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"Homeward Bound" |
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Systems Based Practice
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Now compare your responses to the suggestions below: |
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| Function | PCP, CRCT or Both | Comments | |
| Evaluate patient when he gets sick | Both | Ideally the PCP is the medical home and provides primary care services to Brian. However, there is often a period of transition for complex or unstable patients. Brian’s mother may prefer to bring him back to the CRCT for even minor problems until she gains confidence in her new doctor. Dr. Stark may be uncomfortable with some of Brian’s problems and prefer this arrangement as well. In some cases a qualified PCP is never located for the child and the CRCT continues to provide a mix of primary and specialty services. Since Brian is enrolled in a Medicaid Managed Care Program, the CRCT must have referral authorization to see Brian, though no referral is necessary for him to be evaluated in the Emergency Dept., and hospital admission, if indicated, does not require authorization by his PCP. | |
| Provide well-child care and immunizations | PCP | Brian should follow standard recommendations for well child care and immunizations. This can be an important step in facilitating development of comfort for both parent and PCP in receiving services from the PCP. | |
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Assess
developmental progress |
PCP/CRCT |
The
PCP will assess development as a part of routine well-child care.
Detailed assessment will probably occur during routine CRCT visits.
Developmental progress will be followed by the local infant
stimulation program as well. |
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Determine
equipment needs |
CRCT |
A
PCP may determine needs for some equipment.
PCP authorization may be needed on forms for equipment such as a
wheel chair.
Measurements for a wheelchair would likely occur at the time of a
CRCT visit.
The CRCT social worker would then complete the forms for durable
medical equipment and fax to the PCP for signature. |
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Authorize
disposable supplies |
PCP |
If
Brian needs more disposable supplies, such as suction catheters, his
mother will notify the vendor, who will complete forms and fax to the PCP
for signature. |
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Review
and sign orders for Home Health Assistance |
PCP/CRCT |
Once
it is determined that in-home services are needed, the orders
and the chart notes are faxed to the home health
agency preferred by the family, and arrangements are made for services to
begin. The
inpatient social worker does this.
Modifications to the plan or additional orders are signed by the
ordering physician.
For example, if Brian needs to have albuterol nebs q 2-4 hours for
several days when he develops a URI, the home health nurse may call Dr.
Stark for a verbal order which will be faxed or mailed for signature. Or
Dr. Stark may supply written orders at the time of an office visit.
Changes in care developed at the time of a CRCT visit will be
signed by CRCT physicians.
A HHN may even accompany Brain to either facility for office
visits. |
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Refer
to specialists |
PCP |
Even
if the specialists have been providing services in the hospital, (such as
CRCT or ENT) a referral for outpatient services is necessary.
Office personnel will call Dr. Stark for referral if referral
authorization has expired, but Dr. Stark should attempt to fax the
appropriate referral paperwork prior to visits. |
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Hospitalize |
CRCT/PCP |
If at all possible, hospitalizations should be at a pediatric
hospital, at least while Brian is very young. Local
facilities vary in their ability to deal with unstable small children, and
determination of location for hospitalization must be individualized. |
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Determine
when trache and feeding catheter can be removed |
CRCT
in consultation with ENT or Surgery |
PCP
must authorize specialist services |
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