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.
- If there are no active
PC Assignments for this Patient at other stations, the multiple PACT
request cannot be created.
- A multi-PACT request
will be auto-generated while the assignment has a pending status
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).
- There can only be one pending request per patient per 3-digit
code station at a time. The Multiple PACT request
cannot be used to request an assignment within the same 3-digit
code station.
- There can be multiple requests for the same patient for different
3-digit code stations at one time.
- In order to create/edit a Multiple PACT request for a patient,
the patient must not have a Date of Death associated. If so, a
Multiple PACT request will not be created.
- If there is a PENDING PACT assignment that turns to ACTIVE
at another 3-digit station after a MPACT Request has an overall
status of APPROVED for another 3-digit station, the MPACT Request
WILL NOT change but
the system will automatically generate a new MPACT Request for
this new ACTIVE PACT assignment and add all stations that have
ACTIVE PACT assignments to the Required PACT Approvers section
of the MPACT Request.
Automatic Multiple Pact Requests
- The Multiple PACT request process starts when a patient is being
assigned to a PACT team at the local station.
- Note: Ensure to be
logged into another station than the 3-digit station code of the
patient’s existing ACTIVE PACT team assignment(s).
- 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.
- 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.
- Click the Assign button
to display the Team Assignment box.
- Select the PACT team from the Assign
to drop-down list and click Submit
to complete the assignment.
- 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.
- 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:
- Status
- Pending
- Default when creating a new request, if all involved stations
have not approved or denied the request.
- Approved
- If all involved stations have approved the request.
- Denied
-
If any of the involved stations have denied the request or
- Withdrawn -
If the station needing assignment canceled the request
- Status
Date
- Receiving
Station Name
- Station
Name (Station #)
- Team
name
- Focus
- Reason
- Medically Necessary
or Permanent
Relocation
- Action to
view the request details
- A confirmation message
displays stating the patient was assigned successfully to the PACT
team.
- 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.
- Only the facility’s Travelling Veteran Coordinator (TVC) and
VISN TVC (and backups) can enter the approval/denial.
- All involved
stations must approve or deny the new pending request in order
for the PACT assignment at the requesting station to be considered
for activation.
- 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.
- Navigate to the Patient Profile.
- 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.
- Requirement 1 – The
patient must have a valid encounter date with a teamlet member
of this team within the last 30 days.
- Requirement 2 - The
overall Status of the MPACT must be approved.
The overall status is displayed on the patient’s profile in the
Multiple PACT Requests
section in the Status column. The MPACT Request will remain in
PENDING status until ALL
approvers listed in the Required PACT Approver table of the MPACT
Request have provided an approval.
- 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:
- Status for the Request
- Pending (default when generating a new request and overall
status if all involved stations have not yet approved or denied
the request)
- Approved (If all
involved stations have approved the request)
- Denied (If one
of the involved stations have denied the request)
- Withdrawn (If the station needing assignment cancelled
the request)
- Status Date
- As the MPACT request
receives approvals/denials from other stations, the overall
Status and Status Date will be automatically updated to reflect
new Status/Status Date.
- Station Receiving Request
- Station Name (Station#),
Team name, Focus
- Reason (only populates
after the local TVC selects it and approves the request locally)
- Medically
Necessary
- Permanent Relocation
- Action to view the request
details
Approving Multiple PACT Request:
- Click the Actions
icon (magnifying glass) to display the Create
or Edit Multiple PACT Request screen. This screen will display:
- The Multi PACT Request form will auto-populate and display
the overall status of the request in the Status
of the Request field. This will be Pending until all approvals
are received.
- Request Entered On - (user that generated the request)
- Station Receiving Request – (station that generated the pending
PACT assignment request)
- TVC's listed for that station – (Station Name and Station Number)
- This section will list the TVCs assigned to the selected
station and will automatically populate users holding the
“Traveling Veteran Coordinator” role (TVC) at the station.
The TVC Phone and Email icon will display, if available.
- Reason for Multiple PACT Request (Medically Necessary or Permanent
Relocation)
- Comments – (TVC may enter any additional comments, if needed.)
- The Required PACT Approvals
section will include:
- Station - This column will display all station names and
numbers that have an ACTIVE PACT assignment and these stations
will receive the Multi PACT actionable alert requesting approval/denial.
- TVC's – This column will display all available TVCs for
each station listed. It will display the TVC(s) name, phone
number, and email address, if available.
- Status:
- Pending
- Approved
- Denied
- Withdrawn
- Not Test Submitted for Approval – Once a request is
first submitted during the patient team assignment process,
all other stations listed on the request form will display
a Status of Not
Yet Submitted for Approval to indicate the Multiple
PACT Request has not been sent to the other stations for
approval/denial. The Receiving Station TVC must approve
or deny and select a reason before other stations are
notified. Once the local TVC approves the request, the
status will change for the local station to APPROVED
and display as PENDING
for all other stations listed on this request. Once all
stations have approved this request, the Status column
for all stations will display APPROVED.
- Status Date - This will display a date and time any action
was taken for an existing PENDING Multiple PACT Request.
- Clinical Approval By
- Traveling Coordinator
- Comments (if any)
- Actions - Resend Alerts (Only available for Station Needing
Assignment)
- Reason for Multiple PACT Request (Medically Necessary or
Permanent Relocation)
- Comments – (TVC may enter any additional comments, if needed.)
- Select the appropriate reason from the Reason
for Multiple PACT Request drop-down field.
- Enter any additional information or comments in the Comments
field. This is optional, but helps to communicate between TVCs.
- 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.
- 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.
- If the TVC denies the request, the pending
PACT assignment request will be cancelled and closed with a reason
of Denied.
- If the Multi PACT Request is Pending,
ONLY the Station Needing assignment TVC role can WITHDRAW the request.
This will send an Informational alert to all station(s) TVC(s) and
PCMM Coordinator(s) listed on the request, stating the request is
no longer needed. The station needing the assignment can cancel
the request as long as the overall status of the MPCP request is Pending. Even if the station
needing the assignment has approved the Multi PACT request, that station
can still cancel the request if its overall status is still Pending.
- If a station has a pending assignment that flips to Active
while a Multi PACT request still has an overall status of Pending,
this station will be added to the Multi PACT request as a Required
PACT Approver. The appropriate alerts will be sent to the appropriate
staff members.
- Once the overall status of a Multi PACT request changes from Pending to Approved
or Denied, the request
will be closed and no further changes are permitted.
- A confirmation message displays. Click
Close.
- Upon the TVC closing the Confirmation
message, the system performs the following actions:
- Updates the MPACT Request on the Patient Profile.
- Displays the Status of the MPACT Request as Pending
since all other stations involved have not submitted approvals.
- Updates the Status
Date column to reflect the date and time the Station approved
the request.
- Displays the reason selected by the TVC for this request in
the Reason column.
- Sends Actionable alerts to all TVC(s) at the other stations
listed on the MPACT Request in the ‘Required PACT Approvals’ section
requiring action
on this request..
Approve Station
Process:
- 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.
- 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.
- The TVC scrolls down to the Required
PACT Approvals section.
- The TVC has the option of resending
the alert to the stations listed by clicking the Resend
Alert button in the Actions column.
- 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.
- All involved stations must approve or
deny the new pending request in order for the PACT assignment at the
station to be considered for activation.
- Once a request has been approved or denied
– no further edits are permitted.
- The other involved stations cannot edit
any data. Stations can approve or deny the request.
- The TVC(s) must enter who made the clinical
decision to Approve or Deny the request. This
indicates if the TVC is approving the request or on behalf of someone
else who authorized the approval. This drop-down list will include
all PCMM Web users who hold the clinical
approver permission and is required.
- The TVC clicks Submit
and the record is saved.
- 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 the MPCP request is approved by
all involved stations being asked to approve/deny the request,
the status of the entire request will then be Approved.
An information alert will be sent to all TVC(s) and PCMM Coordinators.
If TVC Denies the
Request:
- The request
will be saved with an assignment status of Denied.
An Informational Alert will be sent to all TVC(s) and PCMM Coordinator(s)
at the other approving station(s) except the TVC’s and PCMM Coordinator’s
station that just provided the denial.
- If the MPCP
request is denied by one station within all the stations being asked
to approve/deny the request, the status of the entire request will
then be Denied.
No
further action on this request will be possible by any other approvers
whose approval may be pending.
- The
system displays the
details of the submitted request in the timeline on the Patient Profile screen.
- The system will track that all approvals needed are received. When
they are, the assignment will be interrogated for activation. If
a qualifying teamlet encounter has been recorded within the previous
60 days from the team assignment date; the assignment status will
be changed from Pending
to Active using the
encounter date as the effective date for the activation.
- Once
a MPCP Request is approved and in Approved
status,
it will be considered valid for 24 months using the Approval date
from the last station to submit its approval on the request. If
the patient is unassigned from that team and is re-assigned again
or if the team itself is inactivated/re-activated in this time
period, the earlier approval will be considered 'valid' during
this 24 month period.
- If
the 24 month timeframe has passed and a patient is then unassigned
from the team, a new MPCP Request is required.
- If
the 24 month timeframe has passed and the patient is still
assigned to the team, the original MPCP Request is still considered
valid.
- If
a MPCP Request is still Pending 15 days after the request’s creation,
the system will automatically generate an informational alert
to all of the outstanding station approver(s) by sending an Outlook
email to remind the recipient(s) to look at the PCMM Web Alerts
and that action is needed.
- If
a MPCP Request is still Pending 30 days after the request’s
creation, the system will generate an informational
Escalation
Alert to the VISN TVC coordinator
of each station that has not responded to the MPCP Request
by sending an Outlook email stating that a MPCP Request has
been pending for 30 days and to look at the PCMMR Alerts to
take action on this request.
- If
a MPCP Request is still Pending 45 days after the request’s
creation, the system will generate an informational
Escalation
Alert to the PCMMR National
Coordinator by sending an Outlook email stating that a MPCP
request has been pending for 45 days and to look at the PCMMR
Alerts to take action on this request.
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.
- Navigate to the Patient Profile.
- In the Multiple
PACT Requests, click the Actions
icon (magnifying glass) to display the Create
or Edit Multiple PACT Request popup screen.
- Navigate to the bottom of the request to access the Approve or
Deny buttons.
- Note: The WITHDRAW
button is no longer displayed since ONLY
the Station Needing Assignment can WITHDRAW a request.
- Click Approve.
- The system automatically displays the Request Status and Entered
By for this action.
- The status will be changed to Approve. The Approver selects a Clinical Decision by:, and
comments may be entered if desired.
- Click Submit.
- A Confirmation message is displayed and the Patient Profile is
displayed.
- That status of the MPACT has changed to APPROVED in the Multiple
PACT Request section.
- The system performs the following actions:
- Updates the MPACT Request on the Patient Profile:
- Displays status as APPROVED since all stations involved
have provided the necessary approvals.
- Updates the date and time the MPACT request was approved
Status Date column.
- Displays the reason for the MPACT request in the Reason
column.
- Sends an Informational alert stating this station has just
approved the request to all other stations on the MPACT Request
except the station that that approved it. Since there is no limit
as to how many ACTIVE PACT assignments a patient can have with
an APPROVED MPACT Request for each PACT assignment, there could
be several stations listed as approving stations on the request.
This Informational alert will be sent each time a station approves
until all approvals are received from all stations involved on
the request.
- Sends Informational alerts to all TVC(s) and PCMM Coordinator(s)
at all stations involved with the request stating that all approvals
have been received and the MPACT Request has been approved.
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.
- 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.
- Note: The patient could
have already had an encounter with a teamlet member and the PENDING
PACT assignment would have flipped simultaneously to ACTIVE when
the overall Status on the MPACT Request changed to APPROVED.
- 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:
- An overall APPROVED MPACT Request
- A valid encounter with a teamlet member in the past 30 days
- 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:
- If the TVC at the station needing assignment selects Permanent
Relocation as the reason for the Multi PACT Request, it is to
assist the patient with an easy transition to the patient’s new station.
Once overall approval is received by the station needing assignment,
the following alerts will be sent:
- An informational alert will be sent to all TVC(s) on the request
stating the relocation has completed and the request has been
WITHDRAWN.
- An actionable alert will be sent to all PCMM Coordinator(s)
on the request stating the relocation has completed; that all
Active PACT assignments need to be unassigned at each of the approving
station(s); and the request has been WITHDRAWN.
See also:
Assign a Patient to a Team
Assign Patient to a PACT
Team
Manage Alerts
View Open
Alerts List for a Current Station