Adapted form: More than Medical: the impact of social determinants of health on utilization risk
Age and Gender: 29-year-old female
Social: Rents a room in a house in Pigtown, does not have a car, she reports she does not have a strong support system, reports her stress level is a 8/10, and is unemployed.
Primary Medical History: Diabetes, Thrombosis (feet), Bipolar disorder
Medication taken at this time: None
Providers she is currently working with: None but visited ED last week due to “high sugar”
Pt story:
She comes to Paul’s Place for clothes and food about 3 times a week. She decides to stop by the clinic because her friend told her she should talk to the nurses. She is unsure what help the clinic can provider or what she needs. She states she has been to the ED 25 times in the last year for care and does not need anything at this time.
Nurses Clinic Manual
One for Clinic and (one or subset for GE )
- Overview and objective
- What do we mean by pt centered care, trauma informed care, respect and dignity
- Orientation and training checklist
- Huddle
- Recruitment of guests for H&W
- Registration
- Social determinants of health assessments
- Goal of visit
- Paperwork
- Charts
- Forms
- Types
- What to review before starting case: (crisis, stress, prior notes, med history, etc)
- Clinic supplies
- Station kits assignment and stocking
- Additional supplies in closets
- Guest encounter – assessment, intervention, referrals
- Typical cases
- Typical conversations
- Typical probing questions
- To get more information
- To assess health comprehensively
- Typical interventions and referrals
- Important metrics and how to address e.g., Plan of care, PCP, insurance, ED diversion, meeting goal, etc
- Working with an IPE team
- Value of each member (proposed scope)
- How to include them
- How each member does their assessment, delivery of intervention, delivery of referrals
- How to communicate and assign tasks in front of guests
- Common problems and solutions
- Guests (e.g., multiple conflicting priorities, elevated guests and deescalation)
- IPE (e.g., IPE classmates not present during whole case)
- Clinic (e.g., unsure of resources)
- Resources
- Documentation of visit
- Reporting off to your instructor
- Instructor vs station nurse
- Debrief
- Sharing a positive story in next week’s huddle
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