Action 5.10

Clinicians use relevant screening processes:

a. On presentation, during clinical examination and history taking, and when required during care

b. To identify cognitive, behavioural, mental and physical conditions, issues, and risks of harm

c. To identify social and other circumstances that may compound these risks

Intent

Patients receive initial and, if necessary, repeated screening for cognitive, behavioural, mental and physical conditions, issues or risks of harm.

Reflective questions

What processes are used for screening patients at presentation, during clinical examination, at history taking and at other appropriate times?

Are the tools that are used validated, and do these screening processes have the capacity to identify cognitive, behavioural, mental and physical conditions, issues or risks of harm?

Do these screening processes have the capacity to identify social and other circumstances that may compound the risks?

Key tasks

  • Work with clinicians to integrate screening processes into their workflow.

  • Develop information about screening processes to include in orientation, education and training programs.

  • Develop strategies and processes for clinicians to provide feedback about the usability and effectiveness of screening processes.

Strategies for improvement

Hospitals

Work with clinicians in different clinical settings and services to integrate the use of screening processes into their workflow. This may include requiring that credentialed medical and other practitioners use screening tools during clinic appointments before a planned episode of care. Ensure that processes identify:

  • When routine screening will occur in an episode of patient care
  • The role and responsibilities of those who are responsible for screening individual patients
  • The process for ensuring that action is taken when conditions or risks are identified through the screening process
  • Indications for repeating the screening process.

Provide orientation, education and training for clinicians to understand their individual roles, responsibilities and accountabilities in using relevant screening processes. Clinicians require training about organisational processes, as well as more specific training about the use of these processes at the ward, unit or service level.

Topics to cover in education for clinicians include:

  • When and how to use relevant screening processes and tools
  • How to partner with patients, carers and families to optimise the identification of relevant information
  • What assessments and actions to take when cognitive, behavioural, mental and physical conditions or issues, or risks of harm are identified
  • When to repeat screening processes to identify evolving conditions, issues or risks of harm
  • How to provide feedback about any issues with screening tools and processes.

Involve clinicians and consumers in reviewing the effectiveness and usefulness of screening processes. Develop processes for ensuring that updates and changes to screening tools and processes are effectively communicated to clinicians. This may involve developing specific, targeted implementation strategies to ensure that clinicians understand how to use and apply newly developed processes in their work, and have opportunities to provide feedback about usefulness and effectiveness of these processes.

Day Procedure Services

Work with clinicians to integrate the use of screening processes into their workflow. In the day procedure setting, this largely relates to processes for pre-admission screening. Referring clinicians may be required to use specific screening tools during clinic appointments before a planned episode of care. The service may also need processes for nurses undertaking pre-admission screening to refer patients for further specialist screening – for example, to identify anaesthetic risks.

Ensure that processes identify:

  • When routine screening will occur in an episode of patient care
  • The roles and responsibilities of those who are responsible for screening individual patients
  • The process for ensuring that action is taken when conditions or risks are identified through the screening process
  • Indications for repeating the screening process.

Tailor orientation, education and training for clinicians so that they understand their individual roles, responsibilities and accountabilities in using relevant screening processes. Clinicians require training about organisational processes, as well as more specific training about the day procedure service’s processes.

Topics to cover in education for clinicians include:

  • When and how to use relevant screening processes and tools
  • How to partner with patients, carers and families to optimise the identification of relevant information
  • Criteria for admission to the service, and processes for referring patients who do not meet these criteria for alternative care
  • What assessments and actions to take when cognitive, behavioural, mental or physical conditions, issues or risks of harm are identified
  • When to repeat screening processes to identify evolving conditions, issues or risks of harm
  • How to provide feedback about any issues with screening tools and processes.

Involve clinicians and consumers in reviewing the effectiveness and usefulness of screening processes. Develop processes for ensuring that updates and changes to screening tools and processes are effectively communicated to clinicians. This may involve developing specific, targeted implementation strategies to ensure that clinicians understand how to use and apply newly developed processes in their work, and have opportunities to provide feedback about usefulness and effectiveness of these processes.

Examples of evidence

Select only examples currently in use:

  • Policy documents or by-laws that outline processes for conducting screening and identify
    • when routine screening will occur in an episode of patient care
    • the roles and responsibilities of members of the workforce who screen patients
    • the process for taking action when risks are identified
    • indications for repeating the screening process
  • Observation of clinicians’ practice that shows use of relevant screening processes
  • Records of interviews with clinicians that show that they understand the health service organisation’s screening processes
  • Training documents about organisational screening processes
  • Communication with clinicians about updates to screening processes
  • Tools or a healthcare record that include prompts to clinicians to conduct routine screening
  • Risk assessment tool that is in use throughout the health service organisation
  • Audit results of healthcare records for screening at presentation, during clinical examination and history taking, and when required during care; the audit should be done in collaboration with patients, carers and families
  • Audit results of healthcare records for completion of history taking for patients that demonstrate that social or other circumstances that may increase a patient’s risk are recorded
  • Observation of clinicians screening patients according to the health service organisation’s policies, procedures or protocols
  • Feedback from patients and carers about screening.
MPS & Small Hospitals

Work with clinicians in different clinical settings and services to integrate the use of screening processes into their workflow. This may include requiring that credentialed medical and other practitioners use screening tools during clinic appointments before a planned episode of care. Ensure that processes identify:

  • When routine screening will occur in an episode of patient care
  • The role and responsibilities of those who are responsible for screening individual patients
  • The process for ensuring that action is taken when conditions or risks are identified through the screening process
  • Indications for repeating the screening process.

Provide orientation, education and training for clinicians to understand their individual roles, responsibilities and accountabilities in using relevant screening processes. Clinicians require training about organisational processes, as well as more specific training about the use of these processes for the different services provided.

Topics to cover in education for clinicians include:

  • When and how to use relevant screening processes and tools
  • How to partner with patients, carers and families to optimise the identification of relevant information
  • What assessments and actions to take when cognitive, behavioural, mental and physical conditions, issues or risks of harm are identified
  • When to repeat screening processes to identify evolving conditions, issues or risks of harm
  • How to provide feedback about any issues with screening tools and processes.

Involve clinicians and consumers in reviewing the effectiveness and usefulness of screening processes. Develop processes for ensuring that updates and changes to screening tools and processes are effectively communicated to clinicians. This may involve developing specific, targeted implementation strategies to ensure that clinicians understand how to use and apply newly developed processes in their work, and have opportunities to provide feedback about usefulness and effectiveness of these processes.

Last updated 29th May, 2018 at 11:35pm
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