TSWF Cardiovascular CPG AIM Form Training May May-Aug 2020 ... Corner... · 2017 ACC/AHA focused...

“Medically Ready Force…Ready Medical Force”

TSWF Cardiovascular CPG AIM Form Training

MayMay-Aug 2020 Form Version

Disclaimer

Content shown is from an AHLTA Training System (ATS) and does not contain actual patient data.

Recent Changes

The following group of slides reflect changes made to the form. The specific training slides for this form follow the change slides.

CORE Compatible Updates

Updated the Hepatitis C screening recommendation on the 'Preventive Services Recommendations-All Patients' Ribbon. The new recommendation: 'The USPSTF recommends screening for hepatitis C

virus infection in adults aged 18 to 79 years.'

Updated the wording in the 'Self-Reported Level of Functioning' row on the PHQ-9

Updated 'Pain Treatment history' section on the Exit CCP tab

Updated 'Chronic Pain' ribbon label to say'Pain Management Care Plan' and verbiage updated within section.

Also changed the 'Pain care agreement on file’ to'Pain Care Informed Consent on File’

Cardiovascular Updates

On the 'Initial Assessment' ribbon added a new link labeled ‘2017 ACC/AHA focused update’.

On the ‘Afib’ Tab, added an additional link labeled ‘2019 AHA/ACC focused update’.

Updates to ‘Antithrombotic Therapy for Patients with Atrial Fibrillation:• Added ‘edoxaban’ to list of medications

• Added two new statements highlighted below

Added new clinical clue on the right of algorithm:'The decision to use an anticoagulant should not be influenced by whether the AF is paroxysmal or persistent (COR I, LOE B). 2019'

Objectives

Cardiovascular Training Objective:Identify the clinical workflows, screeners and tools available in the TSWF Cardiovascular AIM form as they relate to the VA/DoD Clinical Practice Guidelines, ACC/AHA, NYHA, and JNC-8

Cardiovascular Learning Objectives:At the conclusion of today’s activity, the participant will be able to:

• Understand the documentation requirements found on the HPI tab (patient intake/Med Rec/Preventive Services)

• Understand the use of various screeners (Travel/Audit-C/Tobacco use/Annual Questions/Learning Assessment/Military Specific Screening)

• Demonstrate the purpose and use of the Cardiovascular and Metabolic Disorders Chronic Care Plans

• Understand what information can be found on the various reference-only tabs found on the form

Why Use a TSWF CPG AIM Form?

• Integrates recommendations from VA/DoD CPGs

• Provides easily accessible references for clinical decision-making & patient education

• Improves continuity of care and healthcare outcomes

• Standardizes documentation

Workflow Key Points

• Clinical Support Staff (CSS) completes CORE or TSWF Cardiovascular CPG Form Screening Sections

• Provider takes ‘ownership’ of the CSS note

• Provider loads the Cardiovascular AIM form

• Provider reviews and completes the note

Selecting the Proper Template

Select CV-CPG

Select from either your drop-down

list of favorites or via Navigator

TSWF Navigator

Select TSWF Navigator

TSWF Navigator

Select the Cardiovascular form

TSWF Navigator takes you to the most current version of the TSWF forms

“Medically Ready Force…Ready Medical Force” 18

HPI/PFSH Tab

Form version, links to MilSuite, TSWF Navigator, TSWF Resources, and Change Log are listed at the top

HPI/PFSH Tab Condition-Specific Recommendations

Summary of interventions that have a positive impact on morbidity and mortality

HPI/PFSH Tab Cardiovascular Disorders CCP

This CCP is intended for patients with CAD, Cerebrovascular disease, peripheral vascular disease, A-fib, and/or heart failure. Pre-populated text is a starting point;

edit the text to fit your needs. The field copies forward to support continuity of care.

HPI/PFSH Tab Heart Failure Classification

A summary of heart failure classifications is provided for

reference.

HPI/PFSH Tab Links to CV References

Links to various references:

HPI/PFSH Tab Metabolic Disorders CCP

This CCP is intended for patients with hyperlipidemia and/or hypertension (and diabetes). NOTE: no need to use multiple CCPs; feel free to combine

them based on patient’s or your needs.

Link for Diabetic Foot Exam

If appropriate or according to local protocol, complete pre-travel counseling and Infectious Disease Travel Screen

Note: blue clinical clues about various diseases

Screening TabTravel Screening/Infectious Disease Travel Screen

Screening Tab

Links to resources on tobacco cessation

The Single Item Literacy Screener (SILS) for assessing health literacy is in the Annual Questions field. If patient’s response is

either “often” or “always”, conduct a more thorough assessment (see next slide).

Screening Tab

If the SILS response is either “often” or “always,” further assessment of the patient’s health literacy is documented here along with an action plan if indicated. While a link to REALM-SF

is provided here, any appropriate assessment can be used.

BH/Other Screening Tab

This tab is used to screen for depression, suicidality, PTSD, TBI, and sleepiness. Follow Service or local guidance.

BH/Other Screening Tab

Epworth Sleepiness Scale

ROS Tab

Cardiopulmonary-specific ROS

PE Tab

PE TabCardiovascular-focused Section

EXIT/CCP Tab

Obsolete Terms

Review the Obsolete Terms tab for elements that copy forward from previous encounters. This function is very important when performing Copy Forward!

If obsolete terms are not deselected, you will see past medical history terms in an encounter note that the provider is not aware of when he/she signs the note.

Reference Tabs

The remaining tabs contain reference information on the disorders covered on this form (and the reference source)

• Hypertension (VA/DoD CPG & JNC-8): 2 tabs

• Dyslipidemia (VA/DoD CPG & ACC/AHA Guidelines)

• Ischemic Heart Disease (ACC/AHA CPG)

• Chronic Heart Failure (ACCF/AHA CPG)

• Atrial Fibrillation (AHA/ACC CPG)

• There’s also a tab listing common medications used to treat cardiovascular conditions in Primary Care in the DoD & VA

Hypertension

There are two tabs for Hypertension:VA/DoD CPG & JNC-8

Hypertension

Tabs contain algorithms and tables from the respective sources, and links to the full documents

Dyslipidemia

Ischemic Disease Tab

Heart Failure Tab

Atrial Fibrillation Tab

Atrial Fibrillation TabSample Algorithm

TSWF Resource Material

The TSWF repository for training/educational materials and updates:www.tswf-mhs.com/

Primary Care Clinical Community Content Working Group

▪ DHA - Maj Matthew J Royall▪ ARMY - Dr. Robert Marshall▪ AIR FORCE – Dr. Matthew Barnes

TSWF Feedback https://www.milsuite.mil/book/groups/tswfTSWF Website http://www.tswf-mhs.com/

TSWF Cardiovascular CPG AIM Form Training May May-Aug 2020 ... Corner... · 2017 ACC/AHA focused...

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