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PULSE CHECKS ON BETA BLOCKER PATIENTS

10/29/2012

 
TO:          ALL CLINICAL STAFF
FROM:      JERRY ORLOFF
DATE:      OCTOBER 29, 2012

DR. VAISHNAV
Whenever Dr. Vaishnav starts a patient on a beta blocker eye drop (Timolol, Betaxolol, Betagan, Istalol, Betoptic-S, or similar), the assistant in the room with him is to check the patient's pulse, record their reading in the patient's EMR, and then personally report this finding to Dr. Vaishnav.

Dr. Vaishnav would then like to have that patient's pulse checked and recorded by the work up technician on all subsequent visits to our Practice, without exception.

DR. MCMANUS

When Dr. McManus starts a patient on a beta blocker eye drop, he would like his assistant to check the patient's pulse, record their reading in the patient's chart, and then personally report their findings to him.  Dr. McManus would also like that patient's pulse checked by the work up technician at the patient's next examination (i.e. likely a two, three, four, six or eight week IOP check).

Beyond this visit, Dr. McManus will determine if additional measurements of the patient's pulse are necessary.
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DIAGNOSTIC CHECKLIST - RD Consult

10/25/2012

 
Info to Acquire to help us make the decision, whether or not to add the patient on...
From: Jerry Orloff

Sent: Thursday, October 25, 2012 12:37 PM
Subject: RD Consult - Info to Acquire to help us make the decision, whether or not to add the patient on...


I put together a list to help you obtain the necessary data set to help us make the decision, whether or not to accept a patient who may have a Retinal Detachment:


 1.  Name of Referring Physician

2.  Type of Insurance - primary and secondary;  note: if self pay - patient must be informed that the cost of an RD repair - which must be paid in full on the date of the evaluation and surgery is as follows:    Consult:  225     B-Scan (if needed):  150     Surgeon's Fee:  3750      ASC Fee:  2500      Anesthesia:  500    (The usual total cash price is $10,500 - this cash price represents a substantial discount.).

3.  Patient Name, Sex, DOB, Address

4.  Explanation of Recent Findings, i.e. RD OS, Macula On;  symptomatic of vision loss x 2 days

5.  History of previous eye injuries, eye surgeries, eye diseases (definitely find out if the patient is phakic or pseudophakic)

6.  History of medical illnesses/conditions/hospitalizations

7.  Current medications, including all blood thinning agents

8.  Drug allergies/NKDA -  definitely note any reactions to previous anesthesia or claustrophobia

9.  Any other factors that may impact our ability to provide care to the patient - do they have a reliable driver, both to surgery and one day PO as well as someone who can act as a reliable caretaker at home during the PO period, or any factor that would cause the patient to be lost to follow up (i.e. patient moving to California on Saturday).

 (NOTE:  Bring this information to me I will review the matter with Dr. Vaishnav first - to determine if he is able to accept a particular patient;  We will then ascertain ASC/Anesthesia availability and provide this information to Dr. Vaishnav so that he can make the final decision.  Do not under any circumstances accept an outside referral of a potential RD on behalf of Dr. Vaishnav without following the detail of this guideline. 
diagnostic_checklist-_rd_consult_whether_or_not_to_add_patient_on_10252012.docx
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EMPLOYEE PARKING

10/10/2012

 
From: Charlotte Mochel
Sent: Wednesday, October 10, 2012 2:00 PM
To: TEI-Employees&Admin

In our Rockledge and Palm Bay offices, parking is limited so it is very important that employees park where indicated to allow patients to have the parking spots closest to the building.  This applies to Melbourne as well.  It is that all employees adhere to the following:
 
ROCKLEDGE OFFICE
 
Parking under the portico is for physician use only.  You may park on the east side of the building, but keep in mind that parking spots closest to the front door need to be kept for patient use. 
 
Also, doctors using the parking under the portico are asked to park in the two end spots, leaving the center parking spots open for deliveries to the back door, particularly on Tuesdays and Wednesdays.
 
MELBOURNE OFFICE
 
The first two rows behind the building are reserved for patients, doctors, administration and supervisors.  All other areas in the back of the building are available for staff  and must be behind the blue line on the north side of the building.   If you have a medical purpose for parking in other than the designated spots, please contact Human Resources.
 
policy_protocol_employee_parking_10102012.docx
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CONGREGATING NEAR PATIENT CARE AREAS

10/1/2012

 
Applies to:  All Clinic Staff
 
Staff members congregating in the Retina Desk Area/Employee Entrance in the Rockledge Offices cause the Practice to suffer lost productivity.  Talking and laughter can sometimes become loud, thus decreasing patient's perception of our professionalism, as well as potentially raising concerns in their minds as to why they may be waiting.
 
Please remember that patients and those who accompany them to our offices watch and listen closely.  They will interpret your actions and what they see and hear and quickly making assumptions about our office.  Please make certain that you are representing our office in a highly professional manner at all times while you are at work.
policy_protocol_congregating_in_patient_care_areas__10012012.docx
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