CCS-Tools

Client Communications System

Tools

In this section, you will find memo forms, suggested memos, and other documents to help you implement the Client Communication System. Use these "as is" or adapt them to your needs or just create your own. Do whatever works best for you. Included are:

Directory of Primary Contacts – A form to list your main program contacts.

Directory of Spokespersons – A form to list your spokespersons.

Memo Form, standard – a blank form that you can copy and use as needed.

Suggested Memos – Use "as is" or adapt as you feel necessary.

To Renal Administrator – May be helpful to introduce the program to administrators.

To Renal Staff – May be helpful to introduce the program to staff.

To Renal Patients – May be helpful to introduce the program to patients.

To Renal Patients – Subject: Suggestion Box

May be used to let patients know its purpose and where located.

Meeting Report Form – A fill-in form that may be useful in recording results of a CCS or patient meeting.

Communications Check Off Sheet – May be useful in keeping track of those persons who have received specific information whether used by PAC Reps to track information to Spokespersons or used by Spokespersons to track information to patients on their shifts.

Memo to Network – Please use to alert Network as to your progress implementing and using the CCS.

Logos – a page of logos for your use on suggestion boxes etc.

Directory of Prime Contacts

Prime Contacts at the Facility NAME PHONE

Staff Coordinator ___________________________ __________________

PAC Rep ___________________________ __________________

PAC Alternate ___________________________ __________________

Social Worker ___________________________ __________________

Dietitian ___________________________ __________________

Other ___________________________ __________________

Prime Contacts at the Network NAME PHONE

Patient Services ___________________________ __________________

PAC Chairperson ___________________________ __________________

Other ___________________________ __________________

Directory of Spokespersons

NAME SHIFT OR TREATMENT PHONE

_____________________________ ________________ ____________

Memo

Date:

To:

CC:

From:

Subject:

_____________________________________________________________

Memo

Date:

To: Renal Administrator

CC:

From:

Subject: A Client Communication System Program For Our Renal Community

The Renal Network, Inc. is encouraging facilities to implement a Client Communication System program. The purpose of the program is to improve the sharing of information among the Network, facility administration, unit staff, and patients.

As the PAC representative to the Network, one of my duties is to be the general coordinator of this program. Also, the program suggests you appoint a staff coordinator to work closely with me and with administration, when necessary. Together, we will address specific patient concerns at our facility and provide a means for information to be shared with all patients.

Attached is a description of the program and of job functions and responsibilities.

In general, the program involves a two-way flow of information:

- From the Network or facility administration to the patient level.
- From patients to the administration and/or the Network.

One benefit to you: When you have changes or when you have other items that you need to communicate to patients, the Client Communication System program can help you do this.

- Everybody gets the same information.
- Patients may accept change more readily if they hear about it from another patient.

(page 2 – Memo to Renal Administrator)

Another benefit: The Network has many educational resources available for patients. The Client Communication System program can inform the patients of these resources so they can order them.

- The patients will be able to be more responsible for their own education in general areas: access care, sleep problems, exercise, etc.
- This frees up your staff to perform their primary duties.

Still another benefit: the program encourages patients to address their concerns in a non-threatening way. This allows both of you to seek solutions and implement them. This may prevent concerns from becoming grievances.

I am asking for your approval and support to implement Client Communication System within the facility.

If you decide that Client Communication System will be beneficial, please appoint a staff coordinator and let me know who that person is. I will contact him or her immediately and get started.

Of course, if you need to discuss this further, feel free to contact me or call Kathi Niccum, Patient Services Director, at the Network office, 800-456-6919 or 317-257-8265.

I’m looking forward to hearing from you within the next two weeks, and I’m looking forward to getting Client Communication System underway.

Attachments

Memo

Date:

To: Kathi Niccum, The Renal Networks, Inc.

CC:

From:

Subject: Client Communication System Program

_____________________________________________________________

This memo informs you of the status of the Client Communication System

program at ______________________________ (facility name).

_____ We are going to implement the program.

_____ We are not going to implement the program because:

Please return this form as soon as you have attempted to implement the program. Please send to:

Patient Services

The Renal Network

911 E. 86^th Street, Suite 202

Indianapolis, IN 46240

Memo

Date:

To: Renal Staff

CC:

From:

Subject: Client Communication System

_____________________________________________________________

The Renal Networks, Inc., is encouraging facilities to implement a Client Communication System program. The purpose of the program is to improve the sharing of information among the Network, facility administration, unit staff, and patients.

In general, the program involves a two-way flow of information:

- From the Network or facility administration to the patient level.

- From patients to the administration and/or the Network.

As the PAC representative to the Network, one of my duties is to be the general coordinator of this program. Also, _______________________ has been appointed staff coordinator to work closely with me and to obtain administration approvals, when necessary.

The program needs a third group of participants -- patients to volunteer to be spokespersons. We will need a spokesperson for each in-center shift, as well as spokespersons to represent patients using any other modalities our facility offers: home hemodialysis, peritoneal dialysis, and transplant.

As spokesperson, the patient will talk with other patients on the shift (or on another treatment modality). Then he or she will tell me of patient interests, concerns and needs. I will relay this information up the chain.

The spokesperson will also inform patients of meetings, resources, and other information.

Your support is crucial. Please recommend patients who you think can effectively communicate with others. Also, you can volunteer until a qualified patient is available.

(page 2 – Memo to Renal Staff)

I want to start the Client Communication System program as soon as we have spokespersons for some of the shifts/treatment modalities. Simultaneously with this memo to you, I am sending a memo to patients, informing them of the program and asking for volunteers to be spokespersons.

I will contact you in two weeks to see if you have any recommendations for spokesperson.

I am looking forward to implementing Client Communication System. Thanks in advance for any assistance you can give.

Memo

Date:

To: Renal Patients

CC:

From:

Subject: Client Communication System, A Communications Program

_____________________________________________________________

I have three purposes in sending you this memo:

1. To introduce you to the Renal Network, Inc., in case you do not know it already.

2. To describe the Network-sponsored Client Communication System program.

3. To ask you to consider being a spokesperson for the Client Communication System program.

Attached is a brochure describing the Renal Network, Inc. Please read it to see some of the many services the Network is providing for renal patients in four states: Illinois, Indiana, Kentucky, and Ohio.

I represent you at Network meetings as a member of the Patient Advisory Council (PAC) for this state. Periodically throughout the year I have Network information and educational materials to share with you.

Also, I want your input -- problems, concerns, and compliments -- so I can share it with the facility staff and with the Network, as necessary.

Clearly, I am not able to talk personally to each of you on a regular basis. So, with the approval of facility administration, we are starting Client Communication System, the Network-sponsored program to help us communicate back and forth.

I need volunteer spokespersons. For the Client Communication System to work, I need a volunteer spokesperson for each shift, and a separate spokesperson for home hemodialysis, peritoneal dialysis, and transplant patients.

(page 2 – Memo to Renal Patients)

These spokespersons will serve two main purposes:

· . From patients: Each spokesperson will talk with patients on his/her shift/modality. He or she will then relay to me patient concerns, needs, and interests. In turn, I will have regularly scheduled meetings with a staff coordinator and administration. We will work together to address your collective input.

· . To patients: When the Renal Network or our facility has information to relay to patients, I will have a meeting (or correspond by facility mail and/or shift staff) and provide this information to all spokespersons. Each spokesperson, in turn, will relay it to all patients on his or her shift/modality.

I am looking for patients to volunteer to be spokespersons -- people who want to be involved in making things happen, people who will feel comfortable talking with other patients and getting their input. Volunteering for this position will require time. The amount of time in some ways will be up to you. It can be as little as distributing Renal Outreach and Network Resources order forms or as much as implementing an educational program in your facility.

If you are interested in being a spokesperson, or if you need more information, please contact me, or tell a member of your health care team who will contact me for you. Here is how you can reach my alternate or me:

PAC Rep Name:

Phone:

Treatment days, shift:

Mailbox at the facility:

PAC Alternate Name:

Phone:

Treatment days, shift:

Mailbox at the facility:

I look forward to working with you.

Attachment

Memo

Date:

To: All Renal Patients

CC:

From:

Subject: Suggestion Box

A suggestion box will be placed in . Use this box to tell us what is on your mind, for example:

- Suggestions to improve the quality of patient care
- Suggestions to improve safety

· . Suggestions to improve patient comfort

· . Suggestions to improve patient education

· . What you need, what you want

· . Concerns

· . Compliments

You do not have to sign your name unless you want to do so.

However, please sign your name if you want us to get back to you personally with a solution to any problem you may be experiencing.

As your Patient Advisory Council (PAC) representative to the Renal Networks, Inc., I will discuss your suggestions and comments with the staff on a regular basis.

We will work toward solving problems. Then we will take appropriate action and will let you know of any changes/solutions that we will implement.

Thanks for your suggestions.

Meeting Report

Meeting Date: ____ Scheduled in Advance

____ Emergency Meeting

Place and Time:

Attendees:

Review and Evaluation of Previous Meeting’s Action Items:

Issues Discussed, Outcome (Planned Action), Action Items, and Person Responsible:

Client Contact Check List

Date:

From:

Subject:

_____________________________________________________________

Please read the attached material and initial your name.

Then forward the packet to the next person until everyone has read the information.

If you are the last person to read this packet, please forward it back to me.

ROUTE TO LOCATION INITIALS

______________________________ __________ ________

Logos

Client

Communication

System

Client

Communication

System

Client Communication System

Suggestion Box

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