CLINIC HQ

10.4.6.2. Rechecks in Patient Flow

A recheck appointment, as described in the recheck section, is for patients who experience issues after surgery. If a patient is returning to have staples or stitches removed, that appointment is a wellness appointment, not a recheck. The stitches or staple removal can be anesthetic or non-anesthetic. If your clinic routinely does this, you will need two types of wellness appointments, perhaps something like “suture removal + anesthesia” and “suture removal, no anesthesia.” This is important because we do not want a dog who will have stitches removed with pain meds (but no anesthesia) to accidentally get on the anesthetic patient flow board and accidentally get anesthetized. You can set these two types of wellness appointments up easily in Settings > Wellness Settings and tag the type of procedure with anesthetic or non-anesthetic -and when you use that appointment type, viola! The Patient will be in Patient Flow and be either on the “Anesthetic” board or the “Non-Anesthetic” board.

You can add recheck appointments to Patient Flow when the appointment is checked in. This can be set as a default in Patient Flow Settings, or you can manually assign rechecks as either anesthetic or non-anesthetic.

Automatically Add Rechecks to PF

To enable these in Patient Flow, go to Settings > Patient Flow Setup. Click the toggle that enables rechecks in Patient Flow.
Once the appointment is checked in, staff will see it in Patient Flow under Non-Anesthetic.

By default, ALL rechecks begin as “Non-Anesthetic” in HQ. So if you turn on the setting to add rechecks automatically to Patient Flow, they will always be in the “Non-Anesthetic” flow board. You can push the appointment to the Anesthetic Flow if it turns out to be a sedated visit.

Enabling rechecks in Patient Flow

This setting must be enabled before scheduling and checking in the appointment.

Manually Add Rechecks to Patient Flow

Once the appointment is checked in, staff will need to edit the appointment in Checkout.
Click the status, In Progress.
Locate the Action menu in the upper right corner of the checkout screen.
From the Action menu choose whether the animal should follow the Anesthetic flow or Non-Anesthetic flow.

This action option is only available if:
1) The appointment is checked in.
2) The Patient Flow Setup is not toggled on to automatically add the appointment to PF.

If autoadding to PF is disabled, you will manully add the appointment to PF.

If your recheck turns into an anesthetic appointment

Scenario 1: A recheck turns into an anesthetic procedure
A dog comes in under a recheck appointment and needs to be resutured and needs to be anesthetized to do it.

Solution A: You can switch a recheck appointment to an anesthetic appointment in Patient Flow if need be. This will move your animal to the anesthetic Patient Flow tab.

Changing a recheck to an anesthetic appointment

Solution B: You can stick with the Recheck appointment, but add the drugs by using the Action dropdown in the Drugs section.
The drawback to this approach is twofold. First, the dose amounts will not be provided, just a dropdown to insert the amounts (although the drugs will be deducted from the bottle totals). Second, this Patient will be on the non-anesthetic board in Patient Flow, which may cause some confusion. The suture technique will need to be manually written in the “All Medical Notes” field.

Adding another drug

Solution C: You can insert a note into the Recheck appointment saying, “Patient needs to be anesthetized. See new wellness appt for today.” And go ahead and check out the Recheck appointment and “Done” it in Patient Flow. Then, you can quickly make a new appointment using a pre-defined wellness appointment type just for this scenario, perhaps something such as “Wellness +Anesthesia” or “Recheck + Anesthesia” or “Suture Repair with Anesthesia,” whatever is your most common scenario.

The following scenario we saw was clinics needing to hold animals overnight, so they would check the appointment out today and make a recheck appointment for tomorrow to get the Patient on the board for tomorrow. This is an incorrect use of the recheck appointment type, as discussed above. Instead, you can use the “Hold overnight” tool in Patient Flow (if it’s just a few sporadic animals here and there). Or, we can add a tool called “AM Tasks,” which lets you do one of two things:

1. administer drugs to a patient you had the day before
2. hold a patient overnight and do surgery the following day

Below is where you will be able to find non-anesthetic wellness appointments in Patient Flow:

Non-anesthetic appointments in Patient Flow