Combined form saves time for staff, patients

Streamlined intake reduces patient irritation

Think back to your last visit to the doctor. Were you asked the same questions about your symptoms or reason for visiting every time a different staff member entered the room?

Eliminating patient irritation with answering the same questions repeatedly and cutting staff time spent evaluating a patient were the goals of a combined rehabilitation services intake form developed by the William P. Clough Center in New London, NH, a nursing home affiliated with New London Hospital. The center also was spurred on by a recent state mandate by the state Medicare coordinator that providers be more efficient in the area of Medicare patient evaluations.

The form has worked well since the center began using it about a month ago, says Andy Macdonald, PT, director of rehab services at New London Hospital. "The therapists have been happy and sad about the form. It takes less time for them, but at the same time, they’re concerned that they can’t put as much detail on the form," he says.

The system consists of a combined intake form filled out by the first clinical staff member to see the patient for an initial evaluation. Information included on the form consists of presenting complaints, past medical history, and other information relevant to the patient’s medical condition. In addition, discipline-specific forms allow a physical therapist or occupational therapist to evaluate the patient based on standard evaluation criteria, such as range of motion or the ability to perform activities of daily living like dressing or bathing. (See insert for a copy of these forms.)

The information in the discipline-specific forms also conforms with criteria used by the MDS patient assessment instrument nursing homes are required to use, Macdonald says. "Our nurse who coordinates our MDS activities had trouble translating the therapist’s notes, so we started using MDS terms." For example, therapists now evaluate a patient’s range of motion on a scale of 0 to 2, consistent with MDS terminology, rather than listing range of motion by specific degrees.

So far, New London Hospital has used the form only in its nursing home but is considering trying it in other areas of its delivery system, Macdonald says.