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Top Ten Tips to Building Beautiful MARs in Therap

grace_robinson_medication_administrationMy name is Grace Robinson, and I am the Clinical Services Manager at Puget Sound Regional Services, where I manage the medication system for the largest supported living provider in Washington State that tailors its services to meet the needs of Deaf, Blind, and Deaf-Blind individuals with developmental and intellectual disabilities.

One of the ways I support our 70+ clients at this agency is by building and auditing our Medication Administration Records (MARs), to ensure error-free documents for our direct support staff to work from. Having an effective and safe medication management system in place is critical to client safety, as medications have the potential to cause great harm. The Therap MAR gives us a lot of flexibility, which has allowed us at PSRS to improve the quality of care we can provide at our agency.

These are some recommendations I’ve developed based on my efforts to provide my clients and their staff with high-quality MARs:

  1. Avoid using abbreviations on your MAR. Pharmacy labels are small, and pharmacists are forced to rely on abbreviations to effectively communicate physician’s orders to administrators. Therap’s MAR is much less restrictive, so we are able to offer our care team complete instructions that do not assume a level of medical knowledge that our direct support professionals may or may not possess.
  2. Include both the brand and the generic name for each med on your MAR. You would be surprised how many people do not know that Tylenol and Acetaminophen are the same medication!
  3. Does your client take multiple strengths of the same med? Alert your care team to the potential for error by including a warning in the instructions on your Therap MAR. Simply include a commonly-used pharmacy warning, such as ***STOP! POTENTIAL ERROR! DOUBLE CHECK!*** or other cautionary language, as per your pharmacist or doctor’s recommendation.
  4. Always include your medication type on the Therap MAR. Just as we always sort oral, injectable, topical medications, etc, at our sites, we should keep these medications clearly marked for easy sorting on the Therap MAR. This is especially important for drops, such as those meant for the eyes or ears. A clear MAR entry can help your staff prevent a potentially painful or damaging mistake!
  5. Maintain an agency-wide list of your Look-Alike, Sound-Alike drugs, or LASA medications. These are medication which, due to their appearance or name, could easily be mistaken for another medication. This list should be revisited at least on an annual basis. You can alert your staff to these medications by including an advisory in the instructions section of your MAR. Many pharmacies will recommend that your wording read ***CAUTION! LOOK ALIKE SOUND ALIKE MED!*** You will want to consult with your regular pharmacist for guidance as to the specific language that is best to include on your Therap MAR.
  6. Include Tall-man lettering on your Therap MAR, as per the recommendation of the FDA and the Institute for Safe Medication Practices. Tall-man lettering helps draw attention to the dissimilarities in look-alike drug names. Entries for LamISIL and LaMICtal on the MAR, for example, are far less likely to confuse a care team member than side-by-side entries for guanfacine and guaifenesin!
  7. Insist that each order you accept from a physician include clear orders, and an indication for use. Never include the indication within the body of your instructions; instead, take advantage of Therap’s separate “Indication” section, so that this vital information is made quickly accessible on its own line in your MAR.
  8. Set the expectation that your nursing staff will review medication orders prior to the administration of new meds, to ensure that orders are clearly written and complete. It is our right and duty to question physician orders that are illegible, incomplete, or potentially unsafe.
  9.  Audit! Audit! Audit!
  10. Make sure that the manufacturer’s instructions for each medication, with a clear picture of the medication and instructions for its safe storage, are made available to your care team. Therap makes this task much easier for us, by drawing on digital databases to automatically connect us with this information for most medications. In the rare occurrence that Therap is unable to generate this information for your med automatically, you can attach a scanned copy of the manufacturer’s instructions, and attach it to the medication under “Medication Details” in Configuration Mode. You can even attach this information to your medication retroactively, so you do not have the discontinue the med on your Therap MAR to create this update!

I hope that these tips will prove helpful to others working to improve their MARs, or transitioning to the Therap MAR for the first time.

Feel free to reach out to me if you have any questions!

Free Webinar: Therap PodCast: An Open Conversation about Quality Assurance, Sept 7, 2016, 2 PM EDT

We are pleased to announce our free Certified Trainer led webinar on the Therap PodCast: An Open Conversation about Quality Assurance which will be held on September 7th, 2016 at 2pm EDT. Certified Trainers Kristen, Alyssa, and Hollie will walk users through key questions that includes:  Do you check Therap routinely or is that a “false” expectation? What are realistic ways to stay on top of an efficient QA process? .

Click here to register.

By |2016-09-04T09:40:11+00:00September 4th, 2016|Categories: Certified trainer, Quality Assurance|Tags: , , |Comments Off on Free Webinar: Therap PodCast: An Open Conversation about Quality Assurance, Sept 7, 2016, 2 PM EDT

Creative uses of “Individual Contacts”: Surveys, Maps, and Stakeholder Relations

We are pleased to announce our free Certified Trainer led webinar which will be held on September 2, 2016 at 1pm EDT. Certified Trainer, Tom Peterson, Quality Assurance Specialist at D&S Community Services, will walk users through how to take contacts and create Google Maps, conduct Satisfaction Surveys, improve Stakeholder relationships, and verify addresses.

Click here to register.

By |2016-08-28T09:15:36+00:00August 28th, 2016|Categories: Certified trainer|Tags: , , , |Comments Off on Creative uses of “Individual Contacts”: Surveys, Maps, and Stakeholder Relations

Quality Assurance for Billing

Hi All,
We have a wonderful webinar published on Therap’s Youtube page which covers “How to use Therap to Support Billing” . The presenter, Jide Amosu, is a Certified Trainer as well as the Financial Analyst for Capital Hill Day Services. Jide walked attendees through a successful system check and balance for billing by running ISP data reports and attendance reports to support billable services. While there are many approaches to preventing under and/or over billing, Jide did a great job highlighting his agency’s approach to preventing recoupment, over-billing, and under-billing.

I hope everyone enjoys this video as much as I. If you are interesting in using the excel template within the recording, please feel free to email me directly (chelsea.newby@therapservices.net).

 

https://www.youtube.com/watch?v=QJVnvI_YMBg&feature=youtu.be

 

 

Enjoy!

By |2016-11-03T10:15:09+00:00June 10th, 2015|Categories: Uncategorized|Tags: , , , |Comments Off on Quality Assurance for Billing

A Day in the Life of a Therap Administrator

Hi All,
As promised, the webinar titled “A Day in the Life of a Therap Administrator” has been published to YouTube. This webinar was lead by Kristen Thompson, Certified Trainer. This webinar is an excellent resource for both new and existing Therap administrators as it assist with internal quality assurance efforts. Overall, this webinar walks administrators through the actions needed to maintain compliance within the confines of your agency’s quality standard.

 

 

 

 

 

Should you have additional questions, please reach out to Kristen Thompson, certified trainer or myself.

Have a fantastic day!

Chelsea Newby, M.P.A
Training and Implementation Specialist

By |2016-11-03T10:15:09+00:00May 19th, 2015|Categories: Quality Assurance, Uncategorized|Tags: , , , |Comments Off on A Day in the Life of a Therap Administrator

HELP! Too Many Shared Contacts!!!

Have you ever been updating an IDF, adding an Therap appointment or adding a shared contact and think “There’s just too many!” well, this is what makes therap great. You CAN DELETE!. Now, if you just created a therap contact and realized there was another one, the best thing to do is to delete it. otherwise, when you delete a shared contact and it’s been used (such as in appointments, IDF’s etc) all that information will be Poof! Gone.

But fear not, the wonderful programmers have made their way around it. So, in order to DISCONTINUE a Shared Contact, and clean up the giant mess that shared contacts can become you must:

 

1. Have the Admin Ability assigned to you via a Super Admin in your Therap System.

2. Go to the Admin Tab on Dashboard.

3. Under General: Shared Contact: Click “List”.

This gives you the big giant list of shared contacts for your organization. Now looking at them all can all the pages can seem like they’re endless. Cleaning up your Shared Contact list is a bit tedious, but worth it in the end.

so Now that you’ve got the list, what to do?

1.  Find the Shared Contact you are no longer using and click on it.

2. At the Bottom Right corner, you’ll see 2 options.

“Update” or “delete”.

3. Click Delete. ( yes, we will discontinue it, but to get there, we have to click the Delete button :) )

4. Now therap will automatically tell you if your Shared Contact is already in use (such as any past appointments, IDF’s, etc) and where it is being used at.

For Example: If it’s an old pharmacy, it will show you all the old IDF’s it was being used in, or it is being used in (if you haven’t updated those IDF’s like you were supposed too. )

5. Now we know where the Contact is being used, on the bottom right is the Discontinue button. This is great, because it allows us to get it off the shared contact list, but still have the information available if we need it and can be found in the archives (i’ll save the archives for a later post :) )

6. You have now been transported back to the beginning and will see the long list of all your shared contacts again and at the top it will confirm that the shared contact was discontinued.

You then just repeat the process until your Shared Contact List is Short and Simple.

Hope this helps all of you out there that have a Shared Contact list longer the Pi. :)

Happy Spring Cleaning of all those Pesky unused Contacts!.

– Racheal.

 

By |2016-11-03T10:15:12+00:00May 29th, 2014|Categories: Racheal Anderson's Posts|Tags: , , , , , , |Comments Off on HELP! Too Many Shared Contacts!!!

Therap Financial module

As I’ve come to various Therap Conferences, have met my fellow trainers and spoken to various agencies I’ve discovered that everyone uses the Therap Financial Module differently. Some use it to track individual petty cash, to house petty cash to just tracking house expenses. This got me to thinking.. I want to hear everyone else’s ideas and how they use it. Below, i’ll detail out how we use Therap Financial in my houses, and how well it works.

First, We use our Therap Financials to track everything that the individual may have for financial tracking. We have quite a few individuals with our CEO as the Rep Payee. So we track all of their data in therap. From all deposits: wages, SSB, SSI, random funds, to all their expenses: Room and Board, debts, groceries, clothing purchases, etc.

We also use it to track Gift cards! For an individual who has a gift card, we can track purchases and accurately account for all the funds. We just set it up as a new checking accounts and label It with such as “walmart gift card5867” with the last 4 digits of the card number. This helps us keep track in the event that an individual may receive multiple gift cards for the same place and we can always know what was purchased.

I LOVE that we do this. I can easily see and track all expenses, the rep payee can pull reports and know that day their accounts balance without having to go into online banking. Also, I can go in and search for all items over 50.00 and be able to add them to the Personal Property list if needed as a double QA check.

For us, only DSP2’s and above have access to the financial module, as not everyone needs to be privy to the individuals personal information. It’s also great since if an individual wants to know, we can pull it up and show them. by scanning in and attaching receipts and bank statements as well, it just makes life a little easier.

 

 

Training Therap to New Employees

Hi There again,

So for those out there that face some employees that may be, for lack of a better word, Technologically Challenged, how do you have them prove that they understand the documentation that you require on Therap? Ensuring that they have those skills and are competent to be able to write a GER, run reports on Intake/Elimination, Enter ISP Data, or even the most basics of reading SComms and T-logs? Here at CSS we have a great staff that created these wonderful  things called competencies. These competencies detail out a lot of information, everything from understanding of our policies and Mission, Vision and Values, to initial trainings on ISP’s, BSP’s, financials and an understanding of using Person First Language and Person Centered Thinking. Along with all that and many other items, it also has a wonderful page that allows you to mark off their understanding of Therap. Now for us, these are all done over a 6 month period, but it’s reviewed at the 1st, 3rd, and 6th month to ensure compliance with Oregon Administrative Rules (OAR’s) and keeps it all neat and tidy in one place.

When your out there Training Therap, how does everyone do it? Therap is so user friendly with T-Girl, Live Help, and the step by step instruction sheets, it’s a wonder someone may not “get it. ” However, there are those out there in the world of Therap that may have trouble or may not be so used to computers. How do you get them there, and prove that they can demonstrate these skills? By creating a competency!! We have a one day training that is spent with anywhere from 5-10 employees and 2 Trainers (even though I’m the only certified one :)  ) that train  the new employees on how to use Therap and what we want from them in regards to documentation. For Example: Therap’s Purpose, Accessibility,What users use therap, How to access live help/My Issues, What to do when arriving on shift with Therap, Demonstration of Access to IDF’s/EDF’s, “My Account”, T-logs, GER’s, SCOMMs, Health Tracking and Running Reports, Contacts and supports, etc. …… and ANYTHING ELSE you wish to add! It’s a great place to keep everything in one place. This way no one can state that they didn’t know how, or was never trained, or never got the help (they should be accessing LIVE HELP, if not asking).

This helps prevent any error in documentation with the excuse I didn’t know how, or no one showed me, or geesh, I never knew that!. We’ve all heard the excuses I’m sure… but with these, not only to you ensure that your staff have the knowledge, but that they can demonstrate it as well! It makes lives easier all around, by knowing, and trusting that the staff you have in place are not only confident in their abilities on Therap, but they have access to help when they need it, and your job becomes easier by having competent staff that know HOW to Document what they need to, Where they need to.

Now, for everyone out there, I would like to know how you train? Do you have an easier process? A different one? A similar one? We all have so much to offer, and now I’ll be picking your brains on all the possibilities that are out there. ….

with that… I’m off… :D

-Racheal.

 

 

By |2014-03-30T06:22:36+00:00March 30th, 2014|Categories: Racheal Anderson's Posts|Tags: , , , , , |Comments Off on Training Therap to New Employees

How to Complete A Quality Assurance Check with Therap.

Okay, for those that know me I LOVE the Therap MAR. I tend to keep all my ducks in one basket, so for QA checks, I didn’t want them completed elsewhere, or someplace additional that my staff would have to search for or forget about,  so I added them to the MAR itself, (as that’s what they’re QA’ing anyway). Keeps everything neat and tidy. So here it is everyone, How to complete QA checks using the Therap MAR. :) hope you find it as useful as I do.  I also have a Print outable copy, that’s picture friendly as well if anyone feels up to using it, just shoot me an email and I can zip It off into cyber space for you. :)

How to do QA (Quality Assurance) Checks on Therap

First off you will be tracking this medication on the MAR, similar to a PRN medication. To Do this you will see similar steps in the process.

  1. Click “Add New Medication”
  2. This will now take you to the Medication history page. Here is where you begin to create the QA check.
  3. Under Medication Name:
    1. This is where you enter QA and the time that you want the check done. For example:     “ QA CHECK 8AM”  This should be done at each shift change. Normally, just putting QA check is best, you’ll see later, that you can see the time that the QA was done, showing you for each shift change that It was completed.
  4. For all the medication information. Fill in the medication type for “PRN MEDICATION” and  schedule for “As Needed”.  Leaving it blank will cause the QA section to not work properly.
  5. In the comments section, add the purpose for the QA and include all the items you want staff to QA.  For Example: QA check of all MARS, Bubble packs, Intake/Elimination Data, BSL Entries, etc.
    1. This helps to ensure that staff are acknowledging that they checked to ensure that all the listed items are accurate.
  6. Now when you open the MAR you will see that it is listed in the PRN section.
  7. In order to record the QA, you need to open up the Medication up to Record Data in Detailed Mode.
  8. For the very first entry you should scroll down to “administered”. This will allow for follow ups to be completed. This should be completed by your staff only on the 1st day of the new month.
  9. You will now see that the medication has been administered. This is the VERY First and only entry that should be entered like this. You can now click “view” to see the comments.
    1. By viewing the comments, you’re able to see the time and date stamp and the staff responsible for completing the check. This ensures that they are completed accurately and on time at the beginning/end of each shift or per your QA system and does not allow staff to alter the QA check.

Happy QA’ing Everyone. :) – Racheal.

By |2016-11-03T10:15:13+00:00March 28th, 2014|Categories: Racheal Anderson's Posts|Tags: , , , , , , |Comments Off on How to Complete A Quality Assurance Check with Therap.

Bored??

Several months ago, I was told by someone that she heard a manager say, “Does Eddie have nothing better to do than to review my Therap stuff?

Then it hit me… perhaps people don’t understand the concept of quality assurance.   Could it be that what I assume is a common concept is lost on some people?  I can only imagine what this person thought I did at work all day.  “Is Eddie bored so he is checking my documentation?

When I teach classes about reviewing Therap data, I explain the concept of quality assurance.  “How many of you worry about your engine falling apart when you’re driving your car?  No one?  Why don’t you worry about it?  Could it be because you trust that the car manufacturer has some sort of QA process to ensure the quality of the product?

I usually see some eyes light up as the concept of QA suddenly sinks in.  I further elaborate that QA is a continuous feedback process to ensure certain standards are met.  It’s not necessarily punitive in nature, though the lack of improvement may deem otherwise.  It is a process that all managers should be doing with their employees to evaluate performance.

To really drive home this concept, I break it down into these steps:

  1. Determine standards and expectations
  2. Clearly communicate these standards and expectations
  3. Train and provide resources on how to meet these standards and expectations
  4. Evaluate performance against these standards and expectations
  5. Give feedback
  6. Re-train as necessary
  7. Repeat Steps 4 through 6

Wow, this ended up being a longer blog entry than I expected… perhaps I am bored :)

By |2016-11-03T10:15:17+00:00February 21st, 2014|Categories: Eddie Fung's Posts|Tags: , |Comments Off on Bored??