Dr. Weiss?
Bill, hi!
How are you?
I'm fine, Susan, and you?
I'm well, thanks, how's Maria?
Maria's great, she said to say hi.
Oh, she's so sweet, tell her I said hello.
So why are you here?
Well, I've had a bit of a problem
and I was hoping you could help.
OK, what's up?
I did something to my back playing golf.
It's just killing me.
Hmm, we're pretty busy today.
Did you try to schedule an appointment?
That's the problem.
I have an appointment scheduled for tomorrow afternoon,
but I'm leaving the country tomorrow morning on business.
It just slipped my mind.
It's just killing me.
Say no more, we'll get you taken care of.
Stephanie, can you start an intake sheet
for Mr. Olsen, please?
Of course, Dr. Weiss.
OK, here we are.
Thanks, Stephanie.
I'll make sure to tell Ryan that Mr. Olsen's in room three
so he can go ahead and start his intake.
Ok. 30 0:01:12,930 --> 0:01:12,630 Come along, Bill.
Thanks.
Here we are.
You can wait in here.
Someone will be along with you shortly.
Thanks again for squeezing me in.
Sure thing, see you in a bit.
(knock on the door)
Hi, Mr. Olsen, just checking in to make sure you're comfortable.
Is everything alright in here?
Yes, fine.
My back is killing me, but otherwise, I'm fine.
OK, I see here you have a herniated disc.
Does it feel like your lower back?
Is the pain familiar?
Yeah, it's my lower back, and it's all too familiar.
Alright, well, we're a little back up with patients
today but just hang tight Mr. Olsen,
and someone will be with you as soon as possible.
Great.
Thanks.
Excuse me Doctors, but I have a patient, Olsen,
in exam room 3, who isn't on the schedule today and I'm not
sure how we got there.
He's complaining of severe low back pain
and has a history of back problems.
Most recently, he was diagnosed with a herniated disc.
It seems logical that the disc is giving him pain.
I think someone should see him as soon as possible
because we're stacking up patients in the waiting room.
Anybody know anything about this or wanna jump on it?
I'm sorry, Ryan, I'm not sure whose patient he is.
He's not mine.
Alright, thanks anyways.
Thank you.
Hey, Stephanie.
Hey, Ryan, what's up?
I have a patient, Bill Olsen, in three and he's
not scheduled for today, so I'm just trying to
assess on what exactly is going on with him.
Oh, yeah, Bill Olsen.
He's a friend of Dr. Weiss or something.
He caught her attention and approached her directly.
She had me start his intake paperwork and she
took him to three.
She said she'd tell you.
So to make sure that we're talking about the same patient,
he's William Olsen, patient of Dr. Weiss, correct?
Yes.
Alright, thanks.
Yep, and he has a history of low back pain.
Herniated disc, yeah, I have his paperwork right here.
I was just trying to figure out what was up.
I'm going to hurry up and get his vitals,
it seems like we have a long afternoon coming.
No doubt.
(Phone rings)
James and Schwartz,
how may I help you?
Alright, feel better Carolyn, uh, I'll pass it on.
Excuse me, Dr. James?
Yes, what is it, Emily?
Carolyn just called in sick and she's the triage nurse today.
OK.
Do me a favor, gather up the staff, we will need to do
a quick huddle at the front desk before the day begins.
Got it, right away!
OK, perfect.
I'll be there in 10.
OK.
We're swamped today. It's flu season.
We don't have time to stand around.
I know, but Dr. James called this huddle.
He should be here any minute.
Good morning, everyone.
I need tell you that Carolyn called in sick and
she was assigned to triage.
So, we have three providers here today,
so we'll take turns covering for Carolyn.
During your triage shift you'll see your scheduled patients
every 30 minutes instead of every 15.
Any patient you can't see will be passed off to
another provider during your triage shift.
That way we can ensure that anyone who needs
immediate care is appropriately seen.
Any questions?
No?
OK.
Be sure everyone to explain to our patients that
the wait may be a longer today, but
we're doing the best we can.
Alright?
Thanks, everyone.
Let's have a productive day.
Alright sir, if you'll just have a seat right
over there, we will get to you when we can.
Alright, thank you.
We're going to see you right away,
so why don't you come on back in.
It's that first door there on the right.
Alright, sir, we'll get with you as soon as we can, OK.
You can have a seat back in the waiting room.
Of course.
Thank you.
Excuse me everyone, can we have a quick debrief about
today's events?
Kelly.
Sam.
Is that everyone?
Alright, good.
So, what do we think about how we handled our
workflow today without a triage nurse?
I'll start.
When I first heard the news this morning,
I was a bit wary, but from the moment you called the huddle
I felt fine.
It was busy, and everyone was alert and acted as a unit.
We seemed to communicate well and pulled it off just fine.
I'd say it worked for us.
I'd agree with Dr. Schwartz.
I mean, although this isn't something I'd commit to on
a daily basis, I think it'd work as a last resort.
I mean, we managed to come together as a team and
support each other and that led to a successful day.
I think it went well.
Thanks for great leadership today, Dr. James.
It helped us all ease into the situation confidently.
Everyone appeared to be aware of what was happening,
and adjusted to make sure the patients' needs were meet.
Don't forget Emily, she followed up with Dr. James
immediately.
Thanks, Kelly.
So, if a triage nurse does call in sick again,
should this be the plan of action?
That's a good question.
From everything I've gathered today this does
seem to be a completely viable solution.
So, if everybody is comfortable with it,
I think we should adopt this as the new default.
Everybody on board?
I might just suggest that we have a provider or
triage nurse on call for this situation specifically.
I feel that our patients shouldn't be passed around
unless completely necessary.
Point taken, Myles.
I'll look at the schedule and see what we can do
about getting somebody on call.
Anything else?
Alright.
Well, excellent, excellent work today folks.
Let's close this place down and go home.
Alright.
Hello, Dr. Chase. How are you today?
I'm well, thanks.
It's Bridget, right?
It is.
So, how's your first week here been?
So far, so good.
Why did you hear something?
No, not at all, just being friendly.
Good.
Well, I guess I'll here a little while longer then.
Oh, by the way, Dr. Chase, Valerie is the nurse
assigned to you today.
Oh yeah?
I haven't worked with her yet.
It should go well.
She's been here for six years,
so she's very experienced and knows the ropes.
Good to know.
Thanks, Bridget.
I'll see you later, Dr. Chase.
Valerie, do you know where Mr. Biel's lab results are?
They should be under the section for test results.
I'm pretty sure you can access it through the toolbar.
At least that's where Bridget usually puts them.
If you nurses could just think ahead and focus your
attention on what I need for each appointment,
things would go a lot more smoothly around here.
OK, Dr. Chase.
I'll go to the reception and see if maybe Bridget can
point me in the right direction.
Excellent.
(Sighs) Unbelievable.
Dr. Chase?
Did you find Mr. Biel's lab results?
Actually, they're in his digital chart.
Let me show you.
Valerie, I looked through this entire thing.
Here they are.
I guess I did miss them.
Thanks, Valerie.
Sure, that's what I'm here for.
Hi, Mr. Biel, did you forget something?
No, no, no.
I just wanted to tell you to hang in there.
Boy, that new doctor seems like a real piece of work.
I mean, he shouldn't speak to people like that.
Thanks for looking out for me, Mr. Biel, that's sweet.
But Dr. Chase, like all of us, knows it's critical to have
accurate patient information.
He's new to our system, and the labs can be tricky
to find on these new computers.
Let's give him a chance.
Ok, if you say so.
But you tell him to behave himself or I'm going to give
him a piece of my mind next time I'm around here.
I will.
Take care, Mr. Biel, and try to stay away from those
fatty foods.
OK.
See you soon.
Bye-Bye.
Hey, Dr. Chase, do you have a minute?
Sure, Valerie, what's up?
How's your first week been so far?
It's good, everyone here seems nice.
The only tough part is getting used to the computers.
It's a new system for me, you know.
You did seem a bit flustered earlier today.
Mr. Biel actually stopped me on his way out to
talk about his appointment.
He said he was uncomfortable with the way you spoke to me.
What?
Great.
I could tell you were a little perturbed.
Yeah, I guess I was.
You know, our office policy is to use
team debriefs to address these kinds of issues.
Would that work for you?
Oh yeah?
Sure, debriefing is a good idea.
Can we agree then, that in the future you'll address
performance issues directly or in a team debrief?
Definitely.
Just not in front of a patient?
Agreed.
That way, we have complete information
and we problem solve as a team.
Absolutely.
Great.
Everyone here is focused on the same goal -
safe patient care.
If you notice we are slipping please feel
comfortable addressing it immediately.
I understand, and I apologize, Valerie.
I've been pretty anxious the past couple of days.
I know, I get it.
Let's start out fresh tomorrow.
Deal?
Deal.
(Heavy breathing)
Hello.
Hi.
I'm Roberta Aronson.
I have a ten-thirty appointment.
I'm sorry, your name again?
Mrs. Roberta Aronson.
Ok, well it's ten-fifty now, Mrs. Aronson,
let's see what we can do.
You're a bit late, are you feeling alright?
No, I'm really tired.
I have no energy.
It just took me too long to get ready this morning.
It's hard for me to breath.
Ok, yeah, I see you have a history of asthma,
Mrs. Aronson.
Yeah, and it's really bad today.
Oh, I'm sorry about that.
Let's see what we can do.
Thank you.
Hey, Sharon.
Hey, Peter, you got a second.
Sure, what's up?
Mrs. Aronson here is 20 minutes late for her
appointment because she was tired this morning and she says
it's hard for her to breathe.
Well, all of our exam rooms are full right now, and
have you seen the waiting room?
Of course, I signed everyone in.
But I've seen her here before.
And she has a history of bad asthma and
she doesn't look so good.
What should we do?
She seems to be breathing OK now.
See if you can reschedule her for later.
OK.
Mrs. Aronson, unfortunately, I'm going to have
to find you another appointment.
Mrs. Aronson?
Are you alright?
Hang on, Mrs. Aronson!
Peter, please call reception immediately!
This is Peter.
Peter, it's Sharon.
Mrs. Aronson's condition has deteriorated.
She appears short of breath.
There are no nurses or providers at reception.
I'm worried.
Can you notify a nurse and get here right away?
Got it, on my way!
Tanya!
Can I get some help, please?
Thanks, Sharon.
For what?
For speaking up about Mrs. Aronson.
I don't know where my head was at.
No problem, just doing my job.