SOCIAL
-community support groups
-grief counseling
-pastoral care
-psy care
-social services
The purpose of clinical support services (CSS)
provide its specialized services at a level that fully meets patients' and care providers'
needs.
The purpose of the HCO is to assist each CSS in achieving its purpose and to
provide each patient with exactly the set of services needed and integrate those
services into an excellent interprofessional plan of care.
functions of CSS
1. provide excellent care: through 4 processes (patient management guidelines,
functional protocols, scheduling systems, training)
2. maintain patient relationship: All CSSs have both patient and care provider
customers. emergency patients get priority.
3. maintain consultative relationship: CSSs must view care providers and
interprofessional teams as customers and recognize that care providers often have
alternative sources.
, 4. plan and manage operations:
5. improve continuously
How does CSS meet the national academy of medicine goal of SEPTEE
1. patient management guidelines: adopted by selection committees with CSS
members. Specify when CSSs are required, optional or not needed.
2. functional protocols: all CSS activities are learned processes that are formalized and
scripted as functional protocols.
3. scheduling systems:
4. training:
CSS must meet these different aspects of care needs, to complete an order
(patient related considerations)
• Comprehensive. The CSS's level of service must match the requirements of the
patient management protocols.
• Accurate and effective. Errors in diagnostic tests create unnecessary costs and
dangers for patients. Care providers need to be confident in CSS results.
• Prompt. Delays in CSS prolong the care process, reducing efficiency. They also erode
patient satisfaction.
• Supportive of patient needs. The patients' overall response to the care, both clinically
and in terms of satisfaction, is often influenced by the CSS.
CSS must support these needs of the care team
• Consultative advice. Each CSS is an expert resource. Care providers need to rely on
CSS expertise when questions arise about individual patients.
• Guideline and protocol development. Many questions that emerge from adopting
guidelines require CSS participation to answer. Most protocols must be agreed to by the
CSS involved.
• Training. CSS advances can change how care is given. Many procedures originated in
CSS but have moved to general usage; care providers must often be trained to do
them. Various procedures have complex implications for other parts of care, and care
providers must be trained to understand those interactions.
• Assistance with uninsured patients. The plans must be worked out in advance and
specified in the contract with the HCO (see the Plan and Manage Operations section on
the next page).
The transformational culture, for HCOs looking to impress CSSs is sustained by
three elements:
1. Responsive listening by senior leadership. Rounds should include CSSs, and CSS
associates should feel empowered.
2. Training for CSS managers. Just as nurse managers and logistic support leaders are
trained to be responsive listeners and to encourage empowerment, CSS managers
should be trained. Because of the small size of many CSSs, coaches and mentors
come from other CSSs.
3. Celebration and rewards. CSSs should participate in celebration of goals that require
collaboration as well as in achievements within their CSS. Their compensation should
include bonus opportunities that are comparable to those of other associates.
**Alternative contractual arrangements between HCO and CSS:
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