AUTOMATION OF INPATIENT TREATMENT PLANNING
ANIL MITRA, copyright © December 2004

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INTRODUCTION

Treatment plans – coordinate treatment and documentation, reimbursement, licensing

Preliminary Treatment Plan – within 2 hours of admission. Master Treatment Plan – 36 to 72 hours

IMPLEMENTATION

Microsoft Word XP and 2000: FORMS and VISUAL BASIC

ADVANTAGES OF THE AUTOMATION

Medical Necessity – can be forced or encouraged: drop down customizable problem lists

Efficiency – problem statements through menus with option to customize. Problems may be added, removed. Formatting, dates, repetition is automated. Automation of training and help. Print first, any, all pages

A single template is used for preliminary and master plans – change from preliminary to master is automated: only custom new data needs entry; plans may be edited for use in subsequent admissions

Training and tutorial – the template lends itself to tutorial format

Professional appearance and content. Suggestions for improvement easily implemented

Security

Flexibility – customizable, can be viewed / edited from multiple workstations [simultaneous editing not possible]

USE | DEMONSTRATION

Preparation: nurse will have client data and assessment –reason for admit and problems– before entry

Opening a plan: new vs. existing

Enter information: the sequence of operations is “manifest”

Navigation: TAB SHIFT+TAB ¯ CTRL+HOME CTRL+END … MOUSE-POINTER SCROLL

Visual cues: demonstrate selection of items to enter [form fields]

Edit or modify an existing plan: as for entry

Demonstrate editing, adding, deleting, and interchanging problems and goals

Help text: some items have help cues – see status bar or press F1

Complete the plan: Review | Save | Print and exit

NEEDS AND PLANS

Improve drop-down lists; lists for medical concerns

Other kinds of problems: s/r, social, generic, placement. Other problem statements:

Automate problem ® goal ® intervention

Use letters –and description– for Axis IV? Code in this information

Automate SW entries: meet with SW

Sequence under use | demonstration – streamline TREATMENT PLANNING toolbar

Improve automation of training and help

Remove built in toolbars

Security: meet with IS

Consistency: cannot have more than one plan open on one computer

Cannot have any other word documents open – or warning

May have read-only [html] format open; this will need update of html format

Current F:/ version needs update or eliminate

Use of old plans | date stamp

Date stamp in filename or other properties

When opening an existing plan give the following options

Change preliminary | master status; if master ® preliminary, must change date?

Review automation of master ® preliminary change

If attempt to use save dialog before initial, then disallow?

Change date

If status and or date changed, must re-save

Nursing, SW, MD: feedback – lists, cues, problems

Automation, development – later

Code items: repeated code as sub/function, modules; dim; line level modules, enumerating heterogeneous items; _change vs. _click; faulty object: textentry; hierarchy: field, line, group; process hierarchy: rewrite, add/delete, automate entry, up/dn

Cross check number of problems, goals for consistency: each Problem will have at least one stg, one ltg… show this information

Automating the automation: code to generate forms/code; data entry forms; Q & A format and problem suggestion

Allow customization of environment, specifications – problems, goals, interventions etc. – and directories

Learning aspects: store problem definitions etc. in a text file that can be edited from a main console [or separately]; learning = processing integrated with memory

Accessing databases: client, medications, DSM IV

Object oriented code