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1 Building It fromScratch: TheTeam Approach toFunctional Diabetic Limb Salvage
9
of the MDT.Members also participate in monthly
department morbidity and mortality conference.
Factors that can improve communication:
• Electronic Medical Record (EMR): A
shared EMR offers easy access to all diagnostic results, photo-documentation, operative
reports, and clinical assessments.
• Set Meeting Times: Having set times to meet
among specialists within the MDT is essential
as members are less likely to attend meetings
without protected time [37]. This also avoids
confusions and facilitates sustainability of the
MDT.
• Personal Commitment: The most central
component to successful communication is
possessing a shared purpose and willingness
to address the task at hand.
Barriers toCommunication
Although many health care professionals claim
to work in the best interests of a team, studies
have demonstrated that individuals may work
autonomously [38]. Other barriers to a collaborative team environment may include perceived
loss of autonomy, unawareness of the services of
transdisciplinary colleagues, and distrust in decisions of others. Communications and collaboration barriers existing among the clinicals staff
can jeopardize efforts to improve health care
safety and quality care.
Support fromAbove
and improved patient outcomes largely recoup,
and exceed, any losses from initial investments.
Patient Centered Care andRole
ofthePatient
The driving force of any decision made by the
MDT reects the patients’ needs and preferences.
In partnership with core members of the MDT,
the patient should be heard and be able to make
informed decisions about their care. Having a
DFU may be overwhelming for many patients
and easing the process of care is necessary. The
patient should be assigned a contact personnel
who will simplify the pathway of care, offer the
patient information about their treatment plan,
elucidate their expectations, communicate clinical information, and support them through their
wound care. Although any member of the team
can fulll this role, it has been suggested that a
clinical nurse specialist is the preferred team
member to carry out this duty and represent the
patient’s views in meetings [37].
Adherence to treatment plays an important
role in the clinical outcome of DFU.Wound centers with a focus on multidisciplinary care have
been shown to promote patient adherence to
treatment recommendations [39, 40]. Patients
who do not follow treatment recommendations
face signicantly worse outcomes than those
who do. This should guide clinical practice to
identify patients who are at nonadherent and
adopt strategies aimed at improving patient
adherence.
The success of a multidisciplinary care team is
reliant on the hospital administration’s ability to
provide the infrastructure for the development
and sustainability of a wound care center. A committee comprised of leaders from team members
respective institution facilitates administrative
coordination for care organization, resource allocation, and data collection.
Although administrators may be initially hesitant to take on a seemingly nancially and
resource demanding endeavor, the cost benets
Conclusion
The implementation of a multidisciplinary team
approach to diabetic limb salvage is complex and
difcult; however, when successfully initiated in
an academic hospital-based wound care center it
can signicantly improve patient outcomes.
Multidisciplinary teams possess the diversity of
skills knowledge and expertise necessary to treat
the complex diabetic foot ulcer. In the chapters to
follow we will attempt to highlight some of the
10
A. A. AbuElHawa et al.
essential features within a multidisciplinary team
that were discussed in this chapter.
Financial Disclosure Statement The authors have no
inancial disclosures, commercial associations, or any
other conditions posing a conict of interest to report.
References
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Diabetes Care. 2008;31:99.
20. Yesil S, Akinci B, Bayraktar F, Havitcioglu H,
Karabay O, Yapar N, etal. Reduction of major amputations after starting a multidisciplinary diabetic foot
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22. Wilson V, Pirrie A.Indicators of good practice spotlights 2000;1–4.
23. Armstrong DG, Boulton AJM, Bus SA. Diabetic
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Mills JL, Armstrong DG. Toe and ow: Essential
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org/10.1016/j.jvs.2010.06.004.
25. Thiruvoipati T. Peripheral artery disease in patients
with diabetes: epidemiology, mechanisms, and outcomes. World J Diabetes. 2015;6:961.
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WJ, Levine JP, et al. Diabetes is associated with an
increased risk of wound complications and readmission in patients with surgically managed pressure
ulcers. Wound Repair Regen. 2019;27:249.
27. Lipsky BA.A report from the international consensus
on diagnosing and treating the infected diabetic foot.
Diabetes Metab Res Rev. 2004;20:S68.
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Hubley K, Winger L, etal. How to make a hospitalbased wound center nancially viable: The
Georgetown University Hospital model. Gynecol
Oncol. 2008;111:S92–7. https://doi.org/10.1016/j.
ygyno.2008.07.044.
29. McMurray SD, Johnson G, Davis S, McDougall
K.Diabetes education and care management signicantly improve patient outcomes in the dialysis unit.
Am J Kidney Dis. 2002;40:566.
30. McIntosh A, Peters J, Young R, Hutchinson A.,
Chiverton R, Clarkson S, etal. Clinical guidelines for
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Type 2 Diabetes: prevention and management of foot
problems (Revised version). Management; 2003.
31. Gottrup F. A specialized wound-healing center
concept: importance of a multidisciplinary department structure and surgical treatment facilities
in the treatment of chronic wounds. Am J Surg.
2004;187:S38–43.
32. Larsson J, Stenström A, Apelqvist J, Agardh
CD.Decreasing incidence of major amputation in diabetic patients: a consequence of a multidisciplinary
foot care team approach? Diabet Med. 1995;12:770.
33. Joret MO, Osman K, Dean A, Cao C, van der Werf B,
Bhamidipaty V.Multidisciplinary clinics reduce treatment costs and improve patient outcomes in diabetic
foot disease. J Vasc Surg. 2019;70:806–14. https://
doi.org/10.1016/j.jvs.2018.11.032.
34. Sutherland BL, Pecanac K, Bartels CM, Brennan
MB.Expect delays: poor connections between rural
and urban health systems challenge multidisciplinary
care for rural Americans with diabetic foot ulcers. J
Foot Ankle Res. 2020;13:1–10.
35. Rose G, Duerksen F, Trepman E, Cheang M, Simonsen
JN, Koulack J, et al. Multidisciplinary treatment
of diabetic foot ulcers in Canadian Aboriginal and
non- Aboriginal people. Foot Ankle Surg. 2008;14:
74–81.
36. MacRury S, Stephen K, Main F, Gorman J, Jones S,
Macfarlane D.Reducing amputations in people with
diabetes (RAPID): evaluation of a new care pathway.
Int J Environ Res Public Health. 2018;15:999.
37. Lamb BW, Taylor C, Lamb JN, Strickland SL, Vincent
C, Green JSA, etal. Facilitators and barriers to teamworking and patient centeredness in multidisciplinary
cancer teams: ndings of a national study. Ann Surg
Oncol. 2013;20:1408–16.
38. Coles C.Educating the health care team. Patient Educ
Couns. 1995;26:239.
39. Bus SA, van Netten JJ.A shift in priority in diabetic
foot care and research: 75% of foot ulcers are preventable. Diabetes Metab Res Rev. 2016;32:195.
40. Armstrong DG, Bharara M, White M, Lepow B,
Bhatnagar S, Fisher T, etal. The impact and outcomes
of establishing an integrated interdisciplinary surgical
team to care for the diabetic foot. Diabetes Metab Res
Rev. 2012;28:514.
Stang andDay-to-Day
Management: TheNuts andBolts
ofRunning aWound Care Center
AmaraEllis andTaraWallace
2
Page 1:
How
Clinic
Runs
Page 2:
CWH/
HBOT
Stafng
Structure
Page 3: Who
Does What?
Nurse Manager
Roles and
Responsibilities
Page 4: Patient
Services
Manager Roles
and
Responsibilities
Page 5: Why is
Co-Management
Important? Our
Personal
Perspectives
Page 6: Stafng
Roles: Clinical
Page 7:
Stafng Roles:
Administrative
Page 8: The
Triage Desk
Page 9:
What Makes
for Triage
Desk
Success
10:
Scheduling:
Clinic
Master
Calendar
Page 1: How Clinic Runs
Daily Operations, Center forWound
Healing (CWH)
• Open on Weekdays (No Nights, Weekends, or
Holidays):
– Triage Line takes calls from 0800 to 1700.
– Patient Appointments are booked at 15, 20,
or 30-min intervals from 0800 to 1550.
Booking intervals are dictated by that
Provider’s preferred Scheduling Template.
– Appointment types include New Patient,
Post-Operative, or Follow-Up Evaluations.
A. Ellis (*) · T. Wallace
Center for Wound Healing/Hyperbaric Oxygen
Therapy, MedStar Georgetown University Hospital,
Washington, DC, USA
e-mail: amara.e.ellis@gunet.georgetown.edu;
tara.d.wallace@gunet.georgetown.edu
Page 11:
Scheduling:
Outlook Master
Calendar
Page 12:
Scheduling:
Provider and
Orthotic/
Prosthetic
Coverage
Template
Page 13:
Scheduling:
Upcoming
Clinic #s
Page 14:
Scheduling:
Plans of the
Day
Page 15:
Scheduling:
Clinical
Staff
Schedules
Page 16:
Managerial
Tracking of
Clinic
Operations
Page 17:
Associate
Engagement
Page 18:
Leadership
Philosophies:
The
Managers’
Perspectives
– Some Providers also host limited Telehealth
(Remote) clinics during the week.
• Staggered Staff Schedules:
– Earliest associates are scheduled to arrive
at 0700; last associates leave at 1730.
– Registered Nurses (RNs) and Nurse
Practitioners (NPs) work 10-hour shifts to
ensure the entire clinic day is covered.
They have a rotating day off each week.
– Our Certied Medical Assistants (CMAs)
work 8-hour shifts. They stagger start- and
end-times to ensure the entire clinic day is
covered. First arrival is 0730; last departure
is 1700.
• Provider Clinics:
– We have 10 Exam Rooms and 2 simultane-
ous clinics running daily.
– Exam Rooms are split between Providers
(5 each).
– Each clinic is staffed with 1 Attending and/
or NP, 2 RNs, and 2 CMAs.
© Springer Nature Switzerland AG 2023
C. E. Attinger, J. S. Steinberg (eds.), Functional Limb Salvage,
https://doi.org/10.1007/978-3-031-27725-2_2
13
14
A. Ellis and T. Wallace
– There is 1 Triage Nurse for the day, 1 on-
site Radiology Technician, 1 Clinical
Scribe for each Attending, 1 “oating”
CMA, and an on-call Orthotist/Prosthetist.
– We share Wednesday clinics with Vascular
Surgery each week (5 Exam Rooms).
• Patient Volumes:
– Attendings generally see 20–30 patients in
AM, 10–15 patients in PM.
– NPs generally see 10–12 patients in AM,
8–10 patients in PM.
Daily Operations, Hyperbaric Oxygen
Therapy (HBOT)
• Hours are Monday–Friday, 0630–1530 (with
occasional weekend/inpatient cases).
• Each day is staffed by 1 Covering Attending, 1
Nurse Coordinator, and 2 HBOT Techs (1 of
whom is also their Safety Director).
• There are four chambers available, enabling
treatment for up to 12 patients per day.
• Authorization for treatments is submitted
through each patient’s insurance company,
who will determine how many total chamber
sessions and “dives” for which a patient will
be covered.
Attendings/Residents Coverage
• Inpatient rounds and coordination with
other hospital services for ongoing Plans of
Care.
• Consultations for other hospital services.
Operating Room (OR)
• Daily OR cases which are published to the
team via email and saved in our practice Share
Drive.
• These cases involve Attendings, Residents,
OR staff, and Observers/Vendors.
Page 2: CWH/HBOT Stang
Structure
Providers Afliated
– 2 Plastic Surgeons – Vascular Surgery
– 2 Podiatric
Surgeons
– 2 Outpatient NPs – Plastic Surgery/Nerve
– 3 Inpatient NPs – Radiology Tech (allows for
– 1 Rheumatologist – Plastics/Podiatric Residents
– 1 Hyperbaric
Medicine
Specialist
– Infectious Disease
Specialist
in-clinic X-ray capability)
– Physical Medicine and Rehab
(Wound Treatment and
Lymphedema therapy)
– Orthotics/Prosthetics Clinics
– Visiting Nurse Agencies
– Clinical Scribes
– Dermatology
• Weekday outpatient clinic visits.
• Daily OR Cases, both inpatient and outpatient
cases.
2 Stang andDay-to-Day Management: TheNuts andBolts ofRunning aWound Care Center
Wound Center Stang (Fig2.1)
Administrave
Director
Administrator III
15
Hyperbaric
Technologist
Hyperbaric Tech
#1 (Also HBOT
Safety Director)
Hyperbaric Tech
#2
Part-Time
Hyperbaric Tech
30h
Tara Wallace
Paent Services
Manager
CerfiedMedical
Assistant
CMA#1
CMA#2
CMA#3
CMA#4
CMA#5
Administrave
Paent Srvcs
Coordinator #1
Paent Srvcs
Coordinator #2
Paent Reg
Associate#1
Paent Reg
Associate#2
Billing Analyst
AmaraEllis, RN
NurseManager II
NurseSpecialistII
CWHRN#1
CWHRN#2
CWHRN#3
CWHRN#4
CWHRN#5
NursePraconer
OutpaentNP#1
OutpaentNP#2
(20h)
Inpaent NP #1
Inpaent NP #2
(36h)
Inpaent NP #3
(20h)
Fig. 2.1 Org Chart
Execuve
Assistant
HBOT Nurse
Coordinator
16
A. Ellis and T. Wallace
Page 3: Who Does What?
Leadership: Co-Managers
The Clinical Nurse Manager and Patient Services
Manager (PSM) work in tandem to oversee the
day-to-day Clinical and Administrative operations of the CWH/HBOT. As delineated in the
Organizational (“Org”) chart in Fig.2.1, the Nurse
Manager’s direct reports are all Nursing staff; the
PSM’s direct reports are the Administrative and
Medical Assistant staff.
Nurse Manager Roles
andResponsibilities
1. Direct oversight and coordination of day-to-
day Clinical operations, stafng, and troubleshooting. Direct oversight and management
of the department’s RNs and NPs.
2. Updates and maintains clinical stafng and
Provider clinic schedules, as well as the CWH
Master Calendar. Makes all clinical stafng
assignments (daily, weekly, monthly).
3. Performs in simultaneous Nurse Specialist
role in Clinic and at the CWH Triage desk, per
daily stafng assignment needs. Assists with
any other CWH tasks as assigned or
indicated.
4. In coordination with the PSM, approves
staff leave requests and monitors Time and
Attendance. Performs preliminary approval
of Nursing/NP staff timesheets in our
clocking system, MyTime (PSM does them
for Medical Assistant and Administrative
staff).
5. In coordination with PSM, site Administrators,
Nurse Recruitment, and Human Resources,
performs interviewing, hiring, and orientation
for new associates, as well as coaching/mentoring or counseling existing staff.
6. Performs monitoring, documentation, clinical
education, and follow-up on department
Quality and Safety Issues.
(a) Reports or presents on these issues to
Administration as called upon.
(b) Attends various Hospital/Administrative
meetings for these issues as scheduled
and/or as appropriate.
(c) On-site CWH representative and contact
point for department audits—Safety,
Infection Prevention, Dept of Health,
Joint Commission, Magnet, etc.
(d) Acts, documents, and follows up on all
patient-safety related issues with Legal,
Risk, Administration, Safety, Patient
Advocacy as appropriate.
(e) Preparation of and follow-through with
CWH staff for these audits or issues.
7. Directs and archives weekly all-staff Thursday
Meetings. Attends all other Departmentrelated meetings as appropriate.
8. Liaison between CWH/HBOT and Nursing/
Hospital Administration.
9. Updates and maintains departmental archives
in Shared Drives and Spreadsheets.
Page 4: Patient Services Manager
Roles andResponsibilities:
1. Manages the entire patient registration process, ensuring and obtaining complete demographic and insurance information for each
patient appointment.
2. Oversees the entire patient scheduling process, including adherence with all established
policies, determining, and accurately documenting the appropriate appointment type,
referral and/or authorization requirements,
and procedure orders.
(a) Supervises the scheduling of surgical
cases, procedures, and admissions for the
department, including staff adherence
with the appropriate communication of
hospital policies and procedures to
patients and families.
(b) Directs implementation and mainte-
nance of approved organization electronic scheduling and billing system,
triaging referrals and/or orders to the
appropriate physician master scheduling functions. Ensures the performance
2 Stang andDay-to-Day Management: TheNuts andBolts ofRunning aWound Care Center
17
of daily schedules edits as necessitated
by Provider changes.
3. Manages patient check-in and check-out processes for the department, including patient
reception, validation of patient identity, scanning of patient documents to the appropriate
system, and resolution of conicting chart
alerts. Ensures immediate updates and resolution for missing or inaccurate information
prior to patient arrival, insurance verication,
collection, and electronic position of time-ofservice payments, and preparation of charge
batches.
(a) Monitors staff adherence to billing proce-
dures and copayment reports on daily reconciliation department activities.
Oversees batch management. Monitors
encounter form completion and reconciliation and batching process of front- and
back-end billing practice, in order to optimize charge capture and Provider
reimbursement.
4. Directs referral, pre-certication, and authorization processes to all Managed Care
Department requirements and contracts.
Ensures managed documentation of referrals
and authorizations in the approved organizations’ electronic scheduling and billing
systems.
5. Ensures medical records meet departmental
managed care, Joint Commission, HIPPA,
and other regulatory standards.
6. Collaborates with the healthcare team
members, patients, Physicians, and
Department Administrators to identify and
troubleshoot barriers to efficient, quality
service.
(a) Audits staff productivity and utilization of
billing systems to include indexing, scanning, phone notes, les in error and other
appropriate measures.
7. Actively participates in departmental and hospital meetings, such as Clinical Practice and
Managed Care Compliance. Relays relevant
information to administrative and clinical
staff and provides training and associated
documents as appropriate.
8. Implements cross-training schedules between
all administrative positions to ensure adequate
staff coverage.
Page 5: Why is Co-Management
Important? Our Personal
Perspectives
In our experience managing the CWH/HBOT, we
have come to realize that having two Managers is
essential for cohesive and comprehensive coverage of all day-to-day Clinical and Administrative
operations. Foremost, the departmental workload
and its scope is such that it requires at least two
people’s involvement, and two differing areas of
expertise. The Nurse Manager acts as an available
resource, coach, and informational source on the
Clinical side, and the Patient Services Manager is
able to offer the same on the Administrative side.
Managers are also both able to cross-cover any of
their associates’ duties when needed. Both of us
regularly ll in as staff around the clinic - The
Nurse Manager as a clinical and Triage nurse, and
the Patient Services Manager in any one of our
Administrative positions which are vacant on
either the short- or long-term.
We have also found that chemistry to the partnership is key - as much as possible, it is important that your Co-Manager possesses shared
values, motivations, and goals for the practice and
team. We Managers share an ofce and discuss
the minutiae of the day in real time. We can put
our heads together to solve any challenges which
arise, both small- and big-picture, and we brainstorm together and offer each other different perspectives as to how to best approach these issues.
We talk things out and welcome the other’s
insights and advice - even if we sometimes ignore
them, the input is always appreciated. This relationship also allows for the mental security and
relief that yours is a shared burden; that someone
else appreciates what you are experiencing; that
you are supported and championed; and that you
are not alone in your responsibilities.
We Managers look at ourselves as a unit. We let
all of our associates know, from before hire, that we
18
A. Ellis and T. Wallace
work as a team. Our associates and Providers know
that we are aligned, and that they can come to either
of us at any time for assistance or guidance. They
know we approach things in tandem and keep each
other updated to the minute, which we feel is necessary for informed and overall management of the
team. We have found that the symbiotic nature of
this partnership has allowed us to manage our practice effectively and successfully, to recruit, hire,
and retain excellent associates, and to ensure continuity and the highest standard of patient care.
Page 6: Stang Roles: Clinical
This section is meant to provide a consolidated
overview of our CWH/HBOT stafng team and
their roles in our Clinical setting.
Clinical Associates
Certied Medical Assistants (CWH): Our
CMAs see patients with the Providers and Nurses
throughout the clinical day. They are responsible
for rooming the patients into Exam rooms, getting the patient and exam room prepared for the
visit, and removing existing casts and dressings.
They also perform the initial patient intake,
which includes Vital Signs and general screening
for Pain and Fall Risks, Smoking and Allergies,
any Specialized Needs, and currently, COVIDrelated risk factors. The CMAs then conclude the
patient visits by cleaning and re-dressing any
patient wounds as directed, assisting the patient
with their mobility devices, escorting them to
where they need to go from there, and then turning over the Exam Rooms for the next visit. The
CMAs also coordinate for the retrieval and return
of our Sterile Instruments and the ordering and
stocking of clinic supplies. They are occasionally
called upon to assist with complex Inpatient
dressings as well, in order to help expedite patient
discharges.
Nurse Specialists (CWH): Trained in a dual
Clinical/Triage role.
• Clinical: Our RNs see patients with our
Providers in the clinic each day, generally
alternating each patient assignment (every
other exam room). They start the Ofce Visit
note, adding and updating the History of
Present Illness (HPI), Review of Systems
(ROS), and performing a Medication List
Reconciliation. They complete the Wound
Assessment documentation and nish with a
Visit Summary. This Summary is given to and
reviewed with the patient, providing details on
all their instructions and ongoing Plan of Care.
RNs assist the Providers during the visit with
any patient exam or bedside procedural needs.
They are also involved in on-site, real-time
care coordination for consultations from/
referrals to other practices or team members,
any diagnostic testing needs, ensuring any
orders or updates are sent out to the appropriate parties, and updating anyone involved with
the patient’s care. Our nurses are also crosstrained with the CMA role and will perform
those tasks as well when needed.
• Triage: Our nurses assist with anything that
comes through our Triage desk, either as their
coverage assignment for that day, or in any
downtime at the beginning and end of the day.
These tasks are all related to patient requests,
surgical or admissions planning, patientrelated calls and paperwork, and ongoing variable tasks in coordination of patient care and
follow-up.
Nurse Practitioners (CWH)
• Outpatient: Our outpatient NPs act in partnership with our Attendings in their clinics and
host clinics of their own. They evaluate and
examine the patient, assist with or perform
any indicated bedside procedures, and recommend and document the Assessment and Plan
(A&P) for the patient. They follow up on our
specimen results and coordinate with
Infectious Disease for any subsequently
updated recommendations. They are also
cross-trained in the RN, Triage, and CMA
roles and will perform those tasks as well
when needed.
• Inpatient: Our inpatient NPs work with our
Residents and Attendings in ongoing patient
2 Stang andDay-to-Day Management: TheNuts andBolts ofRunning aWound Care Center
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19
care, monitoring, and discharge coordination
from the inpatient side. They round on patients
at the bedside and work closely with Case
Management for ongoing complex discharge
planning and patient follow-up needs. They
also compose our Discharge Summaries and
stay in constant communication with all of
those involved in the patient’s care, to ensure
streamlining and cohesion to their clinical
journey through all systems.
Nurse Coordinator (HBOT): This position
is responsible for the safe and effective operation
and maintenance of the hyperbaric chambers and
related support systems, and oversight of the dayto- day operational activities required to maintain
and grow the Hyperbarics Program. Our Nurse
Coordinator monitors quality and safety issues
and provides nursing care and treatment for
incoming patients. They supervise the technicians and assist in specialized clinical and
research projects. They also assist in Triage tasks
such as insurance authorizations and anything
needed in patient follow-up.
Page 7: Stang Roles:
Administrative
This section is meant to provide a consolidated
overview of our CWH/HBOT stafng team and
their roles in our Administrative setting.
Patient Registration Associates (PRAs):
Our two PRAs are responsible for a multitude of
tasks at the Front Desk. These associates oversee
patient check-in and check-out, insurance verication, and registration updates. Before the
patient arrives for their ofce visit, they verify the
appointment type, check eligibility, and contact
the patient if a referral is needed. If a patient is
within or out of their global period, the correct
appointment type is allocated. At check-in, the
patient is given a demographic form and asked if
any information needs to be updated in our system. The patient’s insurance card, ID, and consent to be treated are scanned into their chart at
check-in. If the patient’s insurance requires a
copayment, it is collected before the patient is
seated. MedStar also has a virtual appointment
verication system called Tavoca, through which
patients can cancel their appointments. In the
event of cancellation, the PRAs reach out to the
patient to reschedule. The Front Desk also scans
in new patient paperwork, submits Medical
Records Requests, and checks our virtual
Administrative Inbox for urgent appointment
requests from the clinical staff.
Patient Services Coordinators (PSCs):
Though we have two positions with this same
title, they encompass completely different roles.
• Patient Services Coordinator (A), sometimes
referred to as our Surgical Coordinator, is
responsible for booking all inpatient and out-
patient surgical procedures for the Providers.
When the patient has completed all their pre-
surgical requirements, PSC (A) is then tasked
with coordinating the surgery booking. If this
is an outpatient procedure, PSC (A) is respon-
sible for obtaining authorization for the proce-
dure through the patient’s insurance company.
For inpatient cases, authorization will already
have been obtained and is handled by the inpa-
tient billing team. Once the procedure is
authorized, the case is sent to the OR sched-
uler for posting. PSC (A) will then update the
patient’s Electronic Medical Record (EMR)
and a posting sheet for the Residents, which is
located on our practice’s Share Drive. Once
the surgery has been completed and entered
into the surgical billing system, PSC (A) then
checks over the submission for errors and
makes any needed corrections. When the sur-
gery bills have been committed, a copy is
printed and then entered into the patient’s
EMR for physician billing. PSC (A) is also
responsible for communicating with the
patient throughout the process of booking
their procedure and post-op follow-up appoint-
ment and providing instruction and guidance
for the day of surgery.
• Patient Services Coordinator (B) is responsi-
ble for ltering and navigating all incoming
phone calls to our department’s Triage line.
This direct line is given to all patients in their
Visit Summaries, with directions to call if they
have any clinical questions or concerns
between their appointments. This position is
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