Multiple PACT Requests for a Patient

Each patient must have only one assigned PACT within the VA system. When multiple PACT assignments are requested, a clinical decision (approval/denial) will be required. There can only be one active request per patient per 3-digit station at a time. Also, there can be multiple requests for the same patient at different stations at one time. A user can view all requested assignments for Multiple PC teams for a patient on the Patient Profile screen.

Note: Multiple PACT requests were previously known as Dual Assignment Request. Multiple PACT requests, MPACT, and Multiple PCP requests refer to the same process – all are interchangeable terms.

When a patient is being assigned to a PACT team at the local station, the patient’s PACT assignments will be evaluated enterprise-wide to determine if an active PACT assignment exists in another 3-digit code station. If determined and the patient has one or more active PACT assignment(s) at other 3-digit code stations, then the system will automatically generate a Multiple PACT Request (MPACT).

Automatic Multiple Pact Requests

  1. The Multiple PACT request process starts when a patient is being assigned to a PACT team at the local station.
  2. On the Patient Profile screen, expand Multiple PACT Requests section to view the overall Status of the request, the date the status changes, and the Receiving Station Name which will include the team name and Focus. The Reason and Action columns will populate after the local TVC approves the request.
  3. In the View Team Assignments section, the user can view the existing PACT assignment(s) and all other team assignments which will include ACTIVE and PENDING assignments for the patient.  The user can assign a patient to a local PACT team in the process of assigning a patient to a team.
  4. Click the Assign button to display the Team Assignment box.
  5. Select the PACT team from the Assign to drop-down list and click Submit to complete the assignment.
  6. If the system finds the patient is active at another station, The Multiple PACT Automatic Creation popup box will display. Click Assign Anyway to continue and complete the pending assignment, or Cancel to cancel. The Attention popup box will display. Click OK.
  7. The system creates a Multiple PACT request. The Multiple PACT Request section in the Patient Profile will contain a table that lists all of the requested assignments for the Primary Care teams and display the following fields:
  8. A confirmation message displays stating the patient was assigned successfully to the PACT team.
  9. The system sends out two alerts to all involved stations (i.e. those stations holding a current active PACT assignment or the station needing assignment). An Informational Alert is sent to the station needing assignment PCMM Coordinator for awareness and an Actionable Alert to the Station Needing Assignment TVC requesting to Approve OR Deny an existing Multiple PACT Request.
  10. The authorized user (TVC) opens the Alerts list (see the View Open Alerts List for a Current Station section), locates the correlating Actionable alert for the request, and clicks the View/Action on Alerts icon in the Actions column. The system will display the Patient Profile screen.
  11. Navigate to the Patient Profile.
  12. On the Patient Profile screen, the PACT team assignment is now displayed in the View Team Assignments section. The Status is PENDING and depends on two requirements before the assignment turns to ACTIVE. The system will validate that each requirement has been met before the PACT assignment turns ACTIVE. An encounter date alone will change a PENDING PACT assignment associated with a Multi PACT Request.
  13. The Multiple PACT Requests section on the Patient Profile  the user clicks the Actions icon (magnifying glass) to display the Create or Edit Multiple PACT Request popup screen. This screen will display:

Approving Multiple PACT Request:

  1. Click the Actions icon (magnifying glass) to display the Create or Edit Multiple PACT Request screen. This screen will display:
  2. Select the appropriate reason from the Reason for Multiple PACT Request drop-down field.
  3. Enter any additional information or comments in the Comments field. This is optional, but helps to communicate between TVCs.
  4. Click Approve to continue, or Deny to deny the requested approval. That status will be changed to Approve. The Entered by will be populated. The Approver selects an option from the Clinical Decision by: drop-down field and comments may be entered.
  5. Click Submit to continue, Withdraw the Request to withdraw, or Cancel to cancel the request. If submitted, the system changes the Status to Approved in the Patient Profile and sends an alert to the original station.
  1. A confirmation message displays. Click Close.
  2. Upon the TVC closing the Confirmation message, the system performs the following actions:

Approve Station Process:

  1. The TVC at the receiving station opens the Alerts list, locates the correlating Actionable alert for the request, and clicks the View/Action on Alerts icon in the Actions column. The system will display the Patient Profile screen.  
  2. The TVC opens the Multiple PACT Requests section and clicks the icon in the Action column for the corresponding record to display the  Multiple PACT Automatic Creation  box.
  3. The TVC scrolls down to the Required PACT Approvals section.
  4. The TVC has the option of resending the alert to the stations listed by clicking the Resend Alert button in the Actions column.
  5. The TVC clicks Approve to continue (and may enter comments if desired), Deny to suspend the approval process. If Deny is selected, the TVC will be required to select a Reason and Date.
  1. The TVC clicks Submit and the record is saved.
  2. The request will be saved with an assignment status of Approved for the station approving the request. The overall status of the request will remain Pending until all required approvals have been obtained. An Informational Alert will be sent to all TVC(s) at the other approving station(s) except the TVC’s station that just provided the approval.

If TVC Denies the Request:

  1. The system displays the details of the submitted request in the timeline on the Patient Profile screen.

Required PACT Approvals Station(s) Process

All other involved stations listed in the Required PACT Approvals section must approve or deny the new pending request in order for the PENDING PACT assignment at the Station Needing Assignment to be considered for activation. These involved stations will not be able to edit any data, they will only be able to approve or deny the request.   Each TVC at all other stations listed in the Required PACT Approvals section of the MPACT Request will review the Actionable alert requesting approval of a MPACT Request for a new PACT assignment for the patient.
  1. Navigate to the Patient Profile.
  2.  In the Multiple PACT Requests, click the Actions icon (magnifying glass) to display the Create or Edit Multiple PACT Request popup screen.
  3. Navigate to the bottom of the request to access the Approve or Deny buttons.
  4.  Click Approve.
  5. The system automatically displays the Request Status and Entered By for this action.
  6. The status will be changed to Approve. The Approver selects a Clinical Decision by:, and comments may be entered if desired.
  7. Click Submit.
  8. A Confirmation message is displayed and the Patient Profile is displayed.
  9. That status of the MPACT has changed to APPROVED in the Multiple PACT Request section.
  10. The system performs the following actions:

The PENDING PACT assignment associated with this APPROVED MPACT Request is still in PENDING status. Even with an APPROVED MPACT Request, the assignment will not flip to ACTIVE until a valid encounter with a teamlet member of the team the patient is assigned is detected by the system within the past 30 days.

  1. The TVC at the original station the request was submitted can view the PENDING PACT assignment on the Patient Profile screen and enter an encounter to flip this assignment to ACTIVE because of the APPROVED MPACT Request.
  2. The patient’s PENDING PACT assignment is now ACTIVE after the system verified the two requirements needed to flip this PACT assignment to ACTIVE. Those requirements are:
  3. When the PACT assignment flips from PENDING to ACTIVE, the Start Date and time will update to reflect the date of the encounter which is the date the team assignment starts as ACTIVE.

Permanent Relocation Process:

See also:

Assign a Patient to a Team

Assign Patient to a PACT Team

Manage Alerts

View Open Alerts List for a Current Station