============================================================================= Run Date: MAR 06, 2014 Designation: PXRM*2*31 Package : PXRM - CLINICAL REMINDERS Priority: Mandatory Version : 2 SEQ #26 Status: Released Compliance Date: APR 06, 2014 ============================================================================= Associated patches: (v)PXRM*2*24 <<= must be installed BEFORE `PXRM*2*31' Subject: PALLIATIVE CARE PATCH Category: - Routine Description: ============ The VA Hospice and Palliative Care (HPC) program office has sponsored the development of this reminder dialog template to document provider-based palliative care consultations at all sites within VHA. This template is critical to improving the process and documentation of clinical care, and facilitating high quality palliative care and programmatic quality improvement. It is the intent of the HPC program office that this national template be formally distributed to VA palliative care programs for voluntary use throughout VHA in early 2014. The current version of the template, PC-NCT 3.0, for national distribution, was developed by the Quality Improvement Resource Center (QuIRC), based in Los Angeles, CA. QuIRC serves as one of three national Quality Centers that support the HPC's Comprehensive End-of-Life Care Initiative to foster quality improvement. QuIRC built the template based on a comprehensive review of the literature and in consultation with a wide variety of program stakeholders and clinical experts. There has been extensive involvement from the field in order to obtain concurrence and refine earlier versions. Our program office goal is to have at least 60% of the VA facilities adopt the PC-NCT over the next two years. Using an earlier version of PC-NCT in 2010, QuIRC gauged interest from facilities about participating in a User Community in order to pilot the template in a clinical setting; garnered feedback regarding the content, ease of use, and utility of the tool; and assessed surrounding the tool's adoption and implementation. After identifying facilities interested in piloting the tool, QuIRC selected five sites (Baltimore, Battle Creek, Indianapolis, Birmingham, and Salt Lake) to make up the User Community based on geographic diversity, palliative care program size and complexity, academic and non-academic status, and the local availability of evaluation resources. The PC-NCT was disseminated to the User Community sites in August 2010. User Community conference calls have been held at least once per month in which we gather valuable feedback to make ongoing modifications which are reflected in the PC-NCT version 3.0. This most recent version captures aspects of care that are most important to assess during a palliative care consultation in a manner that is efficient and helpful to clinicians. In order for the HPC performance measure to be met for a given palliative care consult, four elements must be present - primary diagnosis, CPT code (ending in 3, 4, or 5), qualified provider (MD/DO, CNS, NP, PA) and correct DSS code (351 or 353). For this to occur for an inpatient, the CPRS location of the patient MUST be changed to an outpatient clinic location setup for this purpose PRIOR to beginning the note. The reminder dialog itself has a "change location?" prompt built in. Associated Remedy Ticket(s): =========================== 1. INC000000778314 - Palliative Care National Clinical Template (PC-NCT) Associated NSR(s): ================= N/A Participating Test Sites: ========================= VA Greater Los Angeles HCS - West LA Campus Richard L. Roudebush VAMC - Indianapolis VA Illiana HCS - Danville John D. Dingell VAMC - Detroit REMEDY OVERVIEW: =============== 1. INC000000778314 - Palliative Care National Clinical Template (PC-NCT) Problem: -------- The Hospice and Palliative Care (HPC) program office has developed this reminder dialog template to document provider-based palliative care consultations at all sites within VHA. This template is critical to improving the process and documentation of clinical care, and facilitating high quality palliative care and programmatic quality improvement. It is the intent of the HPC program office that this national template be formally distributed to VA palliative care programs for voluntary use throughout VHA beginning FY2013. Resolution: ----------- The Hospice and Palliatve Care (HPC) Care Reminder dialog template was created. This patch, PXRM*2*31, contains two routines, PXRMP31E and PXRMP31I. They are init tasks that add new entries to the REMINDER EXCHANGE (#811.8) file and the contents of these entries are installed during the post-init. These routines can be deleted after the install. There are two Reminder Exchange entries that will be installed as part of this patch. 1. VA-PALLIATIVE CARE CONSULT 2. VA-PATCH 31 POST HS COMPONENTS Build Components: ================= N/A Data Dictionary: ================ REMINDER EXCHANGE (#811.8) FILE Software & Documentation Retrieval Instructions: ================================================ This patch is being distributed as a host file. The name of the host file is PXRM_2_0_31.KID. This file should be downloaded in ASCII format. The preferred method for obtaining these files is to use File Transfer Protocol (FTP) to download them from: ftp://download.vista.domain.ext/. This transmits the files from the first available FTP server. Sites may also elect to retrieve the files directly from a specific server as follows: Albany ftp.domain.ext Hines ftp.domain.ext Salt Lake City ftp.domain.ext Install guide is also available on the above servers. It is available as .pdf format. This file should be downloaded in BINARY format. File Name: Description: Protocol: ========== ============ ========= PXRM_2_0_31_IG.PDF PXRM*2.0*31 Installation BINARY and Setup Guide PXRM_2_0_31.KID PXRM*2.0*31 Host File ASCII Documentation can also be found on the VistA Documentation Library (VDL) at: http://www.domain.ext/vdl/ Installation: ============= This patch can be loaded with users on the system. Installation will take five to ten minutes. Refer to the Install Guide, PXRM_2_0_31_IG.PDF, for complete details. 1. Use the "Load a Distribution' option on the KIDS installation menu. When prompted to enter a host file type in PXRM_2_0_31.KID 2. On the KIDS menu under the 'INSTALLATION' menu, use the following options, as desired: Print Transport Global Compare Transport global to Current System Verify Checksums in Transport Global Backup a Transport Global 3. On the KIDS menu under the 'INSTALLATION' menu, use the following option to install the patch: Install Package(s) When prompted for INSTALL NAME, use PXRM*2.0*31 4. When prompted "Want KIDS to INHIBIT LOGONs during the install? NO//," respond 'NO'. 5. When prompted "Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO// respond 'NO'. 6. After successful installation, the following init routines may be deleted: PXRMP31I PXRMP31E Routine Information: ==================== The second line of each of these routines now looks like: ;;2.0;CLINICAL REMINDERS;**[Patch List]**;Feb 04, 2005;Build 206 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: PXRMP31E Before: n/a After: B1037570 **31** Routine Name: PXRMP31I Before: n/a After: B2537630 **31** ============================================================================= User Information: Entered By : Date Entered : FEB 25, 2013 Completed By: Date Completed: MAR 06, 2014 Released By : Date Released : MAR 06, 2014 ============================================================================= Packman Mail Message: ===================== No routines included