Milestones
Milestones are hospital requirements that need to be met before a patient can be discharged. They are used by Nursing Units and Case Management to track and complete necessary tasks. If there is an issue with completing a milestone, a Delay Reason can be identified. This practice is crucial for discharge communication, reducing phone calls between departments, and capturing data related to discharge delays. This data helps Case Management identify common barriers and focus on process improvements.
Where you can find this feature: Electronic bedboard® view, PatientTracking Portal® application list views, PreAdmitTracking® application list views, Patient Search list view, Admits Today list view, Admin Tool or Admin > Settings > Capacity Management.
How Milestones Work
Functionality
Milestones are updated to reflect the discharge status of a patient. They can be marked as complete or delayed, with reasons for delays documented. This information is visible to all relevant hospital staff, reducing the need for phone calls and improving transparency.
Open Discharge Milestone Box: Click on the Milestone bar.
Mark Milestone as Complete: Check the box next to the Milestone name.
Select Delay Reason: Choose a Delay Reason from the drop-down menu if needed. Add notes if necessary.
Save Changes: Click "Save."
Milestone Indicators:
Green: Milestone complete.
Yellow: No delays.
Red: Active delays.
Hovering over the Milestone bar will provide additional details.
Milestones are configured to track a patient's progress toward transfer or discharge. You can set milestones as they are completed, mark delayed milestones, and send instant notifications to other staff members. Up to 10 discharge milestones can be configured.
Milestones are used to track key events in a patient's discharge or transfer process. They are essential for ensuring smooth transitions and timely updates. This feature is used by healthcare administrators and staff to manage patient flow and improve efficiency.
Enabling Milestones: The Master Configuration setting Use Discharge/Transfer Milestones must be enabled. A TeleTracking Technologies representative can assist with this.
Display Settings: Discharge milestones appear a certain number of hours before the expected discharge time, as determined by the Hours Before Expected Discharge setting.
Administration: Administrators can create, delete, edit, and set the order of milestones. Users can mark milestones as completed or delayed but cannot change their order.
Automatic Status Changes:
Completion of a discharge milestone can automatically change a patient's status to Confirmed Discharge.
Completion of a transfer milestone can mark a patient as "Ready-to-Move" if configured.
Automatic Completion: Transfer or discharge orders from the ADT system can automatically mark milestones as completed if configured.
Interface Messages: If a discharge milestone is marked completed and then an HL7-based message cancels the order, the milestone will no longer be marked as completed.
New Milestones: Newly added milestones will not apply to patients who already have a set of milestones.
Deletion of Milestones: Milestones already associated with a patient will not be removed even if deleted in the Admin Tool.
Status-Specific Milestones:
Only patients in Pending Transfer status can have transfer milestones.
Only patients in Pending or Confirmed Discharge status can have discharge milestones.
Discharge Milestones:
Physician Order: A physician's order is necessary before discharge, ensuring the decision is based on a medical assessment.
Family Notified: Informing the patient's family about the discharge to prepare them for the next steps in care.
Discharge Teaching: Providing necessary information about post-discharge care, medications, and other instructions.
Transfer Milestones:
Physician Order: Required before a patient can be transferred, ensuring the decision is made by a qualified medical professional.
Nurse-to-Nurse Report: Ensures effective communication between nursing staff about the patient's condition and care.
Transfer Prep: Involves preparing medical records, coordinating with transport services, and ensuring the receiving facility is ready.
Workflows
Updating Discharge Milestones
Click on the Milestone bar to open the Discharge Milestone box.
To make a Milestone complete, place a checkmark in the box to the left of the Milestone name.
To select a Delay Reason, click on the drop-down menu for the appropriate Milestone. The notes column is a free text field that you can use if needed.
Click "Save" once finished. The Milestones bar will now reflect the changes.
Milestone Indicators:
Green: A Milestone has been marked complete. As more Milestones are completed, the longer the bar gets.
Yellow: There are no delays set.
Red: There are active delays.
Hover over the Milestone bar to get additional details.
Note: All milestones do not need to be checked before you can discharge a patient out of TeleTracking. If you want to set a delay, make sure the Milestone is not also checked as Complete.
Identifying Discharge Delay Reasons
Click on the Milestone (multi-color bar).
Select a delay reason from the drop-down menu.
Add notes if appropriate.
When the delay is complete, check off the box in the complete column.
Save and close.
Sending a Milestone Notification
Open Milestone Box: Click "Send Notifications" in the lower right corner.
Search and Type Message: Find the user or group, type your message.
Include Patient Information: Check the "Include Patient Information" box if needed.
Send Notification: Click "Save" to send the message.
Sending A Milestone Notification
If you set a delay, there is also an option to send an alert to a user or group regarding the delay. This is not required functionality, but it is very useful if you need to bring a delay to someone’s attention.
In the lower right corner of the Milestone box, Click the Send Notifications button.
In Search Users and Groups, find the user or group you wish to send the message to
Type Message
If you wish to Include Patient Information in the message, check the box in the upper left corner.
Click Send
Setting Milestones
Transfer Milestones: Set on the electronic bedboard® view, placement list views for patients in Pending Transfer status, Patient Search list view, or Admits Today list view.
Discharge Milestones: Set on the electronic bedboard® view for patients in Pending Discharge or Confirmed Discharge status. Discharge milestone icons and progress bars appear in the PatientTracking Portal® and PreAdmitTracking® application list views.
Displaying Milestone Progress
For PreAdmitted or Inhouse Patients: You can choose to display the progress bar or icon for patients in these statuses, even though discharge planning often begins as soon as the patient is admitted.
Permissions
Viewing and Changing Milestones: If you do not have the required permissions, you can access the Set Milestone Detail dialog box to view it but cannot make changes.
Managing Milestones
Customizing List Views: Ensure the Milestone column or the M column appears on list views to make milestone-related changes. Refer to "Customizing Columns and Layouts on List Views" for instructions.
Marking Milestones:
Click the progress bar or icon in the Milestone column to mark milestones as completed, delay them, change the projected discharge date, or send an instant message.
Sending Notifications: Send instant messages about a patient's milestone status to other staff members.
Editing Projected Discharge Date: Adjust the projected discharge date if a delayed milestone extends the patient stay.
Status Changes:
If a discharged patient's status changes to Inhouse, previous discharge milestones remain in Completed status.
If a patient's status changes to Pending Transfer again, a new set of transfer milestones will be applied.
Permissions Required
Edit Discharge Milestone: To set discharge milestones.
Edit Transfer Milestone: To set transfer milestones.
Allow Sending Milestone Notifications: To send instant messages.
Allow Disabling Discharge Milestone Automatic Timer Alerts: To prevent automatic notifications about discharge delays.
Milestones
Milestones are hospital requirements that need to be met before a patient can be discharged. They help track discharge progress and any delays. This feature is used by Nursing Units, Case Management, Patient Placement, and other hospital staff to ensure smooth discharge processes and effective communication.
Where you can find this feature: Discharge Milestone Box, Milestone bar.
Setting or Viewing Discharge and Transfer Milestones
Discharge and transfer milestones are used by healthcare staff to track patient progress and ensure all necessary steps are completed before a patient is discharged or transferred. This feature is essential for maintaining patient flow and ensuring timely discharges and transfers.
Where you can find this feature: PatientTracking Portal®, PreAdmitTracking® application, electronic bedboard® view.
How Setting or Viewing Discharge and Transfer Milestones Works
Functionality
Discharge milestone icons in the M column in the PatientTracking Portal® application list views and discharge milestone progress bars in the Milestone column in the PreAdmitTracking® application list views or on the electronic bedboard® view appear only for patients who are in Pending/Confirmed Discharge status. However, you can choose to display the progress bar or icon for a patient who is in the Inhouse or PreAdmit status.
To display discharge milestone progress for a preadmitted or inhouse patient:
On the list view, in the Milestone or M column that corresponds to the preadmitted or Inhouse patient, click the colored progress bar or icon to display the Set Milestone Detail dialog box.
On the Set Milestone Detail dialog box, do one or both of the following:
Select the Display Milestone Progress on Console for Any Active Patient Status check box to display the discharge milestone progress bar in the Milestones column in the PreAdmitTracking® application list views or to display the icon in the M column in the PatientTracking Portal® list views for this patient.
Select the Display Milestone Progress on Bed Board for Any Active Patient Status check box to display the discharge milestone progress bar on the electronic bedboard® view for this patient.
Click Save or Save and Close.
Milestones (Discharge or Transfer) and "M" Columns
Milestones and "M" Columns are used in the PatientTracking Portal® to track patient discharge or transfer statuses. These features help healthcare professionals monitor and manage patient progress efficiently. They are used when patients are in Pending Discharge, Confirmed Discharge, or Pending Transfer status.
Where you can find this feature: PatientTracking Portal® application list views, PreAdmitTracking® application list views, and the electronic bedboard view.
How Milestones and "M" Columns Work
Functionality
Milestones Column:
Displays milestones and the patient's projected discharge date.
Milestones with check marks are completed.
Colored bars indicate milestone progress:
Green: Percentage of completed milestones.
Red: Delayed milestones.
Yellow: Incomplete milestones.
Users with the appropriate permissions can mark milestones as completed or delayed, enter comments, or change the projected discharge time.
"M" Column:
Displays icons representing milestone statuses:
Completed: All milestones are completed.
Delayed: At least one milestone is delayed.
In Progress/Incomplete: No milestones are delayed, but at least one is not completed.
Users with the appropriate permissions can mark milestones as completed or delayed, enter comments, or change the projected discharge time.
Workflows
Viewing Milestones:
Hover over the Milestones column to view milestones and projected discharge dates.
Icons in the "M" column provide a quick status overview.
Editing Milestones:
Click in the Milestones or "M" column for patients in Pending Discharge, Confirmed Discharge, or Pending Transfer status.
Mark milestones as completed or delayed, enter comments, or change the projected discharge time.
Displaying Milestones for Different Statuses:
By default, discharge milestone icons and progress bars appear only for patients in Pending/Confirmed Discharge status.
Optionally, display progress bars or icons for patients in Inhouse or PreAdmit status to facilitate early discharge planning.
Configuring Milestones (Discharge and Transfer)
A milestone is a requirement that should be met before a patient in Pending Transfer status can be transferred or before a patient in Pending or Confirmed Discharge status can be discharged. Often, a series of milestones should be completed before a patient can be transferred or discharged.
Examples of transfer milestones:
Physician Order
Nurse-to-Nurse Report
Transfer Prep
Examples of discharge milestones:
Physician Order
Family Notified
Discharge Teaching
In the Milestone Setup section of the Admin Tool or Admin > Settings > Capacity Management component, you can:
Add and delete milestones. However, you cannot edit the text of existing milestones.
Change the order in which milestones are to be completed.
Set whether the completion of a transfer milestone automatically marks a patient Ready-to-Move (Trigger RTM).
Set whether the completion of a discharge milestone automatically changes a patient's status to Confirmed Discharge (Trigger ConfD).
Add and delete delay reasons for milestones.
Icons can be selected to appear on list views in the PatientTracking Portal® application to indicate that a milestone is delayed, completed, or in progress. These icons must be uploaded first through the Icon Management section of the Admin Tool or Admin > Settings > Capacity Management component.
Workflows
To Access the Set Milestone Detail Dialog Box or a Quick View of Milestones
From a list view:
Click a tab to display a list of patients, and then filter the list to display the patient you want to view.
To set transfer milestones, select the Admits Today list view or a placement list view.
To set discharge milestones, select the Pending/Confirmed Discharge list view.
Go to PreAdmitTracking® application > List Views > to display a list of patients, and then filter the list to display the patient you want to view.
To set transfer milestones, select the Admits Today list view or a placement list view.
To set discharge milestones, select the Pending/Confirmed Discharge list view.
Go to Clinical Operations > PreAdmitTracking® application > If your health system is configured for multiple instances of the Capacity IQ® Solution, select the instance name > tab, to display a list of patients, and then filter the list to display the patient you want to view.
To set transfer milestones, select the Admits Today list view or a placement list view.
To set discharge milestones, select the Pending/Confirmed Discharge list view.
Click a tab, and then click the magnifying glass icon and select a unit to display a list of patients.
To set transfer milestones, select a placement list view.
To set discharge milestones, select the Pending/Confirmed Discharge list view.
Go to PatientTracking Portal® > List Views > , and then click the magnifying glass icon and select a unit to display a list of patients.
To set transfer milestones, select a placement list view.
To set discharge milestones, select the Pending/Confirmed Discharge list view.
Go to Clinical Operations > PatientTracking Portal®, and if your health system is configured for multiple instances of the Capacity IQ® Solution, select the instance name > tab, and then click the magnifying glass icon and select a unit to display a list of patients.
To set transfer milestones, select a placement list view.
To set discharge milestones, select the Pending/Confirmed Discharge list view.
To see a quick view of milestones and their progress, move your mouse over the Milestone or M column to display a tooltip.
Tooltip indicators:
Green checkmark: A milestone is completed.
Red exclamation point: A milestone has been delayed and is not yet completed.
Discharge Threshold Exceeded: Indicates that the total time limit set for discharge has expired and the patient is still not discharged.
Proj. Discharge: The patient's projected discharge date appears at the bottom of the tooltip.
In the Milestone column, click the colored progress bar to display the Set Milestone Detail dialog box.
Discharge Threshold Exceeded
The administrator can set as many as two time limits for each unit regarding when users should be alerted if a patient has not yet been discharged from the unit within a certain amount of time after the Physician Order discharge milestone is set. The time limits are called "thresholds." If the time limits have passed and the patient is still not discharged, then subscribing users receive notifications and the Discharge Timer column in the Pending/Confirmed Discharge list view becomes yellow or red. If "Discharge Threshold Exceeded" appears, then the total time limit that was set has expired and the patient is still not discharged.
Milestones Configuration
Milestones are used to track patient discharge and transfer processes. This feature is essential for ensuring smooth transitions and efficient patient flow. It is used by administrators and healthcare staff to manage and monitor patient statuses.
Where you can find this feature: Admin Tool menu or Admin > Settings > Capacity Management.
How Milestones Work
Functionality
Enabling Milestones: A Master Configuration setting called Use Discharge/Transfer Milestones must be enabled. Contact a TeleTracking Technologies representative for assistance.
Displaying Milestones: The Hours Before Expected Discharge and Time to Show Discharge Milestones When Patient in Pending Discharge Status settings determine when discharge milestones appear. Verify the current time is earlier than the specified time if milestones are not appearing.
Discharge Order Sets ConfD: If enabled, a discharge order from the ADT system can change a patient's status to Confirmed Discharge.
Status Changes: If a discharged patient's status changes to Inhouse, previous discharge milestones remain completed. If changed to Pending Transfer, new transfer milestones are applied.
Adding New Milestones: New milestones are not applied to patients with existing milestones. Deleting milestones does not remove them from patients.
Permissions Required
Admin Tool Menu Permission: Required to access the Admin Tool menu or Admin > Settings > Capacity Management.
Milestone Setup Permission: Required to complete milestone configuration tasks.
Workflows
Accessing the Milestone Pages
Admin Tool Menu: Click Milestone Setup > Transfer Milestones or Milestone Setup > Discharge Milestones.
Admin Settings: Go to Admin > Settings > Capacity Management > Milestone Setup > Transfer Milestones or Milestone Setup > Discharge Milestones.
Adding a Milestone
On the Discharge Milestones or Transfer Milestones page, click Add to add a blank box to the Name column.
Type the milestone name in the blank box.
(Discharge Milestones Only) Associate an ADT ID with each milestone except Physician Order. Enter the ADT ID code in the ADT ID column.
Click Save.
Changing Milestone Order
In the Sort Order column, click the up or down arrow for a milestone to adjust its position.
Click Save.
Setting a Discharge Milestone to Change Patient's Status
On the Discharge Milestones page, in the Trigger ConfD column, click the gray Disabled button to change it to a green Enabled button.
Click Save.
Setting a Transfer Milestone to Mark a Patient Ready-to-Move
On the Discharge Milestones page, in the Trigger RTM column, click the gray Disabled button to change it to a green Enabled button.
Click Save.
Selecting Delay Reasons for Milestones
On the Discharge Milestone or Transfer Milestone page, click Delay Reasons to display the Delay Reasons dialog box.
Select the milestone and click the plus sign button to add a blank box.
Type a reason in the blank box.
Enter the ADT ID code in the ADT ID column.
To remove a reason, click the X beside the reason.
Click Save on the Delay Reasons dialog box, then click Save again on the Milestones page.
Milestone Notes and Icons Configuration
This documentation explains how to configure milestone notes and status icons in the Capacity IQ® and PatientTracking Portal® applications. This feature is used by administrators to manage milestone comments and visual indicators for milestone statuses.
Where you can find this feature: Discharge Milestone page, Transfer Milestone page, and Milestone Configuration page in the Admin Tool.
How Milestone Notes and Icons Configuration Works
Functionality
Setting Whether Milestone Notes Overwrite or Are Appended
If you entered an ADT ID for a milestone, you can select whether notes from the ADT system overwrite or are appended to existing milestone comments in the Capacity IQ® solution.
To set this:
On the Discharge Milestone page, in a row for any milestone where you have entered an ADT ID, go to the Note Update Method column.
Select one of the following options:
Overwrite: Only the latest notes from the ADT system will appear, and notes from the last ADT transaction plus manually entered comments will be removed.
Append: The latest notes from the ADT system will be added to the beginning of notes from previous ADT transactions and manually entered comments.
Workflows
Setting Note Update Method
Navigate to the Discharge Milestone page.
Locate the milestone with the ADT ID.
In the Note Update Method column, select either Overwrite or Append.
Deleting a Milestone
Go to the Transfer Milestone or Discharge Milestone page.
Select the check box for the milestone to delete.
Click Delete Selected Records.
Confirm the deletion by clicking OK.
Important Note: Deleted milestones cannot be reactivated.
Selecting Icons to Represent Completed, Delayed, and In Progress (Incomplete)
You can select icons to appear on list views in the PatientTracking Portal® application to indicate milestone statuses.
To select icons:
Ensure the icons you want to use have been uploaded through the Icon Management section of the Admin Tool or Admin > Settings > Capacity Management component.
Display the Milestone Configuration > Status Icon Configuration page by doing one of the following:
Go to Admin Tool > Milestone Setup > Milestone Configuration.
Go to Admin > Settings > Capacity Management > Milestone Setup > Milestone Configuration.
Next to Completed, Not Completed, or Delayed, click the magnifying glass icon to display the Select an Image window.
In the Select an Image window, click the icon that should represent the Completed, Not Completed (incomplete, but not delayed), or Delayed status, and then click OK.
Electronic Bedboard
Electronic Bedboard is used by healthcare professionals to track patient milestones and manage bed occupancy efficiently. It helps in monitoring patient progress, managing delays, and ensuring timely discharges. This feature is used throughout the patient care process to enhance workflow and communication.
Where you can find this feature: Electronic Bedboard view.
How Electronic Bedboard Works
Functionality
Milestone Indicators:
Green checkmark: A milestone is completed.
Red exclamation point: A milestone has been delayed and is not yet completed.
Discharge Threshold Exceeded: Alerts users if a patient has not been discharged within set time limits.
Tooltip Information:
Hover over cells with a T (green), D (blue), or c (red) to see milestone details.
Proj. Discharge: Displays the patient's projected discharge date.
Milestone Management:
Mark a Milestone Completed:
Select the checkbox in the Completed column.
Add comments in the Notes column.
Click Save or Save and Close.
Delay a Milestone:
Select a delay reason in the Delay Reason column.
Add comments in the Notes column.
Click Save or Save and Close.
Milestone Details:
View the date, time, and user responsible for the latest milestone update in the Last Updated and Updated by columns.
Instant Messaging:
Send notifications to users or groups.
Customize recipient list and message content.
Include patient information if enabled in settings.
View message history and delivery status.
Discharge Alerts:
Prevent automatic alerts by selecting the Don't Send Automatic Discharge Timer Alerts checkbox.
Requires specific permissions to disable alerts.
Projected Discharge Date and Time:
Update the projected discharge date and time using the calendar icon.
Ensure the time format is ##:## AM or PM.
Workflows
Accessing and Configuring Electronic Bedboard
Access the Electronic Bedboard view.
Configure the view as needed.
Viewing Milestone Progress
Hover over cells with a T (green), D (blue), or c (red) to display a tooltip.
Check milestone status and projected discharge date.
Managing Milestones
Marking a Milestone Completed:
Open the Set Milestone Detail dialog box.
Select the checkbox in the Completed column.
Add comments in the Notes column.
Click Save or Save and Close.
Delaying a Milestone:
Open the Set Milestone Detail dialog box.
Select a delay reason in the Delay Reason column.
Add comments in the Notes column.
Click Save or Save and Close.
Viewing Milestone Updates:
Open the Set Milestone Detail dialog box.
Check the Last Updated and Updated by columns for details.
Sending Instant Messages
Open the Set Milestone Detail dialog box.
Click Send Notifications to open the Milestone Notifications window.
Search and select recipients or groups.
Customize the message and include patient information if enabled.
Click Send and review the notification history.
Preventing Discharge Alerts
Open the Set Milestone Detail dialog box.
Select the Don't Send Automatic Discharge Timer Alerts checkbox.
Click Save or Save and Close.
Changing Projected Discharge Date and Time
Open the Set Milestone Detail dialog box.
Click the calendar icon and select a date.
Enter the time in the format ##:## AM or PM.
Click Save or Save and Close.