Pneumonia

What is the problem? The admitting physician must determine if the patient meets the criteria for a pneumonia vaccine and then whether the patient has already received the vaccine in the past year. If the patient meets the criteria, the physician may be hesitant to approve the vaccine due to uncertainty about if or when it was last administered. Often the patient does not remember and the doctor does not have the patient’s non-hospital record at his or her fingertips.   

How are we fixing it? We are working on a process involving our Pharmacy Department. The patient’s nurse will do the preliminary screening to determine if the patient meets the vaccine criteria. If the patient meets the criteria, the pharmacist will research hospital records and, if necessary, contact the doctor’s office to determine vaccine date. The pharmacy will then enter the order for the vaccine. 

What is the problem? Patients will occasionally refuse to have counseling to stop smoking. When this occurs, hospital staff must document that the patient did not receive counseling because they refused. On occasion documentation of the refusal is not entered into the medical record.

How we are fixing it? All patients are screened for whether or not they have smoked in recent months. Valley West offers all patients who smoke or have smoked in the previous 12 months written materials regarding how to quit, along with resources to help with quitting; this must be documented. A respiratory therapist will also visit with the patient and provide individual smoking cessation counseling.