Adding a Patient to the Wait List

Adding a Patient to the Wait List

Terminology

A patient is a unique individual for whom the surgeon is providing care. There is one patient record; however, a patient may have multiple cases. When adding a patient, you may be adding a new patient to your list with the patient’s elective surgical procedure (case), or you may be adding a new case to an existing patient. A patient may have only one active case or multiple active cases. Each patient/case combination is an entry on your wait list; however, a case may have more than one procedure if several surgical procedures will be performed at the same time.

As part of the initial configuration of Novari ATC for your site, patient records are retrieved from the hospital’s patient information system and loaded into Novari ATC. If one of your patients has attended the hospital in the past, you may find that patient’s record. In our experience, this is generally what happens. Less frequently you may have to manually add a patient. The patients you manually add to Novari ATC will be added to the hospital’s information system by the patient registration staff, maintaining it as the source of truth for patient information.

To add a patient to the wait list:

• Select List in the Provider’s Office navigation menu, and then select Add Patient.

Finding the Patient

The first step in adding a case is finding the patient.  

To find a patient:

• Enter a patient identifier (MRN), a health card number, or both the name and birthdate.  

• Select a care venue and list type (pooled or not). The default list type can be selected in User Preferences.

• Select Submit.

Once a valid patient identifier is entered, confirm the patient found is the correct one.

In the above example, patient information is hidden.

Novari ATC displays a wait list history for the patient, depending on the system settings. If the patient is already on the wait list, the red warning will appear to confirm this patient should still be added to the wait list. If the patient is the correct patient, select OK. The system will then open the Add Patient page. If not correct, select Cancel to re-enter search criteria. If the patient cannot be found after several confirmed correct attempts, add an unregistered patient.

Adding an Unregistered Patient (Pending Patient Information)

If supported by your installation configuration, you may be able to add a patient to the wait list even if that patient does not yet have a hospital registration number (MRN).  

To add an unregistered patient:

• Select Add an Unregistered Patient tab.

• Enter the patient’s demographics (mandatory fields are marked with a red asterisk *).

• Select Submit.

Once the information is submitted, the case can be added to the wait list. If your installation has been configured with the Patient Registration module, then a registration request will be sent to Patient Registration module.  

The Add Unregistered Patient tab

The Add Patient Form

After selecting the appropriate patient, the Add Patient form appears. This form is used to capture most of the case information. The Add Patient form is highly configurable so the sections you see may differ from what is presented below.

Provider

Select the Provider and Service. Provider is the physician who is expected to perform the surgery. The Service drop-down list can be used to filter the available procedures and diagnoses for the case. The Care Venue selected when finding a registered patient or adding an unregistered patient is displayed to the right of the Service field.

Additional personnel may be added to this case, if configured for the installation. Select Manage beside the Additional Personnel option. See Additional Personnel Manager section in this manual for more information.

Diagnosis

Select the diagnosis category. Diagnosis Description is a free-text field that may be configured as optional or mandatory.  

Procedure(s)

Select the procedure, estimated procedure time, and body site. Depending on the installation, the estimated procedure time will default to an average. If the installation automatically inserts procedure times, that time may be modified, assuming sufficient privileges have been granted by an administrator. Free-text procedure notes may also be entered.  

Providing Responsibility for Payment and other supporting information may be required depending on the care venue that was selected.

There are several methods for selecting a procedure: the drop-down menu, the search function, and the QuickPicks function. In the drop-down menu, select the procedure from the list. The corresponding procedure code will be automatically populated.

By default, Novari ATC displays a short list of all procedures corresponding to the provider and service you selected. You may change this by selecting the Full List option.

If the desired procedure is not appearing, select Search to initiate a search. Enter a keyword from the procedure and select Search. If the search is successful, highlight the appropriate procedure and click Select. If the search is unsuccessful, the search terms may be too specific. Try using a single short term that matches the desired procedure. If the desired procedure is not found, please contact the site administrator.

Alternatively, you may select a procedure from a custom list of procedures by selecting QuickPicks. QuickPicks is a tool designed to display procedures that are more frequently selected than others. Each user can create a list of procedures that they frequently choose. From the QuickPicks page, a procedure can be chosen or the list itself can edited/managed. See QuickPicks section in this manual for more information.

Optionally, select Add to add another procedure that will be performed at the same time.

Referral Information

The contents of this section are highly configurable and may vary depending on the selected care venue and your site’s installation configurations. Note that some referral types require a referral source, while others require a referral type reason.

Important Dates

The contents of this section are highly configurable and the dates, optional and mandatory, may vary depending on the selected procedure at the selected care venue.  

Enter the requested dates following the date format displayed or use the calendar icon.

Priority

Select the priority score and anesthetic requirement. ASA class is an optional field, indicative of the overall health of the patient. The field ‘NPO Since’ can be set as a mandatory or optional field and can be set with both a date and time or set to unknown.

General Info

This section is used for gathering some additional information with respect to bed utilization, patient availability, and patient alerts. The contents of this section are highly configurable and may vary depending on the selected care venue and your site’s configurations. Comorbidities and Medications appear when PreSurgical Screening is enabled for the care venue. For more about Pre-Surgical Screening, please read Novari ATC Pre-Surgical Screening User Guide.

To add Patient Alert / Comorbidities / Medications, select its Edit button.

An example of the Patient Alerts window

Estimated Length of Stay (ELOS)

When adding a new case to the wait list, the estimated length of stay (ELOS) may be specified. The ELOS for the case will appear only when an IP (inpatient) post-procedural destination is selected. Otherwise, the ELOS will not display. Any decimal places will be rounded down to the nearest whole day.  

Notes

Through this feature, general notes and patient concerns can be added to the patient’s case. These are for office use only and are not available in any other module such as Care Venue or Pre-Surgical Screening.

Submission

Once information has been entered in all mandatory fields, select Submit and the new wait list entry will be added to your elective surgical procedure wait list. Any relevant booking forms may automatically appear, prompting additional fields to be filled based on the care venue.  

Whether booking forms automatically appear is a preference that can be managed from the User Preferences module.  

Other required QuickScreens (i.e., for paediatric cases) may be conditionally triggered as well when relevant.  

The Case Details page contains information about the patient (such as demographics) and information about the surgical procedure (the patient’s case).  

Information about the status of the patient’s case is also displayed. For example, when Current Surg Date and Days to Target are highlighted in red, the patient has missed their target date for their given priority score. Days on List is the number of days the patient has been waiting for their procedure.  

The patient information on the Case Details page may vary from the sample shown below depending on your site’s configuration settings.  

A sample Case Details page with privacy toggled on

To view a patient’s detail:

• The Case Details page appears at the end of the Add Patient process.  

• Alternatively, a patient’s name can be selected from the wait list or by clicking on Patient when it is visible in the Provider’s Office navigation menu.  

Editing Case Details

To edit a field on the Case Details page:  

• Click on the underlined field heading or any link and some icons (the mouse pointer changes to the link pointer   indicating the text or icon can be clicked).

• Generally, a dialog appears. Enter the corrected/changed information.

• Select Update/Save or Cancel as appropriate.

For example, to edit the diagnosis description; click on the Diagnosis Description heading, supply the new description, and select Update.

If the field heading is NOT underlined, you cannot edit it from the Case Details page. Some fields on Case Details page are calculated by Novari ATC, such as Adjusted Days to Target.

The following headings navigate to new pages for more detailed input:

• PSS Status - Navigates to the Pre-Surgical Screening (PSS) module to display the patient’s PSS status. To learn more, please read Pre-Surgical Screening guide.

• Send – Note: This is an action that sends the patient to Pre-Surgical Screening if PSS has been configured for your site. To learn more, please read Pre-Surgical Screening guide.

• Booking Form – Navigates to the OR Booking Form. You may be prompted to complete missing information.

• Wait 2 System Delay – Opens the Wait 2 System Delay page (Your site may use a different label for Wait 2 delays.)

• Procedure Audits (Cancellations) – Displays outstanding procedure audits awaiting resolution.

• Documents – Opens the Print Documents page.

• Attachments – Opens the Attached Documents page.

Sending Messages

You can send a message regarding the case to Care Venue, Pre-Surgical Screening or Patient Registration and you can see messages that were sent from Care Venue, Pre-surgical Screening or Patient Registration concerning this patient.

To send a message:

• Select Send a Message Regarding this Patient.

• In the message dialogue, select the recipient, enter your message, and select Send.

Sent and received messages are displayed in the message area. Please see Getting Started guide for more information about messages.

Case Details Actions

You can perform a number of actions when viewing a patient’s case details. The actions available may vary depending on how your installation was configured.

Case Details Actions contains a list of commonly used actions

Change History

Change History provides a list of all changes that have been made to a wait list entry, including a description of the change, the time of the change, and the identity of the person making them.  

QuickQuote

QuickQuote provides statistical data relevant to the currently selected procedure including:

• The number of times the provider has performed this procedure at the selected priority level.

• The average wait time in days.

• The maximum wait time in days.

• The minimum wait time in days.

• The total number of days the patient has waited.

• The number of days by which the patient has exceeded the average wait time.

QUICKQUOTE WILL ONLY REPORT THIS INFORMATION IF THERE IS ENOUGH DATA ON A GIVEN PROCEDURE/PRIORITY COMBINATION. IF THERE ARE NOT ENOUGH SIMILAR CASES TO JUSTIFY STATISTICAL ANALYSIS, NO INFORMATION WILL BE PROVIDED.

Remove from Waitlist

The Remove from Waitlist action allows a case to be removed from the wait list without performing the requested surgery. Select the date and reason for removal and, optionally, enter a note.

Create Duplicate Entry

Create Duplicate Entry lets you quickly create a duplicate (secondary) wait list entry for the patient with a different procedure, procedure time (in minutes), and body site (laterality). Please note that it is only available for specific procedures as identified by your site administrator. Novari ATC creates a copy of the original (primary) wait list entry, applies the procedure specified and adds it to the wait list as a new entry.  

The purpose of keeping a secondary wait list entry linked with its primary wait list entry is to keep closely related procedures visibly linked and to reduce the effort required when duplicating a procedure.  

An example of this would be eye surgery for each eye. You can add a case for one eye and then duplicate it for the second eye, changing the laterality.

The ability to duplicate wait list entries is governed by the following rules:

• The primary procedure must be configured to allow duplication. This configuration is defined and managed by the site administrator. If attempting to create a duplicate entry, but the option is disabled in the Case Details Actions menu, contact your site administrator and request that the procedure be modified.  

• The case being viewed cannot be the duplicate entry of another wait list entry.

If the case in question does not satisfy the criteria, then the link will be greyed out. This means that a duplicate wait list entry cannot be created from Case Details; however, a new wait list entry can be added manually using the Add Patient process.

If the primary case has more than one procedure, only the first procedure is copied to the secondary entry.

Once the Create Duplicate Entry action is completed, Novari ATC creates a new wait list entry and displays the Case Details page of the new wait list entry. It is recommended you carefully review the Case Details page.  

Under Case Detailss Action on the Case Details page, you will see the related entries for the patient. You can unlink the secondary entry from the primary one and vice versa by selecting Unlink. To navigate between the primary and secondary cases, select the Surgery Date.

This is located at the top right of the Case Details page and indicates the existence of a primary or secondary wait list entry

Unlink disassociates a secondary wait list entry from the primary wait list entry; the link between the primary and secondary case is severed. The two cases would continue to exist on your wait list, but as completely independent cases with no reference to each other.

It is important to understand that while two cases are linked, they are still managed independently. For instance, if there are changes to the procedure time, diagnosis, or any information about the primary entry, it will not automatically update the secondary entry, and vice versa.

The secondary entry appears on the wait list, as shown below.

Notice in the image above that each entry is assigned a number located beneath the MRN. [1] denotes the primary wait list entry and [2] denotes the secondary wait list entry.