Info
About Milestones
Milestones are key events or requirements that need to be fulfilled before a patient can move to the next stage in their healthcare journey. Let's break down the examples you've given:
Transfer Milestones:
Physician Order: Before a patient can be transferred, a physician's order is required. This ensures that the decision to transfer the patient has been made by a qualified medical professional.
Nurse-to-Nurse Report: Communication between nurses is crucial during patient transfers. This milestone ensures that relevant information about the patient's condition and care is effectively communicated between the nursing staff.
Transfer Prep: This milestone likely involves the necessary preparations for the physical transfer of the patient. It could include tasks such as preparing the patient's medical records, coordinating with transport services, and ensuring that the receiving facility is ready to accept the patient.
Discharge Milestones:
Physician Order: Similar to the transfer process, a physician's order is necessary before a patient can be discharged. This ensures that the decision to discharge is based on a medical assessment.
Family Notified: Informing the patient's family about the impending discharge is important for several reasons, including preparing them for the next steps in the patient's care and addressing any concerns or questions they may have.
Discharge Teaching: Providing the patient and their family with necessary information about post-discharge care, medications, and any other relevant instructions. This education is crucial for a smooth transition from the healthcare facility to home or another care setting.
These milestones help ensure a systematic and coordinated approach to patient transfers and discharges, promoting patient safety and continuity of care. The specific milestones may vary between healthcare institutions, but the general principle of having key requirements before a transfer or discharge is consistent across the healthcare industry.
In order to monitor a patient's progress toward transfer or discharge, you have the ability to set discharge or transfer milestones as they are completed. Additionally, you can mark any delayed milestones and send instant notifications to other staff members.
You may set transfer milestones on the electronic bedboard® view view, on any placement list views that display patients who are in Pending Transfer status on the Patient Search list view, or on the Admits Today list view.
You may set discharge milestones on the electronic bedboard® view, on the Pending/Confirmed Discharge list view, on the Patient Search list view, or on a list view that displays patients who are in Pending Discharge or Confirmed Discharge status. By default, 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 Capacity IQ® PreAdmit application list views or on the electronic bedboard® view appear only for patients who are in Pending/Confirmed Discharge status. However, as discharge planning often begins as soon as the patient is admitted, you can choose to display the progress bar or icon for a patient who is in the In-house or Pre-Admit status. See To Display Discharge Milestone Progress for a PreAdmitted or Inhouse Patient
If you do not have the permissions listed in Permissions Required, you can access the Set Milestone Detaildialog box to view it. But you may not change it.
Before You Set Milestones
Here is some important information:
It's important to note that for milestones to be available, a Master Configuration setting called Use Discharge/Transfer Milestones must be enabled. A TeleTracking Technologies representative can assist your organization in enabling this setting.
The list views display discharge milestones a certain number of hours before the patient's expected discharge time. This is determined by a Master Configuration setting called Hours Before Expected Discharge and Time to Show Discharge Milestones When the Patient is in Pending Discharge Status. This setting determines the number of hours before a patient's projected discharge date and the time that discharge milestones will begin to appear for the patient on list views. If you're experiencing issues with discharge milestones not appearing, it's important to verify that the current time is earlier than the time specified through this setting. If you have any questions or need assistance, a TeleTracking Technologies representative can help enable this setting for your organization.
The administrator creates, deletes, edits, and sets the order of milestones in the Admin Tool or Admin > Settings > Capacity Management. A user can mark a milestone completed or delayed, but cannot change its order, remove it, or add a new one.
The administrator can select to have the completion of a discharge milestone change a patient's status to Confirmed Discharge automatically.
The administrator can select to have the completion of a transfer milestone mark a patient "Ready-to-Move" automatically. If more than one transfer milestone is configured to mark a patient "Ready-to-Move" when completed, all of those configured milestones must be completed for the patient to be marked "Ready-to-Move" automatically.
A transfer order or discharge order from the ADT system could automatically mark a milestone as completed if the administrator configured it that way. For example, the administrator could have configured Diagnostic Testing milestone to be marked completed automatically if a transfer order is received from the ADT system.
If a patient is in Confirmed Discharge status and the Physician Order discharge milestone has been marked Completed, and then an interface (HL7-based) message is received to cancel the physician's order, then the Physician Order milestone will no longer be marked Completed.
If a Master Configuration setting in the Admin Tool or Admin > Settings > Capacity Management component called Discharge Order Sets ConfD (confirmed discharge) is enabled, then a discharge order from the ADT system can change a patient's status to Confirmed Discharge.
If administrators add new discharge or transfer milestones, the new milestones will not be applied to patients who already have a set of milestones associated with them. For example, if Discharge Milestones 1 through 4 are already associated with the patient Chris Smith, and then an administrator adds Discharge Milestone 5, Discharge Milestone 5 will NOT be associated with Chris Smith.
Milestones that are already associated with a patient will not be removed, even if an administrator deletes them in the Admin Tool or Admin > Settings > Capacity Management component.
Only patients in Pending Transfer status can have transfer milestones associated with them.
Only patients in Pending or Confirmed Discharge status can have discharge milestones associated with them.
The Milestone column must appear on a list view so that you can make milestone-related changes to a patient record. If a patient has a bed request, the Milestone column has a progress bar. If you have the Edit Discharge Milestone or Edit Transfer Milestone permission, you can click this progress bar to mark milestones completed, delay them, change the projected discharge date, or send an instant message.
You can send another staff member an instant message about a patient's milestone. For example, if a staff member is waiting to hear that a physician's order has been received, you can mark the Physician Order milestone completed, and then send that staff member a message about it.
You can edit a patient's projected discharge date. For example, if a delayed milestone results in an extended patient stay, you may change the projected discharge date.
If a discharged patient's status is changed to In-house again, the patient retains all previous discharge milestones. Previously completed milestones will remain in Completed status.
However, if a patient's status is changed to Pending Transfer status again, a new set of transfer milestones will be applied to the patient. If a new milestone has been added recently, it will be applied to the patient.
Permission Required
You must have the:
Edit Discharge Milestone permission to set discharge milestones.
Edit Transfer Milestone permission to set transfer milestones.
Allow Sending Milestone Notifications permission to send an instant message.
Allow Disabling Discharge Milestone Automatic Timer Alerts permission to prevent an automatic notification about discharge delay.
To Display Discharge Milestone Progress for a PreAdmitted or Inhouse Patient
By default, 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 Capacity IQ® PreAdmit application list views or on the electronic bedboard® view appear only for patients who are in Pending/Confirmed Discharge status. However, as discharge planning often begins as soon as the patient is admitted, 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 in-house patient:
On the list view, in the Milestone or M column that corresponds to the preadmitted or In-house 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:
To display the discharge milestone progress bar in the Milestones column in the Capacity IQ® PreAdmit 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 Console for Any Active Patient Status check box.
To display the discharge milestone progress bar on the electronic bedboard® view view for this patient, select the Display Milestone Progress on Bed Board for Any Active Patient Status check box.
Click Save or Save and Close.
To Access the Set Milestone Detail Dialog Box or a Quick View of Milestones:
From a list view:
Do one of the following:
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, you select the Pending/Confirmed Discharge list view.
Go to Capacity IQ® PreAdmit application > List Views > <list view name>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, you select the Pending/Confirmed Discharge list view..
Go to Clinical Operations > Capacity IQ® PreAdmit application > If your health system is configured for multiple instances of the Capacity IQ® Solution, select the instance name > <list view 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, you select the Pending/Confirmed Discharge list view.
To see a quick view of milestones and their progress, move your mouse over the Milestones column to display a tooltip
Green checkmark | A milestone is completed. |
Red exclamation point | A milestone has been delayed and is not yet completed. |
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. |
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.
Electronic BedBoard
From an electronic bedboard® view:
Access and configure an electronic bedboard® view.
To see a quick view of milestones and their progress, move your mouse over a cell displaying a T with a green background, a D with a blue background, or a c with a red background to display a tooltip.
Green checkmark | A milestone is completed. |
Red exclamation point | A milestone has been delayed and is not yet completed. |
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. |
Proj. Discharge | The patient's projected discharge date appears at the bottom of the tooltip |
In a cell displaying a T with a green background, a D with a blue background, or a c with a red background, press and hold the Shift key, and then click to display a menu.
On the menu, click Transfer Milestones or Discharge Milestones to display the Set Milestone Detail dialog box.
To Mark a Milestone Completed:
On the Set Milestone Detail dialog box, in the Completed column, select the check box for the completed milestone.
To add comments, type text in the Notes column.
Click Save or Save and Close.
The green progress bar expands to indicate that additional milestones have been met.
To Delay a Milestone:
On the Set Milestone Detail dialog box, in the Delay Reason column, select a delay reason.
To add comments, type text in the Notes column.
Click Save or Save and Close.
The red progress bar appears to indicate that a milestone has been delayed.
To View the Date, Time, and User Responsible for the Latest Milestone Update:
On the Set Milestone Detail dialog box, to view the last date and time that a user selected a milestone delay reason, entered notes about a milestone, or marked a milestone completed, and then saved the change, see the Last Updated column.
On the Set Milestone Detail dialog box, to view the user who last selected a milestone delay reason, entered notes about a milestone, or marked a milestone completed, and then saved the change, see the Updated by column.
To Send an Instant Message:
On the Set Milestone Detail dialog box, click Send Notifications to display the Milestone Notifications window.
On the Milestone Notifications window, in the Search Users and Groups list, begin to type the first or last name of a recipient or a notification group name. When the name appears in the list, select it.
If you selected a notification group name and you would like to remove names of users in the group who should not receive the message, then click the + sign next to the group name to display the names of group members individually in the list, and then click the X beside individual names to remove them.
Only users who have Alpha paging devices or who are selected to receive notifications through email, onscreen messages, or handheld devices and who have the Receive Placement Pages permission can be selected. Notifications cannot be received on digital paging devices. Users in the selected notification groups who do not have Alpha paging devices, who have not selected email, onscreen messages, or handheld devices as delivery methods, or who do not have the Receive Placement Paging permission will not receive the message. Only users who are signed in will receive the message. A tooltip states: "Some users in this group may not receive this message."
To delete a row, click the X button beside the row.
In the Message section, type the message text.
If the Milestone Instant Notifications: Include Patient Information global setting is enabled in the Admin Tool or in Admin > Settings > Capacity Management, then you can include patient information (such as name) from this patient's record in the message. The Include Patient Information check box is selected. To exclude patient information, clear the Include Patient Information check box. If this check box is not available, then the global setting has not been enabled and patient information will be excluded.
Click Send. If the number of recipients that you selected for a message exceeds the maximum allowable number configured for the Master Configuration setting called Maximum Number of Recipients for Notifications, then a warning message appears. To avoid a possible adverse effect on performance and on the paging system, you might want to remove some recipients and send a separate message to those who were removed. However, you can still send the message without removing recipients. To continue sending without removing recipients, click OK
To view the history of messages sent and see the message sender, message text, recipients, all of the methods through which the message was delivered to each recipient (for example, email address, screen, or handheld device), and the success status of the message delivery (for example, Pending or Yes), view the Notification History section of the Milestone Notifications window.
Click Close, and then Save or Save and Close.
To Prevent an Automatic Alert About Discharge Delay (For Discharge Milestone Only)
If you do not want users who subscribed to automatic discharge timer alerts to receive alerts when this patient exceeds the discharge timer thresholds (time limits) set for the home location or last known home location, select the Don't Send Automatic Discharge Timer Alerts check box, and then click Save or Save and Close.
Note If you do not have the Allow Disabling Discharge Milestone Automatic Timer Alerts permission, this check box appears gray and is not available to select.
To Change the Proj. Discharge Date and Time:
On the Set Milestone Detail dialog box, in the Proj. Discharge section, click the calendar icon, and then select a month and date.
In the box to the right of the calendar, type the time in the following format: ##:## AM or PM (for example, 03:00 PM). You cannot enter a pasttime. Dates and times that are automatically calculated using the enterprise or unit length of stay time do not override manually entered dates and times.
Click Save or Save and Close.