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Fast Forward Rounds
Game board and Questions
Instructions for Running the Game
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Slide 3: the game board (use a poster company to print a large laminated copy)
Slide 7: the game questions (each colored square represents one question)
To open a question, click on the colored square corresponding to the location of each
team’s marker on the game board. All teams start in the “HOSPITAL,” so Team 1
should receive question 1 under “Hospital”
The presentation is set up with an automatic timer allowing 1 minute for each team to
provide an answer; after 1 minute the “Time’s up” sign appears
If you want to bypass the timer before 1 minute is up, hit enter after the question
appears. Continue to hit enter until the answer appears.
To return to Slide 7, click on the house icon at the bottom of each question slide
To maximize efficiency and ensure all teams get sufficient play time:
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Use the team numbers to delineate the order of play, i.e. Team 1 goes first, Team 2 second, etc.
Allow each team to answer one question before moving on to the next team.
If a team gives an incorrect answer, they remain on that square and in the next round receive
another question from the same content area.
END = HOME
START = HOSPITAL
From Hospital to Home
Hosted
by
The Fast Forward Rounds Course
Rules of the Game
• The object of the game is to get
from The Hospital to Home
• Each team must answer a
“discharge summary” question
correctly to get out of The
Hospital
• Each colored square represents
a different question category
• Your team will have 1 minute to
answer each question
• If you get the question wrong,
you must repeat that square
• The 1st team to get “Home” and
answer a case question correctly
wins!!!!
Official Judges
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Veronica LoFaso
Sharda Ramsaroop
Karin Ouchida
Primary care resident
REHAB/
HOUSING
COMPREHENSIVE
CARE
HOME
CARE
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COMMUNITY
RESOURCES
HOSPITAL
HOME
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5
Name 2 reasons for a PT consult
in the hospital
other than a fracture.
Time’s Up !
Gait evaluation
Strengthening exercises
Range of motion
Row 1, Col 1
Describe 3 consequences of poor
transitional care.
Inadequate or no follow-up
Confusing or incorrect med regimen
Insufficient patient and/or
caregiver education
Patient/caregiver dissatisfaction
Increased health care utilization
Time’s Up !
1,2
Name 3 examples of durable
medical equipment (DME).
Shower chair
Grab bar
Bedside commode
Cane, walker
Wheelchair, chair pad, etc.
Alternating pressure mattress
Time’s Up !
1,3
Who pays for adult day programs?
A.
B.
C.
D.
Medicare
Medicaid
Both Medicare and Medicaid
Neither Medicare nor Medicaid
Time’s Up !
Answer: B
1,4
Does your team’s discharge
summary have a complete
list of medications?
A complete list includes:
Name
Dose
Frequency
Duration (if applicable)
Indication for all prn medications
Time’s Up !
1,5
A 65-year-old man is admitted with
pneumonia and treated with 3d of
Ceftriaxone™ and azithromycin. He is
going home on levofloxacin and needs to
complete a 14 day course of antibiotics.
What discharge instructions
do you want to give him?
Time’s Up !
Name of antibiotic
How to take it
Potential side effects
Indication
Duration
Signs/sx to report
1,6
Name 2 reasons for an OT consult
in the hospital other than a
swallowing evaluation.
ADL training
Cognitive training
Upper extremity range of motion
Upper extremity strengthening
Splint application
Time’s Up !
2,1
Define medication reconciliation
at the time of discharge
from the hospital.
The act of comparing the
patient’s discharge medication
list with the inpatient list and the
previous home medication list
Time’s Up !
2,2
Name 3 examples of skilled care.
Skilled nursing care
Wound care
Administration of IV/SQ meds
Education about meds, conditions
Diet instruction
Time’s Up !
Physical therapy
Occupational therapy
Speech and language therapy
2,3
Name 2 functions of a
senior center.
Meal site
Screening (e.g BP check)
Recreational center
Social service agency
Mental health counseling
Volunteer coordination
Community meeting place
Time’s Up !
2,4
Does your team’s discharge
summary have a complete and
succinct hospital course?
Litmus test: If you were the patient’s
next provider would you have enough
information to know what happened
during the hospitalization?
Time’s Up !
2,5
A 70-year-old woman who takes ibuprofen
for OA is admitted with an upper GI bleed
and found to have a gastric ulcer. Her baby
ASA and ibuprofen are discontinued. She
will go home only on a PPI bid. What
discharge instructions do you want to give
her?
Time’s Up !
Name of PPI
Reason for PPI
How to take PPI
Avoid NSAIDs
Warning signs/sx of GI bleed
2,6
Who reimburses for short-term
sub-acute rehabilitation in NY?
(Medicare, Medicaid, Both or
Neither?)
Time’s Up !
Both!
3,1
Within 10%, what percentage of
patients experiences an adverse
event during the transition from
hospital to home?
Time’s Up !
20%!
3,2
Name 3 reasons why it is
important to perform a functional
assessment on patients
in the hospital.
Time’s Up !
It is a predictor of mortality
It helps anticipate needs upon discharge
It helps uncover deficits/limitations
3,3
Name an inexpensive community
service you could recommend to a
recently hospitalized, homebound
65-year-old patient who requires
help with shopping and cooking
Time’s Up !
Meals on Wheels
Shop and Escort program
3,4
Does your team’s discharge
summary have complete followup information?
Time’s Up !
Name(s) of providers
Contact information
Appointment date/time (ideally)
3,5
A 65-year-old man is admitted with his 4th CHF
exacerbation this year. He reports taking all of
his meds but privately his wife tells you he
often skips his diuretic when he goes to Yankee
games. While at Yankee stadium he also eats
hot dogs and fries. How would you:
(1) assess for medication compliance and
(2) give dietary instructions?
Time’s Up !
How do you take your diuretic?
Do you ever miss doses? Why? In what settings?
What is your understanding of your disease?
Instructions for limiting/avoiding salt
3,6
Name 2 services provided in an
assisted living facility.
Meals in a common area
Laundry
Housekeeping
Personal care assistance (some)
Medication management (some)
Time’s Up !
*REMEMBER:
NO SKILLED CARE PROVIDED! *
4,1
Within 10%, what percentage of
adverse events is related to
medications?
Time’s Up !
66%!
4,2
You perform a functional assessment
and discover your patient has limited
proximal range of motion in her
upper extremities. Name 3 actions
she may find difficult to perform.
Time’s Up !
Reaching for objects
Fastening her bra
Combing her hair
Brushing her teeth
4,3
Describe 2 characteristics of a
patient for whom you would
recommend a personal
medical alert system.
Lives alone
History of falls or gait impairment
Cardiac or pulmonary disease
Unable to use or reach phone
Cognitive impairment
Time’s Up !
4,4
Does your team’s discharge
summary include relevant signs
and sx the patient should report to
a physician?
Time’s Up !
The signs/symptoms should be relevant
to the pt’s recent illness, e.g. if admitted
for CHF should report increased weight,
LE edema, SOB, CP etc.
4,5
A 70-year-old woman is admitted with
new onset atrial fibrillation and started
on warfarin. What discharge
instructions would you give her
regarding this new medication? What
follow-up does she require?
Time’s Up !
Reason for taking
How to take it
Possib drug interactions Diet instructions
Warning signs/sx
PT/INR monitoring
4,6
How many hours per day does a
patient need to be able to
participate in restorative therapy to
qualify for acute rehabilitation?
Time’s
Up
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THREE!
5,1
Describe 2 ways to assess a
patient’s health literacy.
Ask pt to describe how to:
Take a medication
Perform a health-related action
Adhere to a prescribed diet
Time’s Up !
Ask pt to explain their disease or
condition
5,2
In which of the following patients
will Medicare NOT cover home
health aide services?
A. Pt who requires daily dressing changes
B. Pt who requires PT for strengthening exercises
C. Pt who requires OT for help with daily activities
D. Pt who requires speech-language therapy
E. Pt who requires help with dressing and bathing
Time’s Up !
Answer: E
5,3
Name 3 health-related services
offered at a medical-model
adult day care program.
Time’s Up !
PT
OT
Speech therapy
Nutrition
Wound care
Med management
Blood sugar, BP, HR monitoring
5,4
Does your team’s discharge
summary have a complete
problem list?
Time’s Up !
A complete problem list includes:
Reason for hospitalization
Complications during hospitalization
Co-morbidities
5,5
A 75-year-old man with DM is admitted with
cellulitis and a foot ulcer. He admits to not knowing
how to follow his blood sugars at home and his Hgb
A1c is 12. He is started on twice daily insulin
injections. He completes a course of antibiotics for
the cellulitis. The ulcer remains open with drainage.
He now has difficulty ambulating because of pain
from the ulcer and confesses he has already had two
falls at home. Name 5 home care services that
should be set up prior to his discharge.
Time’s Up !
Wound care
FSBG teaching
Physical therapy
Insulin admin/teaching
Nutrition
Home safety eval
5,6