How has your charting Changed since Covid?

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mrhunt

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Pretty straightforward.....How has your charting changed Universally on EVERY pt, Regardless of covid Symptoms or not? Or ideas to toss around to each other for WAYS to change charting / narratives to be more inclusive?

For me, Now i have a generic statement saying that i made sure i left my pt with a surgical mask in place before Hand off to Receiving facility (my countys new protocol) as our county is extremely Strict on it and we actually get generic mass emails from EMS office stating hospitals are complaining and "remember to mask everyone please" b

And a statement under pertinent negatives stating how pt has no covid-19 symptoms and listing the main ones (sob, cough, fever, recent travel,bodyaches, loss of taste or smell) Or if a pt DOES exibit something covid related explaining why in detailed terms why it doesnt appear to be for x,y &z reasons.

I also frequently now list that the receiving facility does not treat pt as a PUI (especially if theyre coming in for SOB or something) so as to clear ourselves from having to do extensive Decon of several hours considering we now only decon if receiving Hospital treats pt as a PUI and not otherwise (even if we gown up in full PPE initially)
 
Only thing that has chafed is now in the first line of our “narrative” we include what PPE we put on. Aside from that everything else is unchanged
 
DesertMedic66 said:
Only thing that has chafed is now in the first line of our “narrative” we include what PPE we put on. Aside from that everything else is unchanged
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You also got the extra CONFIRMED COVID-19 reason for transport and Destination type for the weird COVID facility thing, yeah?
 
DragonClaw said:
You also got the extra CONFIRMED COVID-19 reason for transport and Destination type for the weird COVID facility thing, yeah?
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We have COVID added in to our list of impressions but no COVID facility. We don’t have any designated COVID facilities here and all hospitals will accept them.
 
I added an infectious line to my review of systems for the standard COVID questions. I also have a line at the end to the effect that no signature was obtained due to infection control precautions. That’s about it. Oh- we also have a tab in the crew field of ESO for PPE now, too.
 
We added COVID-19 as a reason for transport, a reason no signature(s) was/were obtained, added a COVID questionnaire to the assessment, and I instructed people to detail their PPE in narrative. That's about it.

The thing is at my current gig, we don't receive our billings, or any money directly. We get a budget and any money that comes back goes to the town. The plus side is we don't have to worry about sustainability or profitability. It costs what it costs to run the department and the town gets back what it gets and there isn't a lot of arguing back and forth, at least about most things. The downside is that we don't get any of the bennies. We spend budget money on CARES stuff and when Uncle Donny signs the check, the town gets to cash it.

All of that to say there isn't a reward at the end of the tunnel if I were to bang my head against the wall trying to maximize COVID billing and reimbursements, so I’m not. Compliance, yes; frills, homie aint got time for that game.
 
I chart PPE worn and whether or not they had a positive, negative, or inconclusive screen.
 
hometownmedic5 said:
We added COVID-19 as a reason for transport, a reason no signature(s) was/were obtained, added a COVID questionnaire to the assessment, and I instructed people to detail their PPE in narrative. That's about it.
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So I do part time shifts at my e.r. as a front door screener for covid. Just routine, are you short of breath, cough, bodyaches, loss of taste or smell, recent travel or contact with anyone sick.

If any are yes I ask of they're chronic or not or easily explained by a pre-existing medical condition such as asthma or whatever and then send them on their way. Quick temp check and make sure they have a mask. I do the exact same for all my pts in the ambulance.

What does your covid screening look like, or how does it differ?
 
It sounds like we're asking the same questions. The rules for ours were decided by the State(what questions to ask etc). The state even uses the same PCR system as their EMS data aggregation tool for compliance; so they wrote the rules and the questions and then forced an update on my PCR form. The rest of it came from "suggestions" the state said we should implement for COVID. I do everything the state data coordinator tells me to do, otherwise she nags.
 
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