclinicroomso Obtainkeycards(4)fordistributiontostudents(2;1cardperteam),preceptors(1),and
forthemselves(1)o Setuplaptops(oneineachconferenceroom)andbringuptheEMRsofthepatientswho
willbeinterviewedintheroomo Setupaudio/visualequipmentinconferenceandclinicroomsforpreceptorviewingo Logintoadditionalcomputers(inthepreceptorviewingroom)andpullupEMRsof
patientsforthedayo Ensurethereareadequatecopiesofallforms(Summaryofcareplanform)onhando Writeonthewhiteboardthedifferentteamgroups(ifitisthefirstday),andwriteoutthe
schedule• Studentswillarriveat9:15amatthe3Bclinicandmeetinthemainconferenceroom• Preceptorswillarriveat9:15amatthe3Bclinicandmeetinthemainconferenceroom
I.IntroductionsandAssigningofRoles-ForallStudents,Staff,andPreceptorsIntroductions,siteorientation,andassigningofroles(duration:30minutestotal)
• Generalroundtableintroductionsofstudents,preceptors,andstaff(15minutes)• Forthefirstdayofeachblock:Siteorientationtolocationofclinicrooms,washrooms,emergency
exits,etc.bystaffmember(15minutes)• Shiftsupervisorwillgiveabriefrundownoftheday’sscheduleaswellasverbalsummariesofthe
twonewpatients• ShiftsupervisorwillcollectVCHconfidentialityformsfromstudents• Teamswillsplitintopre-assignedgroups(Teams#1and#2)anddecideonassignmentofspecial
roles:o Onetime-keeper–thisstudentwillkeeptheteamonschedulebyredirectingpatientsas
neededandensuringequalopportunityforeachstudenttoconducttheirinterviews.Preferablyastudentwithpriorexperiencewithfacilitatinggroupdiscussions.Thisstudentwillalsobeinchargeoftheaccesskeycardfortheday
o Twodocumentarians–thesestudentswillrecordpatientinformationontotheirEMRusingalaptopduringinitialpatientintake,dividingthedutiesasnecessary.Preferablystudentswithpriorexperiencewritingclinicalnotes
IIa.ForaTeamSeeingaNewPatientStep1.Patientchartreviewandpreparationfornewpatientinterview(duration:30minutes)ShiftSupervisorResponsibilities:
• Shiftsupervisorshouldliaisebetweenfrontdeskstaffandstudentsfrombothteamstoletthemknowiftheirpatientsareontimeorrunningbehindschedule
CHIUS Three Bridges (3B) Student Clinic 12
StudentResponsibilities:• Studentswillreviewthechart(bothpaperandelectronic)oftheirassignedclientscheduledforthe
dayandobtainpertinentinformation• Studentsshouldusethistimetodeterminewhatinformationtheyrequirethatismissingfromthe
patientrecords,andwhatquestionstheyplantoaskthepatiento Itmaybehelpfulforeachteamtosplitfurtherintorelatedprofessions(e.g.medicine,
pharmacy,andnursingseparatefromPT,OT,andsocialwork)whendecidingwhichstudentwillaskcertainquestionsthatmayoverlapareasofexpertise
PreceptorResponsibilities:• Preceptorsshouldbeavailableduringthelatterpartofthistimeforconsultationbystudentsifany
questionsariseduringthechartreviewStep2.Patientinterview(duration:60minutes)ShiftSupervisorResponsibilities:
• Shiftsupervisorwillgreetpatientinwaitingroomandinvitethemtotheirassignedconferenceroom
StudentResponsibilities:• Studentswillgreettheirpatient,introducethemselves,andproceedtotakeafocusedhistory• TheDocumentarianswillrecordinformationgatheredontothepatient’sEMR(inSOAPnote
format,focusingontheSubjectiveandObjectiveheadings)• TheTime-keeperwillhelpfacilitatetheinterviewbyensuringitdoesnotexceed60minutesin
lengthPreceptorResponsibilities:
• Preceptorscanviewalivefeedofthepatientinterviewintheconferenceroomsfromanearbyclinicroom.Theywillhaveaccesstothepatient’sEMRandmayrefertothisandgathermoreinformationwhilewatchingtheinterview.
Step3.Studentandpreceptordiscussion(10minutes)ShiftSupervisorResponsibilities:
• Shiftsupervisorwilltakepatientbacktothewaitingroomforthedurationofthestudent,preceptor,andteamdiscussion.Thepatientcanbeencouragedtousethiswaitingtimetofilloutassessments(e.g.McGillPainquestionnaire),readpamphlets,orgrabacoffeeorteawhiletheywait
StudentResponsibilities:• Studentscanusethistimetolookupadditionalinformation,anddiscussindividuallywith
preceptorstheirideasontheassessmentandplanforthepatientsPreceptorResponsibilities:
• PreceptorsshouldbeavailableduringthistimetodiscussassessmentwithstudentsStep4.Preceptorandteamdiscussion(20minutes)ShiftSupervisorResponsibilities:
• Shiftsupervisorcancheckonthepatientiftheyarenotneededbytheotherteamduringthistime• Shiftsupervisorshouldgetasenseifthepatientwillhavetoreturnforafollow-upappointmentor
notatthispoint
CHIUS Three Bridges (3B) Student Clinic 13
StudentResponsibilities:• Studentswillreconvenewiththeirpreceptorsandclinicstaffandpresentthepatient’scasein
conferenceroom• Students,withinputandassistancefrompreceptorsandclinicstaff,willidentifymissing
information(ifany)and/orexaminationsrequired• Students,withinputandassistancefrompreceptors,willcollectivelycomeupwithanappropriate
diagnosisand/orcareplanforthepatient.• Issuesidentifiedandinterventionsrequiredwillbecategorizedasacuteorfollow-up• Studentsshouldfilloutthe“SummaryofCarePlan”form,highlightingthegoalsoftherapyand
counsellingpointsforeachpatientrelevanttoeachprofession(seeAppendixforform)PreceptorResponsibilities:
• Preceptorsshouldbepresentduringeachteam’sgroupdiscussiontoprovideinputandadviceStep5.Patientmanagement(duration:30minutes)ShiftSupervisorResponsibilities:
• Shiftsupervisorwillmeetthepatientinthewaitingroomandinvitethembacktotheirassignedconferenceroom
StudentResponsibilities:• Studentswillperformanyadditionalhistorytakingand/orexaminationsasnecessary
o DocumentarianswillrecordadditionalinformationontotheEMRasneeded• Studentswillcommunicatethecareplanthathasbeenpreviouslyestablishedbythe
interprofessionalteam,usingthe“SummaryofCarePlan”formasaguide• Thepatientcanthenchoosetoreceiveintervention(s)duringthecurrentappointmentordefer
untilnextappointment• Iftheclientchoosestoreceiveacuteinterventionsatthecurrentappointment,interventionscanbe
deliveredas:○ Individualconsultsbyaparticularstudentofanappropriatefield(e.g.thepharmacy
studentperformingamedicationreview),oramultidisciplinaryconsult(e.g.OTandSWstudentsdiscussinghomesupportstogether)
• Studentswillonlyperform/deliverinterventionsuptotheircomfortlevelundertheguidanceoftheirpreceptorasappropriate**NOTE:Ifapreceptorisnotonsite,theyshouldbeconsultedpriortotheprovisionofanyinterventions(e.g.byphone)
PreceptorResponsibilities:• Preceptorscanviewalivefeedofthepatientmanagementintheconferenceroomsfromanearby
clinicroom.Theywillhaveaccesstothepatient’sEMRandmayrefertothisandgathermoreinformationwhilewatchingthesession.
Step6.ArrangeFollow-UpAppointment(duration:5minutes)ShiftSupervisorResponsibilities:
• Shiftsupervisorwillleadpatientbacktowaitingroomandliaisebetweenthemandfrontdeskstafftochooseatimeforafollow-upappointmentifneeded
CHIUS Three Bridges (3B) Student Clinic 14
• Shiftsupervisorshouldobtainacontactphonenumberfrompatient,andverbalconsenttoprovideaphonecallreminderonedaypriortoanyfuturefollow-upappointments
StudentResponsibilities:• None
PreceptorResponsibilities:• None
IIb.ForaTeamSeeingaFollow-upPatientStep1.Patientchartreviewandpreparationforfollow-uppatientinterview(duration:15-30minutes)ShiftSupervisorResponsibilities:
• Shiftsupervisorshouldliaisebetweenfrontdeskstaffandstudentsfrombothteamstoletthemknowiftheirpatientsareontimeorrunningbehindschedule
StudentResponsibilities:• Studentswillreviewthechart(bothpaperandelectronic)oftheirassignedclientscheduledforthe
dayandobtainpertinentinformation.Theyshouldbefamiliarwithpriorgoalsoftherapyandcounsellingpointsestablishedonpriorclinicvisits
• Studentsshouldusethistimetodeterminewhatinformationtheyrequirethatismissingfromthepatientrecords,andwhatquestionstheyplantoaskthepatienttoassesstheirprogresssincethelastclinicvisit
o Itmaybehelpfulforeachteamtosplitfurtherintorelatedprofessions(e.g.medicine,pharmacy,andnursingseparatefromPT,OT,andsocialwork)whendecidingwhichstudentwillaskcertainquestionsthatmayoverlapareasofexpertise
PreceptorResponsibilities:• Preceptorsshouldbeavailableduringthelatterpartofthistimeforconsultationbystudentsifany
questionsariseduringthechartreviewStep2.Follow-uppatientinterview(duration:45minutes–variablebasedoncomplexityofpatient)ShiftSupervisorResponsibilities:
• Shiftsupervisorwillgreetpatientinwaitingroomandinvitethemtotheirassignedconferenceroom
StudentResponsibilities:• Studentswillgreettheirpatient,introducethemselves,andassessthepatient’sprogresssincetheir
lastclinicvisit• TheDocumentarianswillrecordinformationgatheredontothepatient’sEMR(inSOAPnote
format,focusingontheSubjectiveandObjectiveheadings)• TheTime-keeperwillhelpfacilitatetheinterviewbyensuringitdoesnotexceed45minutesin
lengthPreceptorResponsibilities:
• Preceptorscanviewalivefeedofthepatientinterviewintheconferenceroomsfromanearbyclinicroom.Theywillhaveaccesstothepatient’sEMRandmayrefertothisandgathermoreinformationwhilewatchingtheinterview.
Step4.Studentandpreceptordiscussion(10minutes)
CHIUS Three Bridges (3B) Student Clinic 15
ShiftSupervisorResponsibilities:• Shiftsupervisorwilltakepatientbacktothewaitingroomforthedurationofthestudent,
preceptor,andteamdiscussion.Thepatientcanbeencouragedtousethiswaitingtimetofilloutassessments(e.g.McGillPainquestionnaire),readpamphlets,orgrabacoffeeorteawhiletheywait
StudentResponsibilities:• Studentscanusethistimetolookupadditionalinformation,anddiscussindividuallywith
preceptorstheirideasonthenewassessmentandplanforthepatientPreceptorResponsibilities:
• PreceptorsshouldbeavailableduringthistimetodiscussassessmentwithstudentsStep5.Preceptorandteamdiscussion(30minutes)ShiftSupervisorResponsibilities:
• Shiftsupervisorcancheckonthepatientiftheyarenotneededbytheotherteamduringthistime• Shiftsupervisorshouldgetasenseifthepatientwillhavetoreturnforafollow-upappointmentor
notatthispointStudentResponsibilities:
• Studentswillreconvenewiththeirpreceptorsandclinicstaffandpresentthepatient’supdatedstatusinconferenceroom
• Students,withinputandassistancefrompreceptorsandclinicstaff,willidentifymissinginformation(ifany)and/orexaminationsrequired
• Students,withinputandassistancefrompreceptors,willcollectivelycomeupwithanynewdiagnosisand/ormodifythecareplanforthepatientasneeded
• Issuesidentifiedandinterventionsrequiredwillbecategorizedasacuteorfollow-up• Studentsshouldfilloutanew“SummaryofCarePlan”form,highlightinganynewgoalsoftherapy
andcounsellingpointsforeachpatientrelevanttoeachprofession(seeAppendixforform)PreceptorResponsibilities:
• Preceptorsshouldbepresentduringeachteam’sgroupdiscussiontoprovideinputandadviceStep6.Patientmanagement(duration:30minutes–variablebasedoncomplexityofpatient)ShiftSupervisorResponsibilities:
• Shiftsupervisorwillmeetthepatientinthewaitingroomandinvitethembacktotheirassignedconferenceroom
StudentResponsibilities:• Eachteamwillperformanyadditionalhistorytakingand/orexaminationsasnecessary
o DocumentarianswillrecordadditionalinformationontotheEMRasneeded• Eachteamwillcommunicateanychangestothecareplanthathasbeenpreviouslyestablishedby
theinterprofessionalteam• Thepatientcanthenchoosetoreceiveintervention(s)duringthecurrentappointmentordefer
untilnextappointment• Iftheclientchoosestoreceiveacuteinterventionsatthecurrentappointment,interventionscanbe
deliveredas:
CHIUS Three Bridges (3B) Student Clinic 16
○ Individualconsultsbyaparticularstudentofanappropriatefield(e.g.thepharmacystudentperformingamedicationreview),oramultidisciplinaryconsult(e.g.OTandSWstudentsdiscussinghomesupportstogether)
• Studentswillonlyperform/deliverinterventionsuptotheircomfortlevelundertheguidanceoftheirpreceptorasappropriate**NOTE:Ifapreceptorisnotonsite,theyshouldbeconsultedpriortotheprovisionofanyinterventions(e.g.byphone)
PreceptorResponsibilities:
• Preceptorscanviewalivefeedofthepatientmanagementintheconferenceroomsfromanearbyclinicroom.Theywillhaveaccesstothepatient’sEMRandmayrefertothisandgathermoreinformationwhilewatchingthesession.
Step7.ArrangeFollow-UpAppointment(duration:5minutes)ShiftSupervisorResponsibilities:
• Shiftsupervisorwillleadpatientbacktowaitingroomandliaisebetweenthemandfrontdeskstafftochooseatimeforafollow-upappointmentifneeded
StudentResponsibilities:• None
PreceptorResponsibilities:• None
III.Post-ConsultationWrap-up–ForStudents,Staff,andPreceptorsStep1.SOAPnotecompletion(20minutes)ShiftSupervisorResponsibilities:
• NoneStudentResponsibilities:Forteamswhosawanewpatient:
• StudentsfromeachteamwillsplitupandaddtheirownAssessmentandPlan(SOAPnoteformat)totheEMRoftheirnewpatient,undertheheadingoftheirownprofession
o e.g.Pharmacy§ Assessment-PatienthaspoorlycontrolleddiabeteswithanA1cof9.5%§ Plan(acute)–SuggestedpatientrecorddailyFBGsbeforebreakfast,lunch,dinner,
andatbedtimeinalogbook§ Plan(follow-up)–WillreviewFBGsinlogbooktwoweeksfromnowatnextclinic
visitanddiscussstrategiestohelpstabilizelevels(timeneeded~10minutes)Forteamswhosawafollow-uppatient:
• StudentswilladdnotestotheEMRofreturningpatientsundertheheadingoftheirownprofessiondescribingthedeliveryofinterventionsandifanyfurtherfollow-upisneeded,followingtheSOAPformat
PreceptorResponsibilities:• PreceptorsshouldbeavailabletoreviewthecompletedSOAPnotesandsuggesteditspriorto
reviewbythestaffphysician
CHIUS Three Bridges (3B) Student Clinic 17
Step2.Endofdaydebrief(10minutes)• Thestudents,preceptorsandstaffwillmeetintheconferenceroomattheendofthedayto:
a. Havearoundtablediscussionsummarizingcasesseenthroughoutthedayandlearningpoints
b. EvaluatewhatwentwellandwhatrequiredimprovementStep3.Clinicclean-up(5minutes)ShiftSupervisorResponsibilities:
• ShiftSupervisorwillcollectkeycardsfromstudentsandpreceptors• ShiftSupervisorwillpackupandsecureallaudio/visualequipment• ShiftSupervisorwilllockdoorstoconferenceroomandanyclinicroomsthatwereinuse
CLINICDAYS2AND3-NOTESClinicdays2and3shouldbesimilartoday1withafewexceptions:1.Allclinicparticipantsshouldarrive15minuteslaterthenscheduledonday1(nositeorientation)
• ShiftSupervisorat9:15amforclinicsetup• Everyoneelseat9:30amforateamhuddleandroleassignments
o Roleassignmentsmaybenewstudentsorthesameaslastday2.Endofblockdebriefattheendofday3(20minutes)
• Students,preceptors,andstaffwillmeetinthemainconferenceroomtodoadebriefofthedayaswellasthefortheentireblock
• Thefollowingquestionscanbeusedasaguide:1. Didanythingsurpriseyouonlearningabouteachother’sroles?2. Wheredidyoufindrolesoverlapped?3. Whatroleswereuniquetoeachprofession?4. Howcanyouworktogethermorecloselytoaddressthepatient’sconcernseffectively?5. Knowingwhatyouknownow,howwillthischangehowyouworkwithpatient’s/other
professionals?6. Didyouidentifyanyactions,processes,orissuesthathelpedorinterferedwithgroup
functioning?
CHIUS Three Bridges (3B) Student Clinic 19
B.WELCOMEINFORMATIONFORM-FORSTUDENTSANDPRECEPTORSDear_______,PleasefindbelowsomeimportantinformationforyourperusebeforethestartofyourclinicshiftattheThreeBridgesclinic.Placementdates:_______Streetaddress:ThreeBridgesCommunityHealthCentreat1292HornbyStreet,Vancouver,B.C.,CanadaV6Z1W2YourShiftSupervisor:_______ShiftSupervisor’scontactinformation(emailandphone):_______Dresscode:BusinesscasualPleasebringapieceofIDshowingyouareeitheraUBCstudentorVCHemployee.Itisrecommendedyoubringaclipboardandpen/pencilfornote-takingpurposes.Transportation:Takingpublictransportationishighlyrecommended–theclinicisabouta3minutewalkfromtheYaletown-RoundhouseSkytrainstation,andiseasilyreachedbybusfromtheGranvilleSkytrainstation.Toentertheclinic,thereisadoormarkedwitha‘B’about10meterstotheleftofthemainentrancefacingHornbySt.Thisdoorleadstothemainconferenceroomandshouldbeunlocked.Ifitislocked,pleaseenterthroughthemainentranceandsigninwiththesecurityguardatthedoorandmakeyourwaytothemainconferenceroom(askthesecurityguardfordirections).Orientationchecklist:Itismandatorytocompletethefollowingchecklistbeforethestartofyourclinicblock:http://www.chius.ubc.ca/chius-clinic/chius-interdisciplinary-clinic/Suggestedpreparation:Familiaritywithinyourareaofpracticeinworkingwithpatientswithdiabetesandchronicpainishighlyrecommended.Knowledgeofcommonpracticesintheassessmentandtreatmentofthesepatients,aswellaslocalresourcesforreferralisadvised.
CHIUS Three Bridges (3B) Student Clinic 20
C.DOCUMENTSANDFORMS
QUEENSLANDPATIENTINTAKEFORMLinktodownloadorprint:http://chius-health.sites.olt.ubc.ca/files/2015/05/Queensland-Patient-Intake-Form.pdf
SUMMARYOFCAREPLANFORMLinktodownloadorprint:http://chius-health.sites.olt.ubc.ca/files/2015/05/Queensland-Patient-Intake-Form.pdf
PRECEPTORINVITATIONFORMLinktodownloadorprint:http://www.chius.ubc.ca/chius-clinic/chius-interdisciplinary-clinic/
CERTIFICATEOFAPPRECIATION–FORPATIENTSLinktodownloadorprint:http://www.chius.ubc.ca/chius-clinic/chius-interdisciplinary-clinic/
TEMPLATEFORCLINICSCHEDULELinktodownloadorprint:http://www.chius.ubc.ca/chius-clinic/chius-interdisciplinary-clinic/
TEMPLATEFORCLINICCALENDERLinktodownloadorprint:http://www.chius.ubc.ca/chius-clinic/chius-interdisciplinary-clinic/
ORIENTATIONCHECKLIST–FORSTUDENTSLinktodownloadorprint:http://www.chius.ubc.ca/chius-clinic/chius-interdisciplinary-clinic/
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