Assemble a FluFIT Team. August 8, 12-1pm Central

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Assemble a FluFIT Team August 8, 12-1pm Central

What is FluFIT? Eligible patients are offered take-home stool tests at the same time as their annual flu shot Why implement FluFIT? A Research-Tested Intervention Program Reach the unscreened during annual flu shot activities Increase your CRC screening rates A first step toward other innovative programs

Available Online: http://www.flufit.org/ program/wf004814_ Final_082313.pdf

1.) Assemble a FluFIT team 2.) Choose times & places for FluFIT, and advertise 3.) Design patient-flow & line-management plan 4.) Develop systems to support follow up of dispensed kits 5.) Implement your program: Final preparations

By: Chastity L. Dolbec, RN, BSN Director of Patient Care & Innovation Coal Country Community Health Center Beulah, Center, Killdeer, and Hazen, North Dakota

2015 Patient Demographics 7,867 unique patients 61% Private Insurance 17% Medicare 22% Uninsured / Medicaid 31,227 visits

Physician/Provider Lead RN Chronic Care Coordinators / BHCC Provider Nurse (RN, LPN, RMA) Certified Nursing Assistants / Unlicensed Assistive Person (UAP) Nursing Assistant Support Staff lab, radiology, reception, med recs, certified coders and billers, behavioral health

Coal Country Community Health Center Sakakawea Medical Center Mercer County Ambulance Beulah Drug and Hazen Drug Knife River Care Center Custer Health

Custer Health Nursing Support staff Marketing / Communications Beulah Drug Pharmacist Sakakawea Medical Center Rural Health Clinic RN Chronic Care Coordinators Nursing students from DNP (Dakota Nursing Program) Support staff - reception

Coal Country Community Health Center FluFIT Champion RN Chronic Care Coordinators Certified Nursing Assistants assisted CCCHC and Custer Health Float Nurse Support staff reception Marketing Director of Clinical Operations Billing / Reception

Cheerleader Coordinate FluFIT campaign Coordinate efforts with all Medical Neighborhood partners Plan, organize, and lead team meetings Plan and organize training Prepare documentation templates Problem-solve and update plan as needed

Planning meetings Winter/Spring CCCHC, SMC, Beulah Drug, Public health Resources utilized: flufit.org toolkit ACS FluFOBT Program Implementation Guide for Primary Care Practices CCCHC standing orders and clinical guidelines Webinar on FluFOBT: A Proven Approach to Increase CRC Screening Developed action plan and timeline Order flu vaccine, supplies, training, advertising, etc.

Follow-up meetings Summer Discussed workflow of community FluFIT days Layout of clinic to accommodate patient visits Role of team members Reception Nursing Support staff Prepare documentation templates for all organizations Flu Vaccination Authorization Record and Flu-iFOBT Consent Form (one page form)

Flu (Injectable) Vaccination Authorization Record and FLU-iFOBT Consent Form This form must be signed by the vaccine recipient on the date the vaccine is administered. Manufacturer: Lot Number: Expiration Date: Facility Site: Admin Site: RA LA I have read or had explained to me the "Influenza Vaccine Information Statement." I have had an opportunity to ask questions which were answered to my satisfaction. I understand the benefits and risks of influenza vaccine and request that it be given to me or to the person for whom I am authorized to make this request. If I am between the ages of 50 and 75 and being offered a FIT kit for colorectal cancer screening today (if eligible), it has been explained to me. Clinic Staff Initial Patient Name Primary Care Provider ifobt Eligible Age 50-75, no FIT/FOBT this year, OR ifobt Given To Patient no colonoscopy in 10 yrs Yes No Yes No Declined Please complete the following questions: 1. Is the person to be vaccinated sick today? YES or NO 2. Does the person to be vaccinated have an allergy to eggs or to a component of the vaccine? YES or NO 3. Has the person to be vaccinated ever had a serious reaction to influenza vaccine in the past? YES or NO 4. Has the person to be vaccinated ever had Guillain-Barre syndrome? YES or NO

Please complete the following questions if you are between the ages of 50 75 years old: 1. Are you between the ages of 50 75? YES or NO 2. Have you had a colonoscopy within the last 10 years? YES or NO a. If you have had a colonoscopy when/where was it performed? 3. Have you done a home stool test for colorectal cancer within the last year? YES or NO 4. Do you have a personal history of Crohn s disease or Ulcerative Colitis? YES or NO 5. Do you have a personal history of polyps or colorectal cancer? YES or NO 6. Do you have a personal history of polyps or cancer in a family member younger than age 60? YES or NO 7. Are you currently experiencing rectal bleeding, blood in your stool or other symptoms? YES or NO Comments: [ ] Immunization given without incident [ ] VIS Refused [ ] VIS Given Nurse Signature: Initials: Date: Patient Signature: Date:

Preparation meetings late Summer/early Fall Reviewed workflow and documentation including screening, tracking and follow-up protocol Primary care completes follow-up on all FITs given Training - flufit.org HOW TO DO IT - 5 Simple Steps FluFOBT Implementation Guide for Primary Care Practices STAFF TRAINING - The 5 Key Elements Facts about flu and CRCS Organize workflow Eligibility

Preparation meetings late Summer/early Fall Advertising Supplies Population Health review of all patients age 50 75 years CRCS and Pneumococcal vaccines including PPSV23 and PCV13

Flu FIT Day Screenings completed If eligible received flu, pneumonia, and FIT card with instructions and return by date Deferred order created in EMR for tracking Follow-up of abnormal test with referral system through our local medical neighborhood Improved access through local surgical team at CAH Post implementation meeting What went well, improvements needed Screening form and documentation templates updated

Update Standing Orders?? Every patient age 50 74 receiving flu receives screening Electronic documentation for screening and administration of vaccines and FIT Additional team members CAH Hazen Drug