Schedules, Work Lists and Workflow

Schedules, Work Lists and Workflow - these are the things that make OpenVPMS easy to use. Reception staff and clinicians can almost carry out all their work starting from the Scheduling and Work List screens. The system has a concept called 'workflow' which automates many of the necessary steps to get from an appointment being made to having the visit and invoicing all completed and the patient happily checked out.

Note that you do not have to used either schedules or work lists - you can check a patient in from their Patients|Information screen.  But it really does make life easier - the schedule(s) allow you set up an orderly system to enable customers to be serviced with minimum delay, and the work lists allow you to see the queue of things to be done and monitor what is happening.

This page contains the following headings: Schedules, Work Lists, Workflow, Check-In, Consult, Check-Out, Transfer, Follow-Up, Appointment status, Task status, Status Updates, Multi-Day Resource Bookings, Staff Availability, and Tools.

Schedules
A schedule is a simply a diary of appointments. The following features are provided:

  • as many schedules as you need - you will probably want one per clinician (or perhaps per on-duty clinician) and one for 'any clinician'
  • you can define 'schedule views' to allows groups of schedules to be displayed at the same time
  • schedules can belong to more than one view
  • schedules can also represent resources, ie consulting rooms and surgeries
  • each schedule can have its own minimum time slot size (eg 5 minutes, 15 minutes)
  • schedules with different minimum time slot sizes can be combined on the same schedule view
  • you can tailor the check-in process for each schedule by defining the available worklists, documents, and whether or not there will be a weigh-in step
  • schedule views can be assigned to one or more practice locations and configured to be the default when the location is changed
  • schedules can have multiple appointment types (with a default) and each appointment type can be assigned a default appointment duration
  • appointment types can be colour coded
  • scheduling dates can navigated by day, week, calendar selection and also by entering abbreviations eg 6w to jump 6 weeks ahead
  • a clinician can be assigned to an appointment
  • schedules can highlight appointments by appointment type, clinician or appointment status colour
  • appointments can be easily moved between dates and schedules
  • schedule views can be filtered to show specific times (Morning, Afternoon, Evening, AM, PM) as well as filtered by clinician
  • when the appointment is created any relevant customer and patient alerts are displayed
  • when an appointment is selected, the customer and patient details are shown in the left panel
  • the appointment details include a 255 character notes area, and a set of user defined list of reasons
  • the way the appointment is displayed in the schedule is customisable, and the presence of notes is indicated by a bubble icon display to save space

Work Lists
A work list is at its simplest, a queue or list of things to be done. However, it can also be used to manage hospital occupancy, boarding kennels and other resources. While schedules contain appointments, work lists contain 'tasks'. The following features are provided:

  • as many work lists as you need - you will probably want one per reception area/waiting room, one per resource (eg hospital, boarding kennels), and perhaps a general 'to do' list
  • you can define 'work list views' to allows groups of work lists to be displayed at the same time
  • work lists can belong to more than one view
  • for resource work lists, you can set the number of slots in the list to corresponds with the number of kennels etc that the resource has.  For queues and lists, the number of slots is set high - normally 100.
  • work lists can be combined on the same work list view
  • work lists views can be assigned to one or more practice locations and configured to be the default when the location is changed
  • work lists can have multiple task types (with a default) and each task type can be colour coded
  • each worklist can be tailored to control the list of documents presented for use at check-in time and also whether or no a weigh-in screen is presented
  • for a given date, only those tasks whose start & end dates span the selected date are shown - thus it is possible to 'book' a resource for some future period of time, and it is also possible to look at an earlier date to see what was happening on that date
  • the dates can navigated by day, week, calendar selection and also by entering abbreviations eg 6w to jump 6 weeks ahead
  • a clinician can be assigned to a task
  • work lists can highlight tasks by type, clinician or task status colour
  • tasks can be easily transferred between work lists
  • work lists views can be filtered display tasks by status (incomplete or complete) and to highlight tasks for a selected clinician
  • when a task is selected, the customer and patient details are shown in the left panel
  • the task details include a 255 character notes area
  • the way the task is displayed in the work list is customisable

 

Workflow
Buttons on the Scheduling and Work Lists screens enable you to proceed through the steps necessary to process a job from start to finish. These buttons are:

  • New - create a new appointment or task
  • Check-In - checks in the patient
  • Consult - displays the Visit Editor (which enables you to enter all the visit details , ie medical records, invoice items, reminders & alerts, and documents from one screen)
  • Check-Out - checks out the patient

The normal division of labour is that the Reception staff create the appointments and check the patient in. The vet(s) then use the Consult button to enter all the visit related data using the Visit Editor, and then press it's Completed button when they are done. Reception then takes over and does the Check-out.

Check-In
The Check-In button is available on Scheduling and Patient Information screens.  Pressing it does the following things:

  • displays a window to:
    • enter or update the patient
    • enter or update the clinician
    • enter the patient weight
    • enter a work list and task type
    • print documents
      These are a list of patient letters and forms (for example admission forms).
      The list of documents is determined by the Templates of the appointment schedule and the selected work list.
      If any letters are selected and these have fill-ins, then these will be prompted for. Depending on the document template setup, the forms may be printed immediately or held until check-out time.
  • a task is created in the selected work list. The task type is set to the default for the work list, the notes field is set to the appointment reason with any appointment notes concatenated to it so it comes out like 'Checkup - owner worried about weight gain'. The task status is set to Pending.
  • creates a Visit entry in the patient's medical record with reason set to the appointment reason, and the status 'In Progress'. Note that in some cases an existing visit is re-used - see Concepts/Visits.
  • if no open invoice exists, a new one is created
  • presents the Visit Editor screen. The appropriate visit information could be entered immediately, but normally (since the Reception staff are probably doing the check-ins and not the clinicians) this is exited using the OK button without entering further information.
  • updates visit status to In Progress, the appointment status to Checked-In, and the task status to In Progress

Consult
The consult activity is much simpler. Pressing the Consult button (on either the Scheduling or Work List screens) displays a clinician prompt if required, and then brings up the Visit Editor screen. This is used to:

  • add to and edit the medical record
  • add items to the invoice
  • manage reminders and alerts
  • add any required documents to the medical record

The Visit Editor can be exited using one of the following buttons:

  • Cancel - discards any pending updates (ie those for which the Apply button has button not been used)
  • OK - applies any pending updates but does not update any status
  • In Progress - applies any pending updates, and if the invoice status was previously Completed, sets it back to In Progress
  • Completed - applies any pending updates and sets the invoice status to Completed, and the activity and task status to Billed

Note that the In Progress and Completed buttons are only available on the Invoice tab of the Visit Editor.

Check-Out
Pressing the Check-Out button (on either the Scheduling or Work List screens) does the following:

  • presents a Select Boarding Appointments screen, if a boarding appointment is being checked out. This allows other boarding appointments for the customer to be checked out at the same time.
  • presents the Invoice Edit screen to:
    • automatically charge boarding fees
    • allow any last minute changes to the invoice
  • presents the Finalise Invoice? window so that you can finalise the invoice. If you say Yes, then its status will be set to Finalised.
  • if the invoice is now finalised then the Pay Account? window is displayed. If you say Yes, then the New Payment window is displayed so that the payment can be made.
  • if there are documents to be printed (eg the invoice and any patient documents), then the Print window will be displayed allowing you to print either all or selected documents
  • the activity and task status are set to Completed

Transfer
The Transfer Transfer button on the Scheduling screens is designed for use after a consultation in which it decided to admit the patient to hospital or for surgery. It does the following:

  • presents a work list select screen to allow the appropriate work list to be selected
  • displays a Print window if the target work list has templates or Use All Templates is ticked, listing the available templates to print
  • adds a new work list task for the selected work list, for the appointment patient. The task will be given the same status as appointment if they have a status in common. If not, it will be set to In Progress.
  • updates the appointment status to Admitted, provided it is not Billed or Completed

Pressing the Transfer button on the Work List screens simply allows you to transfer the selected entry from one worklist to another.

Follow-Up
The Follow-Up Task facility allows you to quickly add a task to a worklist that has been defined as usable for follow-up tasks. These can be any worklist, but it is normal to create specific worklists such as 'Reception to follow up' and 'Dr Bloggs To Do'. You can create a follow-up task either from the Patients workspace by clicking the icon next to the patient's ID in the left panel, or if the 'Follow Up At Check Out' option is set for the Practice, then the New Follow-Up Task window will be automatically displayed at checkout time.

You can define one or more follow-up worklists (in order of preference) for each user and each practice location. When the New Follow-Up Task window is displayed, the default worlist is set from those set the current clinician, or if they have none, then the current user, and if they have none, the current location.

Appointment status
The appointment status can be as follows:

  • Pending - the initial status when the appointment is created
  • Checked-In - has been checked-in
  • In-Progress - activity is in progress
  • Billed - the associated invoice is complete
  • Admitted - can be set manually
  • Cancelled - appointment cancelled - set manually by editing the appointment
  • Complete - has been checked-out

Task status
The task status can be as follows:

  • Pending - the initial status when the appointment is created
  • In-Progress - activity is in progress
  • Billed - the associated invoice is complete
  • Cancelled - task cancelled - set manually by editing the task
  • Complete - has been checked-out

 

Status Updates

The following table shows the change in status of the appointment (in the schedule), the task (in the work list), and the invoice as things progress from a new appointment to all being completed. The actions are the buttons that are pressed on the various screens. Where the same action is shown for both the Schedule and the Work List, this simply means that the button is shown on both screens and you can use either one.

Schedule Work List Invoice Visit
Button Status Button Status Button Status Status
New Pending   -   - -
Check-In Checked In   Pending   - In Progress
Consult In Progress Consult In Progress   In Progress (unaltered)
        OK (unaltered) (unaltered)
        In Progress In Progress (unaltered)
  Billed   Billed Complete Completed Completed
Check-Out Completed Check-Out Completed Finalise=Y
Finalise=N
Finalised
Completed
Completed
             

You can of course manually alter the status, but in general you should not need to do, the workflow will take care of setting the appropriate status resulting from each action. The exceptions are: placing an invoice on hold, and cancelling an appointment or task  - you need to do these manually - but you won't need to do this often.

Note also that because the appointment and task are linked, changing the status of one will generally change the status of the other. Thus if you have an appointment checked in (and thus the task has been created and has status Pending), then the customer walks out, then you can simply change the status of either the task or the appointment to Cancelled and this will also update the other one automatically.

 

Multi-day Resource Bookings
This section discusses how to handle multi-day resource bookings. 

The scheduler can handle appointments that span the midnight boundary, so you can make an appointment for a 7-day stay in a boarding kennel. However, this does not give you the optimum resource control. The trick is to use work lists (rather than the appointment schedule) and do things is as follows:

  • set up a work list that represents the kennels (or hospital), and set the number of slots to match the number of runs/kennels/cages
  • when you get a booking for the boarding kennel, create a task in the kennels work list, with the start and completed date/times set for the expected stay - the status will be Pending
  • when the patient arrives use the Consult button to move the status to In Progress and if necessary open an invoice and add notes etc to the visit record
  • when the patient leaves, use the Check-Out button to do the discharge processing

Because we have limited the number of slots in the work list, the system will tell you if you are trying to book boarding between dates where the number of cages/runs available on any day between those dates exceeds the maximum.

 

Staff Availability
It is useful to be able to show on the schedule periods when staff are not available. This can be accomplished as follows:

  1. create a dummy customer with the Name "--Do Not Use--", First Name "Dummy 'No Customer' customer", and Company Name "-" - this provides us with a customer to be used where there is none [necessary since when creating an appointment, one must specify the customer]
  2. create an Appointment Type "Block Out", and Appointment Reasons such as "~Off Duty~", "~Meeting~", and "~Lunch~" - the use of the tilde ~ groups these reasons together at the bottom of the reasons list

You can now create 'appointments' which indicate staff unavailability for various reasons.

 

Tools
The tools to set up the above facilities are:

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