Feature Image
[SELFIE IN BLACK SHIRT]
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2018 Selfie - Keith Torkelson
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Primary Source Document(s)
11_CBC_FY_2017_18_18082101_Summary
Report
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Blog
Clozapine RX 4 Ecstasy
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Blogger Title
Complete Blood Count (CBC)
Component of Clozapine Management – By Keith Torkelson MS (Pathology)
Google Plus Information
Monthly CBC Routinely Showing
Marked Improvement – 2012-2018 – Clozapine Cost Containment – Errors by Chester
D Mojica MD – Central City Community Health Center (CCCHC)
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A CBC Driven Progress Report
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Abstract – Executive Summary
The subject of this report is
Keith E Torkelson, MS. The topic of this
report is the monthly Complete Blood Count (CBC) lab work required for
prescribing Clozapine in the United States of America (USA). Keith E Torkelson, MS is the principal about
Mentalation Solutions Group (MSG). This
paper is the product of us here at MSG.
Yearly we publish our findings in a report we call our Christmas Report
Card (CRC). This report about CBCs is
just one of this year’s topics selected for our 2018 overall report. The data window for the CBCs described in
this report is from August 8, 2017 till September 18, 2018. We closed our CBC data collection with the
completion of Keith’s yearly physical (September 27, 2018). This paper details the clinical and clerical
processes associated with a routine CBC.
For the purpose of sampling (capturing) the CBC experience MSG created
an assessment tool. We call our
assessment tool our Vitals Plus Instrument.
It was built upon the online MD Rating Service Vitals’ standard
instrument. We extended Vitals 7 Items
to 25 Items.
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Of Complete Blood Counts (CBCs)
Our CBC blood collection services
are performed at Central City Community Health Center (CCCHC) in Garden Grove
California. The first CBC in this year’s
series was on August 8, 2017. For that
encounter we awarded our CBC Team 85.7%.
100.0% would be a perfect encounter.
The last or final CBC in this series was on September 18, 2018. For that encounter we awarded our CBC team
76.2%. The data points in-between are
non-linear. As we retrieve and
re-evaluate a year’s worth of CBC related records we discover some calculation
errors. In hindsight our Calculation
Error Rate (CEE) is approximately 1/16 (+/- 2).
We briefly address incidences of being called in over ½ late. We were called in late on over half of the
occasions. For the lab results data we
now use Quest Diagnostics directly via their Patient Portal MyQuest. We assume all data we get directly from Quest
is always true and correct. Notice we
SKIP some months in collecting detailed information. We do this because our Confidence in the CBC
Team has grown justifiably. Near the end
we include our Dynamic Cast of Characters (DCC). In one year there has been substantial
turnover in our CBC Team. One element
that would greatly assist our CBC Team @ Central City Community Health Center
(CCCHC) is the re-implementation of routine Satisfaction Surveys. CCCHC abandoned Satisfaction Surveys
somewhere back in 2014 or even earlier.
On this we dovetail an emerging problem.
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Emerging Problem – PCP Error Rate
Today September 27, 2018 at 1030AM
we had our routine yearly physical with our CCCHC PCP, Chester D Mojica (CDM).
We were prepared and confident that the only issue we have is COPD. He discussed some problems. We will address two only. CDM stated that our last A1c was 6.1. The lab running the CBC test, Quest
Diagnostics, reported our last A1c is 5.3.
5.3 (% of Total Hemoglobin) is well within the normal range. Doctor Mojica indicated our A1c is a problem
warranting some lifestyle restrictions. He
says we are pre-diabetic! Just to cover
two Ostrich Eggs with one stone, we will share our A1c as reported by Quest in
whom we trust. Doctor Mojica also
indicated that we were overweight. The
day of the exam the nurse weighed us at 142 Pounds. We are 5’ 7-1/2” tall.
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Partners
-
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List of Tables – Matrices – Figures
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Matrix – CCCHC Mediated CBC Ledger – Part 1 of 3 –
201708-201712
Matrix – CCCHC Mediated CBC Ledger - Part 2 of 3 –
201801-201802
Matrix – CCCHC Mediated CBC Ledger - Part 3 of 3 –
201803-201809
Figures – Physical Exam – A1c Results [LAST MINUTE]
Charting for the Record – 2018 - Database (MSG) – Metadata
Charting for the Record – 2017 - Database (MSG) – Metadata
Matrix - CBC Savings – CALC –
Last Reviewed: 20180928-F:
Table CBC Tracking Information – Results
Figures – CBC Results
Matrix – Rubric for MSG Binary Scoring
Table - Cast of
Characters – Centered About CBC (2017-2018)
Table - Vitals-Plus
Method – Combined Scores
Table - Vitals-Plus
Method – Vitals Standard Elements
Table - Vitals-Plus
Method – Vitals-Plus Elements – Part 1 f 2
Table - Vitals-Plus
Method – Vitals-Plus Elements – Part 2 f 2
Table - Vitals-Plus
Method – Vitals-Plus Elements – Combined Parts 1 and 2
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Matrix – CCCHC Mediated CBC Ledger – Part 1 of 3 –
201708-201712
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|
||||||
Appt Date
|
Vitals
|
Vitals
Plus
|
Vitals + Plus
|
Note(s) & Scheduling
|
||
-
|
||||||
20170808-TU-CBC
|
4.5/5
90%
|
13.5/16
84.4%
|
18.0/21
85.7%
|
Baseline for 2017/18 Cycle
Weight = 150 lbs
|
||
20170905-TU-CBC
|
4.5/5
90%
|
13.5/16
84.4%
|
18.0/21
85.7%
|
Jocelyn
|
||
20171003-TU-CBC
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SKIP
|
|||||
20171010-TU
Yearly Physical
|
2017 Physical Exam CDM
Weight = 147 lbs
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|||||
20171031-TU-CBC
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5.0/5
100%
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14.0/15
93.3%
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19.0/20
95.0%
|
|||
20171128-TU-CBC
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Rescheduled
|
|||||
20171129-W-CBC
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5.0/5
100%
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14.0/15
93.3%
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19.0/20
95.0%
|
|||
20171227-W-CBC
|
5.0/5
100%
|
14.0/15
93.3%
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19.0/20
95.0%
|
Weight = 144 lbs
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||
2017-END
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||||||
Matrix – CCCHC Mediated CBC Ledger - Part 1 of 3 –
201708-201712
Last Reviewed: 20180928-F:
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Sources of Intel
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At-A-Glance Planners (2017 & 2018)
Wall Calendar
Vitals Plus Data Sheets
Appointment “Cards”
MSG Database
Other PRN
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Matrix – CCCHC Mediated CBC Ledger - Part 2 of 3 –
201801-201802
Appt Date
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Vitals
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Vitals
Plus
|
Vitals + Plus
|
Note(s) & Scheduling
|
||
-
|
||||||
20180124-W-CBC
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5.0/5
100%
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14.0/15
93.3%
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19.0/20
95.0%
|
Gabby
Weight = 145
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||
20180209-F-IFL
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4.0/5
80%
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6.0/15
40.0%
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10.0/20
50%
|
|||
20180221-W-CBC
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5.0/5
100%
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14.0/15
93.3%
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19.0/20
95.0%
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Gabby
Weight = 142
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Matrix – CCCHC Mediated CBC Ledger - Part 2 of 3 –
201801-201802
Last Reviewed: 20180928-F:
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Matrix – CCCHC Mediated CBC Ledger - Part 3 of 3 –
201803-201809
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|
||||||
Appt Date
|
Vitals
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Vitals
Plus
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Vitals + Plus
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Note(s) & Scheduling
|
||
-
|
||||||
20180307-W-CBC
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SKIP
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Jocelyn
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||||
20180404-W-CBC
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5.5/6
91.7%
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13/14
92.9%
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18.5/20
92.5%
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Gabby
No BP or TEMP
Self Weight = 142
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||
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|
||||||
20180502-W-CBC
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SKIP
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Jocelyn
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||||
20180529-TU-CBC
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3.0/5
60.0%
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9.5/15
63.3%
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12.5/20
62.5%
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Beatrice
(*) What’s up with this?
Self Weight = 145
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20180626-TU-CBC
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SKIP
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Team Martha
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||||
20180724-TU-CBC
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SKIP
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Rebecca
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||||
20180810-Full Lab
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Source of A1c Result 5.3 % of Total Hbg
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|||||
20180821-TU-CBC
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SKIP
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No Note
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||||
20180918-TU-CBC
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4/5
80.0%
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14.0/16
87.5%
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18.0/21
85.7%
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Team Martha
QC – ERRORS FOUND with US
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20180918-TU-ERR
Correction
|
4/5
80.0%
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12.0/16
75.0%
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16.0/21
76.2%
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ReCALC
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||
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||||||
20180927-TH-PHYS
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Separate
Report
Pending
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Yearly cycle ends
Our PCP made some remarkable errors
Weight = 142
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||||
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Matrix – CCCHC Mediated CBC Ledger - Part 3 of 3 –
201803-201809
Last Reviewed: 20180928-F:
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Gabby V Beatrice (Beatriz)
In the table(s) above we
reference both Gabby and Beatrice. Early
in 2018 we tried to figure out the Clerical Counter Dynamic (CCD). We came to believe that Gabby was user
friendly and Beatrice too serious. For
our last six CBC appointments or so Gabby has not been about Central City
anywhere. (*) For our May 29, 2018 CBC
we noticed that Beatrice has become user friendly. Beatrice has sustained this
change.
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½ Late: What would you do?
We ask ourselves what is the
appropriate behavior when your practitioner's team has not called you in and
are running behind over a half hour.
Some members in the waiting room just get up and leave. For us we do not have just leaving as an
option. At about the ½ late point we begin to stress or feel a bit
anxious. Anxiety is what we are being
treated for. So you go to the doctor and
the tardy timetable aggravates one’s conditions. One of the issues is: They do not appropriately perceive we
consumers have things to do. We cannot
always allocate a ½ day just to getting our monthly CBC run.
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Improvement Bonus & Decreased
Vigilance
When the CBC Team demonstrated
substantial improvement we used to award them 1.0 point for an improvement
bonus. We also gave the team member most
deserving a, thumbs up, reward. In the
data above notice we SKIPPED assessing every monthly transaction. We were able to skip because our confidence
has grown across the CBC delivery team.
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Physical Snag
We picked our Yearly Physical as the date to close this
year’s CBC Report. We had our Physical
yesterday September 27, 2018. It was
supposed to be our best Physical yet for the term 2012-2018. Our doctor Chester D Mojica made some
errors. We will include just two of his
errors below: A1c error and weight error.
This paragraph is part of our preparation to address Dr. Mojica’s errors
at our next routing CBC in October (2018).
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[INSERT PHYSICAL NOTICE]
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Signage About Central City
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Table – CaseNotes – Needing Correction – Physical with
Chester D Mojica MD
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||||
Declarations
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CDM
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Actual
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||||
Weight
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Says We’ve gained weight
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20180927-TH
142 lbs
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A1c
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Says A1c is 6.1 and problematic
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20180809
Quest says A1c = 5.3
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||
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Table – CaseNotes – Needing Correction – Encounter Physical
– 20180927-TH – Last Reviewed: 20180928-F:
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Link To Celery Diet
Celery Diet (Includes Data on
Weight)
Double XX – Nutrition – Celery
Diet – Digital Appointment – By Keith Torkelson (2018)
Date Chartered = 9/6/18
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[INSERT ACTUAL SCALE MEASUREMENT]
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Sample Actual Weight Measurement for Keith Torkelson (2018)
Keith is Five Foot Seven with a 30" Waist
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Figures – Physical Exam – A1c Results
Source Document
Assess_Vitals_18092704_CDM_Physical
[INSERT A1C RESULTS]
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Results From 8/9/2018
Our Latest A1c
Results From 8/9/2018
Our Latest A1c
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Charting for the Record - 2018
Database (MSG) – Metadata
-
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Charting for the Record - 2017
Database (MSG) – Metadata
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Potential For Savings - CBC Cost Containment
About two years ago (2016) we
were discussing cost containment about Behavioral Health Services (BHSs) with
our Behavioral Health Doctor (BHD). His
name was Bum Soo Lee MD. We both agreed
that BHSs were quite pricey. One of the
components that we thought might save the systems such as CMS was the monthly
Complete Blood Count (CBC) work associated with prescribing Clozapine. We agreed that it might be wise for public
health to intervene and dictate that only once every other month is now
indicated. We here at MSG envisioned the
savings at around one-hundred million per year.
Below we finally got around to approximating potential saving about
Clozapine related CBC testing. We are
quite surprised.
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Matrix - CBC Savings – CALC –
Last Reviewed: 20180928-F:
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|
||||||
# With
Schizophrenia
(Americans)
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Fraction
Prescribed Clozapine
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# On Clozapine
|
||||
3,200,000
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0.04
|
128,000
|
||||
-
|
||||||
# On Clozapine -
|
Cost/CBC
|
CBC expenses
|
||||
128,000
|
$100
Per CBC
|
12,800,000
Per Month
|
||||
-
|
||||||
Cost per Month
|
CBC/Year
|
CBC Cost per Year
|
||||
12,800,000
|
12
|
153,800,000
|
||||
Cost per Month
|
CBC/Year
|
Potential Savings per
Year
|
||||
12,800,000
|
6
|
76,800,000
|
||||
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|
Matrix - CBC Savings – CALC –
Last Reviewed: 20180928-F:
-
Approximations
We used the following information
for our CBC savings approximations.
Unfortunately the Diagnostic Labs will be hit with less CBC related
income.
-
Source
-
FYI - Number of People with
Schizophrenia in the US?
“Worldwide about 1 percent of the
population is diagnosed with schizophrenia, and approximately 1.2% of Americans
(3.2 million) have the disorder. About 1.5 million people will be diagnosed
with schizophrenia this year around the world.”
-
Source Report – Reprint
MSG_Psychiatry_Referral_Bera_18032002_Part-IIIB
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Vignette - Here Is The News! –
Clozapine Risk & Contingency
As we write this paragraph it is
June 26, 2018. We will carry this
paragraph through multiple publications because we find it important. There is an issue with our primary
medication, Clozapine, for which we have no tangible fix. Today while at the clinic for our routine
Complete Blood Count (CBC) work we overheard another consumer, Sam I Am,
sharing in the waiting room. Sam reports
that after being rather stable on Brand-name Clozaril (Generic Clozapine) for
over twenty (20) years his CBC lab values converted. In other words he is now suffering low
numbers of White Blood Cells (WBCs).
Most likely it is his Neutrophils of the WBC family that are low. This is termed Neutropenia. Bad news!
Neutropenia indicates that you cannot be prescribed Clozaril (Clozapine)
anymore. We will leave the “doctor”
anonymous. In response “doctor” stops
Sam I Am’s Clozaril cold turkey while he waits for a second lab to confirm the
problem. Sam reports he has not been
sleeping because Clozaril is essential for a full restful night of sleep. When we left him about 11am we wished him
luck because the lab and his Clozaril disposition are pending. Sam is quite bright when it comes to how much
he has learned as a Behavioral Health Consumer (BHC). He said that a relative said why not reduce
the Clozaril rather than take it away cold turkey. Further his relative advices that on a
reduced dose he might get the benefit of sleep and get his WBC number(s) up
again. For us, also on Clozapine, we
have worried quite a bit about a life without Clozapine. Actually in 2012 we suffered catastrophic
losses and Clozapine was in the scenario.
As Sam puts it Clozaril was a real game changer for him. We agree, for us Clozapine has been a game
changer. In the next paper we will
address what we call our Clozapine Contingencies. This puzzle should be printed and shared with
Medical students in their Pharmacology Course because good “fixes” are pending.
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Table CBC Tracking Information - Results
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|
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Field
|
Detail
|
Note
|
||
-
|
||||
Client
|
Keith Torkelson
|
|||
Collection Lab
|
Central City
|
|||
Referrer
|
Rimal B Bera MD
|
|||
Testing Lab
|
Quest Diagnostics
|
|||
Date(s) of Interest
|
20180208 - 20180917
|
9 CBCs
|
||
-
|
Table CBC Tracking Information – Results
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Results for Keith Torkelson
From 8/9/18
Time Series Results for Keith Torkelson
White Blood Cell Count
From 8/9/18
How is it a fuss?
We will not address why CBCs are a fuss for us in much
detail. Basically we have been on
Clozapine since 2006. Since that time we
have only suffered one gap about our monthly Clozapine prescription. Clozapine has been associated with damaging
the consumers’ blood cell system. CBCs
measure the blood cell system. If there
is drop in ones polynuclear cells (PMNs) AKA Neutrophils the consumer’s health
may deteriorate. CBC exams are required
to support the risk mitigation efforts while the consumer is dependent on daily
Clozapine. Our elevated PMNs might be
translated as slightly protective.
Without monthly and favorable values as reported by CBC our or any
pharmacy will not fill our prescription.
Historically (one incidence) without Clozapine we will end up in the
hospital within 72 hours.
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[INSERT VITAL PLUS ASSESSMENT]
Associated Document > Assess_Vitals_18091802_CBC QC
Cleaned
-
Scoring
Assessment_Scoring_17121201_Rules V2018
-
20171212 - Assessment Scoring
We routinely apply a few types of
scoring methods. We describe them as:
Binary, Stars, and Percentiles.
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Matrix – Rubric for MSG Binary
Scoring
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|
||||
Nature
|
Range
|
Best
|
QUAL
|
|
-
|
||||
Binary
|
0.00 | 0.50 | 1.00
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1.00
|
No | SoSo | Yes
Options 0.25 – 0.75 PRN
|
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Stars
|
0.0 – 5.0
|
5.0
|
Example
Compare with CMS Stars Scores
|
|
Percentile
|
000.0 – 100.0
|
100.0
|
Inter-assessment comparisons
and migrations (Portability)
Fidelity with Education
Standards
|
|
-
|
Matrix – Rubric for MSG Binary
Scoring – Last Updated: 20180810-F:
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Binary Scoring Method (BSM)
P-Pass (1.0) | So-So (0.5) | F-Fail (0.0)
Note: Example of Share - Clozapine & BND 1.5
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Legacy Publication
-
Keith Torkelson – Awarded Provider High Scores (201711)
Post Title
MSG Vitals-Plus Assessment Instrument – Applied to Central
City Community Health Center – By KE Torkelson (MS-Pathology) (MSG, 2017) -
Satisfaction Survey for Health and Human Services – Context of Annual Christmas
Report Card (MSG, 2017).
-
CBC Centered Encounter
Notes
Site = Central City Community Health Center - Garden Grove
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Table - Cast of
Characters – Centered About CBC (2017-2018)
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|
|||||
Character
|
Clerical &
E_Clerical
|
Clinical
|
Note
|
||
-
|
|||||
Anon MD
|
X
|
Should have
business cards
|
|||
Anon PA
|
X
|
Should have
business cards
|
|||
Beatrice/Beatriz
|
X
|
Vast improvement
(2018)
|
|||
Bethany
|
X
|
Possibly maternity
leave
|
|||
Bum Soo Lee MD
|
X
|
X
|
Behavioral Health
Doctor – 2012-2017
|
||
Chester D Mojica
MD
|
X
|
X
|
New issues at
Physical
|
||
Cynthia
|
X
|
||||
Gabby
|
X
|
Looks like she has
moved on
|
|||
Jeff Gibbs
|
Unproductive
partner
Investigating how
to kill the association
|
||||
Jocelyn
|
X
|
||||
Martha
|
X
|
X
|
Most reliable
|
||
Others PRN
|
X
|
||||
Rimal B Bera
|
X
|
X
|
New 2018
|
||
-
|
Table - Cast of
Characters – Centered About CBC (2017-2018)
Last Reviewed: 20180928-F:
-
Measures of Quality
& Satisfaction
-
Table - Vitals-Plus
Method – Combined Scores
Measures of Quality and Satisfaction – Process Clozapine
Related CBC
Date of Encounter: 20180918-TU:
-
|
|||||
Clinical
|
Clerical &
Scheduling
|
||||
Patient Ratings
Service Experience Element
|
20180918
(TU)
CBC
Team
|
Appt Made
20180821-TU
By Team Martha
For: 20180918-TU
|
Sample CALC
|
||
-
|
|||||
Items = 7
|
4/5
80.0%
|
4/5
80%
|
Sum/# Scored
4.5/5
%
|
||
-
|
|||||
Items = 18
|
12.0/16
75.0%
|
13.0/16
81.3%
|
Sum/ # Scored
13.5/15
%
|
||
-
|
|||||
Items = 25 (CALC)
|
16.0/21
76.2%
|
17.0/21
82.0%
|
Sum/# Scored
18.0/20
%
|
||
-
|
|||||
Star Equivalents
(5.0 Stars is the Best)
|
3.8
|
4.0
|
4.50
|
||
With Bonus
IF – THEN Impression
Add 1 to Numerator
|
Stayed
|
Stayed
|
(18+1)/20 * 100 =
95.0%
|
||
-
|
Indications of Satisfaction: Actual Data from 20180918-TU:
Encounters (CBC and Scheduling) – Last Reviewed: 20180928-F:
-
Table - Vitals-Plus
Method – Vitals Standard Elements
Measures of Quality and Satisfaction – Process Clozapine
Related CBC
Date of Encounter: 20180918-TU:
-
|
|||||
Clinical
|
Clerical &
Scheduling
|
||||
Item
#
|
Patient Ratings
Service Element
|
20180918
(TU)
CBC
Team
|
Appt Made
20180821-TU
By Team Martha
For: 20180918-TU
|
Sample
CALC
|
|
-
|
|||||
01
|
Ease of Appointment
|
1.0
|
1.0
|
1.0
|
|
02
|
Promptness
|
0.0
|
0.0
|
1.0
|
|
03
|
Courteous Staff
|
1.0
|
1.0
|
1.0
|
|
04
|
Accurate Diagnosis
|
NA
|
NA
|
X
|
|
05
|
Bedside Manner
|
1.0
|
1.0
|
1.0
|
|
06
|
Spends Time w Me
|
1.0
|
1.0
|
0.5
|
|
07
|
Follows Up After Visit
|
NA
|
NA
|
X
|
|
-
|
|||||
Items = 7 (MAX)
|
4/5
80.0%
|
4/5
80%
|
Sum/#Scored
5.0/5*100
|
||
Star Equivalents =
|
4
|
4
|
|||
-
|
Indications of Satisfaction: Actual Data from 20180918-TU:
Encounters (CBC and Scheduling) – Last Reviewed: 20180928-F:
-
Table - Vitals-Plus
Method – Vitals-Plus Elements – Part 1 f 2
Measures of Quality and Satisfaction – Process Clozapine
Related CBC
Date of Encounter: 20180918-TU:
-
|
|||||
Clinical
|
Clerical &
Scheduling
|
||||
Item
#
|
Patient Ratings
Service Element
|
20180918
(TU)
CBC
Team
|
Appt Made
20180821-TU
By Team Martha
For: 20180918-TU
|
Sample
CALC
|
|
-
|
|||||
01
|
Accountability
|
1.0
|
1.0
|
1.0
|
|
02
|
Clozapine Awareness
|
1.0
|
0.5
|
1.0
|
|
03
|
Doctor’s Orders
|
1.0
|
1.0
|
0.5
|
|
04
|
Error Free
|
1.0
|
1.0
|
1.0
|
|
05
|
Guidance
|
1.0
|
1.0
|
X
|
|
06
|
Paper Trail
(E-Paper Trail)
|
0.0
|
1.0
|
1.0
|
|
07
|
Pharmacy
|
NA
|
NA
|
X
|
|
08
|
Phone Support
|
NA
|
NA
|
X
|
|
09
|
Promotes Recovery
|
1.0
|
1.0
|
1.0
|
|
10
|
Satisfaction Survey Offered
|
0.0
|
0.0
|
0.0
|
|
-
|
|||||
6.0/8
|
6.5/8
|
||||
Carry
|
Carry
|
Stayed
|
|||
-
|
Indications of Satisfaction: Actual Data from 20180918-TU:
Encounters (CBC and Scheduling) – Last Reviewed: 20180928-F:
-
Table - Vitals-Plus
Method – Vitals-Plus Elements – Part 2 f 2
Measures of Quality and Satisfaction – Process Clozapine
Related CBC
Date of Encounter:
20180918-TU:
-
|
|||||
Clinical
|
Clerical &
Scheduling
|
||||
Item
#
|
Patient Ratings
Service Element
|
20180918
(TU)
CBC
Team
|
Appt Made
20180821-TU
By Team Martha
For: 20180918-TU
|
Sample
CALC
|
|
-
|
|||||
11
|
Scheduling
|
1.0
|
0.5
|
1.0
|
|
12
|
Situational Awareness
|
1.0
|
0.0
|
1.0
|
|
13
|
Timeliness
|
1.0
|
1.0
|
1.0
|
|
14
|
TimeSpent
|
1.0
|
0.0
|
1.0
|
|
15
|
Values Consumer
(Member-Account)
|
1.0
|
1.0
|
1.0
|
|
16
|
Values Consumers Time
|
1.0
|
0.5
|
1.0
|
|
17
|
Healthful Environment
|
1.0
|
1.0
|
1.0
|
|
18
|
Agent of Remedy
|
1.0
|
1.0
|
1.0
|
|
-
|
|||||
8.0/8
|
5.0/8
|
||||
Carry
|
Carry
|
||||
-
|
Indications of Satisfaction: Actual Data from 20180918-TU:
Encounters (CBC and Scheduling) – Last Reviewed: 20180928-F:
-
Table - Vitals-Plus
Method – Vitals-Plus Elements – Combined Parts 1 and 2
Measures of Quality and Satisfaction – Process Clozapine
Related CBC
Calculations
Date of Encounter: 20180918-TU:
[ERRORS FOUND 20180926 Recalculations]
-
|
|||||
Clinical
|
Clerical &
Scheduling
|
||||
Item
#
|
Patient Ratings
Service Element
|
20180918
(TU)
CBC
Team
|
Appt Made
20180821-TU
By Team Martha
For: 20180918-TU
|
Sample
CALC
|
|
-
|
|||||
Plus Part 1
|
6.0/8
|
6.5/8
|
Carried Forward
|
||
Plus Part 2
|
6.0/8
|
6.5/8
|
Carried Forward
|
||
-
|
|||||
Plus Parts 1 & 2
Items = 18 (MAX)
|
12.0/16
75.0%
|
13.0/16
81.3%
|
Sum/# Scored
13.5/15*100
|
||
Star Equivalents =
|
3.8
|
4.1
|
|||
Impressions - Sustained or Improvement Bonus
|
1.0
|
||||
-
|
Vitals-Plus – Last Revision: 20170926-TU: (Theta Version)
Indications of Satisfaction: Actual Data from 20180918-TU: Encounters (CBC and
Scheduling) – Last Reviewed: 20180928-F:
-
This is the End
Images At the End
Time Series Results for Keith Torkelson
Blood Glucose Level
From 8/9/18
Results for Keith Torkelson
Blood Glucose Level
From 8/9/18
Results for Keith Torkelson
White Blood Cell Count
Sample from 2018 of Being In Range
-
We ask you does Keith AKA Buster Look Overweight Like his Doctor Told him Last Week September 27, 2018? (AVEY)
He does look a bit stressed though :o)
-
Promote WorldWafers
-
-30-
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