News Blast

5 | 5 | 95 Success Stories are shared by TLC Associates and serve as inspiration to improve and uplift our associates and patients. Read. Improve. Uplift. Repeat. Submit your story to tlcnewsblast@kroger.com to be published in future issues.

NP Cherri Gettis, The Little Clinic Broadway, Wichita, Kansas

As shared by Cherri: In December, a female patient came in with SOA and a low O2 Sat. She also had diminished breath sounds and crackles in her lungs. She really did not feel well and I was afraid she had pneumonia. I recommended that she seek treatment at the emergency room, but the patient really did not want to go to the ER.

Earlier this month, the patient came by the clinic to thank Cherri for her care and concern. Turns out the patient was diagnosed with cancer. This was a shock to the patient since she did not have signs or symptoms that would make her think she had cancer. The patient stated if it wasn’t for Cherri and The Little Clinic she would of never gone and would not have known until maybe it was too late. She was very thankful. She was happy that TLC was here to help her or her outcome could have been different.

Thank you, Cherri, for providing the life-changing guidance the patient needed!

Handling and Disposal of SharpsFrom Martha George, Compliance and Accreditation Manager

Careful and appropriate handling of contaminated/used sharps can prevent injury and reduce the risk of infection. All clinic associates must follow established work practices to decrease the incidence of accidents, injury and exposure to bloodborne diseases such as human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and other bloodborne pathogens.

Notice: This document contains confidential and privileged infor-mation that is intended only for employees of The Little Clinic.

Any disclosure, copying, distribu-tion, or reliance upon the con-tents of this document is strictly prohibited.

Inside This Issue:

5 | 5 | 95 Success Stories ................................. 1Survey Ready 365 ........................................... 1Coder’s Corner ................................................ 3Medication Entry in Telephone Encounter ...... 4Marketing Shout Outs .................................... 5Friendly & Fresh Testimonial .......................... 6Announcements ............................................. 6

TheLittleClinic.comInside Select Stores

May 25, 2016 Edition

Notice: This document contains confidential and privileged information that is intended only for employees of The Little Clinic.

Any disclosure, copying, distribution, or reliance upon the contents of this docu-ment is strictly prohibited.

Inside This Issue:

5 | 5 | 95 Success Stories .........................1

Survey Ready 365 ...................................1

Coder’s Corner ........................................3

Medication Entry in Telephone ...............4

Marketing Shout Outs ............................5

Friendly & Fresh Testimonial ..................6

Announcements .....................................6

Page 2May 25, 2016 Edition

In order to assure the safety of all associates in our clinics, observe the following:

• Dispose of all sharps in Sharps disposal container immediately or as soon as feasible after use.

• Sharps disposal containers must be located in a place that prevents children or mentally unstable patients from accessing the sharps.

• Sharps disposal containers that are not secured to a wall must be located in a place that prevents spill or being knocked over.

• Recapping, bending or removing needles is only permissible if there is no feasible alternative. If recapping is absolutely necessary, use one-handed scoop technique. Scoop Technique: Use the needle itself to pick up the cap. Push the cap against a hard surface to secure.

• Sharps disposal containers must be packaged for destruction when ¾ full or upon 30-day expiration date – whichever comes first.

• Sharps containers must be labeled with a 30-day expiration date if something other than a sharp object is placed in the container. The first day a non-sharp item is placed in Sharps container, date the Sharps container 30 days out by writing on the Sharps container: “EXP,” and 30-day expiration date: EXP 7/20/16. This must be written with a Sharpie and obvious to all who use the Sharps container. Non-sharps items are those that pose a risk of contamination, i.e., live vaccine vials, or that that are contaminated or saturated with visible blood or body fluid.

• Sharps mail-back containers MUST be packaged immediately upon discontinued use, and MUST be packaged per directions included with box. Improper packaging may expose others to contaminated waste.

• Mail back sharps cannot be stored in clinics and must be mailed for destruction within 5 days of discontinued use and packaging.

• Manifest tracking form MUST be completed by clinics when preparing to mail sharps. Clinics must keep the “generator” copy in the communication binder. The tracking manifest is matched with the destruction notice and kept for 3 years. Clinics should check online for destruction notices at least monthly.

Discontinued, full or expired Sharps containers processed for mail-back MUST be packaged exactly per instructions provided with the mail-back kit. The instructions and manifest are in a packet attached to the side of the mail-back container.

Failure to package mail-back Sharps containers properly, results in exposure risk to others.

For more information visit OSHA Bloodborne Pathogens and Needlestick Prevention page.

Survey Ready 365 continued...

All non-sharp items that are disposed of in sharps containers are considered, by law, regulated biomedical and/or biohazardous waste. The law prohibits storage of regulated

biomedical or biohazardous waste in excess of 30 days. This is the reason why we must be diligent regarding the 30-day expiration date on sharps containers when we place

nonsharps in the containers.

Notice: This document contains confidential and privileged information that is intended only for employees of The Little Clinic.

Any disclosure, copying, distribution, or reliance upon the contents of this docu-ment is strictly prohibited.

Inside This Issue:

5 | 5 | 95 Success Stories .........................1

Survey Ready 365 ...................................1

Coder’s Corner ........................................3

Medication Entry in Telephone ...............4

Marketing Shout Outs ............................5

Friendly & Fresh Testimonial ..................6

Announcements .....................................6

Page 3May 25, 2016 Edition

Coder’s CornerFrom Chris Jamieson, Medical Coder

Welcome to another edition of the Coder’s Corner. Chris Coder here to share more tips and tricks about some common errors we can easily avoid. I promise this won’t take long, so let’s get started!

Back in the ICD-9 days, we had a section in our coding books for “External Causes of Morbidity” or the “E codes.” This section included codes for accidents, poisoning, animal bites, you know, all the good stuff. The rule was that E codes could never be used as the primary diagnosis. The injury itself should always be primary.

Smash cut to ICD-10. With ICD-10, E codes have been replaced with V, W, X and Y codes. Just like the E codes, any diagnosis code beginning with V, W, X or Y cannot be coded as the primary diagnosis. Using these codes as primary will surely cause a denial and will delay reimbursement for weeks.

So, now you are asking yourself, “How should I code this? Can you provide me with an example, Chris?” Why sure I can! When a patient comes in for their first encounter with a bug bite on the right arm, the primary diagnosis would be S40.861A, insect bite of right arm, initial encounter. Follow that up with a secondary diagnosis of W57.XXXA, bitten or stung by insect, initial encounter. And in case you are wondering, if the patient has a third or fourth diagnosis those can be added also. The main thing to remember is to not use an external cause code as primary.

That’s all I got for this week folks! Don’t forget I’m available Monday through Friday at the drop of a hat to answer questions, clear things up for you or to just double check on something you feel unsure of. I am YOUR coder. I can be reached by phone at 615-425-4234 or by email at Christopher.Jamieson@thelitttleclinic.com. Take care and I’ll see you guys next time!

Notice: This document contains confidential and privileged information that is intended only for employees of The Little Clinic.

Any disclosure, copying, distribution, or reliance upon the contents of this docu-ment is strictly prohibited.

Inside This Issue:

5 | 5 | 95 Success Stories .........................1

Survey Ready 365 ...................................1

Coder’s Corner ........................................3

Medication Entry in Telephone ...............4

Marketing Shout Outs ............................5

Friendly & Fresh Testimonial ..................6

Announcements .....................................6

Page 4May 25, 2016 Edition

Medication Entry in Telephone EncounterFrom Lee Nelson, EMR Manager

eClinicalWorks has discovered an issue that could potentially cause patient medications to reflect inaccurately under Current Medications if documented via specific workflow through the Telephone Encounters window only. eClinicalWorks has corrected this issue in versions V10- C12 and higher, and has suggested a workflow change to avoid the potential situation.

Issue DescriptionWhen a user creates a Telephone Encounter to add medications for a patient, and a specific series of steps are followed, a drug discrepancy occurs in the patient record. As a result, the patient’s Current Medications section will not reflect the most current medication list.

The issue occurs in the following scenario:1. Create a Telephone Encounter for a patient.2. Add a note in the Message window.3. Click the Rx tab (add a medication or simply click the tab and move on).4. Click the Virtual Visit tab and open the Treatment section, and then order a new

medication. 5. Send the order to the pharmacy as required(print/eRx).6. Click on any other area of the Telephone Encounter and make a change (for example,

go to the Message tab and add a note).

The medication ordered from the Treatment section in the Virtual Visit (Step 4) is replaced by the first one ordered (Step 3) on the Rx tab visually and does not display in the Current Medications. Even if no medication was added in Step 3, the medication added in Step 4 does not display the Rx tab was used.

The second medication added does not display on the patient’s chart. However, the prescription logs show the second drug was sent to the pharmacy based on the method used to prescribe (print/eRx).

What to do until the issue is Resolved? In the interim:

• DO NOT use the Rx Tab in the Telephone Encounter window!• ONLY use the Treatment section of the Virtual Visit in the Telephone Encounter

window.

Notice: This document contains confidential and privileged information that is intended only for employees of The Little Clinic.

Any disclosure, copying, distribution, or reliance upon the contents of this docu-ment is strictly prohibited.

Inside This Issue:

5 | 5 | 95 Success Stories .........................1

Survey Ready 365 ...................................1

Coder’s Corner ........................................3

Medication Entry in Telephone ...............4

Marketing Shout Outs ............................5

Friendly & Fresh Testimonial ..................6

Announcements .....................................6

Page 5May 25, 2016 Edition

Marketing Shout OutsFrom Kaitlin McMasters, Marketing and Customer Service Manager – Kansas and Heather Tseng, Field Marketing Manager, Colorado

PCT Caitlyn Turner, PCT Sharon Phillips and Clinic Manager NP Cherri Gettis at The Little Clinic in Broadway, Wichita, Kansas

Below is a picture of a marketing table at clinic #17101. The clinic staff worked with store management to display products that are applicable to TLC and that the providers recommend to our patients. This is a great way to show our value to store management!

NP Mary Tierney, PCT Meg Schultheiss and RDN Jessica Riggs at The Little Clinic in Lafayette, Colorado

The staff at The Little Clinic in Lafayette worked on their tobacco cessation competition. Jessica Riggs handed out walnuts with her information and did Dietitian PA announcements. NP Mary Tierney and PCT Meg Schultheiss set up goodie bags filled with Quit Line brochures, TLC tobacco cessation brochures, TLC General Services brochures, stress balls, water bottles, mints, magnets and walnuts with Jessica’s info. The team made up a Tobacco Cessation sign and have this displayed outside the clinic alongside brochures and some goodie bags and they engaged with passing-by shoppers and also handed goodie bags out to a couple store departments who have several employees who smoke. One patient’s father just quit smoking and is going to give the information to his uncle who needs to quit. He was excited when we gave him our goodie bag. See below for a picture of our work!

Notice: This document contains confidential and privileged information that is intended only for employees of The Little Clinic.

Any disclosure, copying, distribution, or reliance upon the contents of this docu-ment is strictly prohibited.

Inside This Issue:

5 | 5 | 95 Success Stories .........................1

Survey Ready 365 ...................................1

Coder’s Corner ........................................3

Medication Entry in Telephone ...............4

Marketing Shout Outs ............................5

Friendly & Fresh Testimonial ..................6

Announcements .....................................6

Page 6May 25, 2016 Edition

Staff at The Little Clinic in Richmond, Kentucky

The Little Clinic is convenient and right inside of Kroger. The staff is friendly and helps with our needs. The prices are about $85 on average, so decent prices. Most of the times I go, they are busy, but while you wait you can shop around Kroger! Overall, I would recommend going to The Little Clinic for minor health problems. ~ Patient review on Yelp.com 

AnnouncementsMay 2016 Grand Rounds Tomorrow

Date: Tomorrow, May 26, 2016 5 pm CTTopic: DOT PhysicalsSpeaker: Gina HaffnerThe Little Clinic – Advanced Clinical Provider

Convenient Healthcare & Pharmacy Collaborative 2nd Annual Conference

July 19-21, 2016 | Orlando, Florida Your special discount code is:Hilton Orlando Bonnet Creek CHPC16TLC

At the 2nd Annual Convenient Healthcare & Pharmacy Collaborative CE conference, pharmacists, nurse practitioners and physician assistants will join one another in learning the latest about disease prevention, healthcare screenings, chronic care management and treatment of common acute and chronic conditions.

This unique conference will offer attendees the opportunity to network and share best practices while earning up to 10 CE credits on topics ranging from allergic rhinitis to diabetes.

CE Topics include:• Respiratory Disease • Mental Health • Diabetes• Cardiometabolic Conditions • Dermatology • DOT Updates• Allergies • Orthopedics • And more...

Testimonial