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UW Health Patient Assessment Tools (PAT) Resource Guide

UW Health Patient Assessment Tools (PAT) Resource Guide - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Questionnaires, Related






UW Health Patient Assessment Tools (PAT)
Resource Guide



Purpose: To provide an overview of the styling and processes required for Patient Assessment
Tool approval.

Last Revised: April 2015
Next Review: April 2017
Approved by: Patient Assessment Tool Workgroup
Developed by: Center for Clinical Knowledge Management (CCKM)
For more information, contact Ryley O’Brien (robrien@uwhelath.org or 608-890-6697)







2

Table of Contents
Guiding Principles ........................................................................................................................................... 3
Patient Assessment Tool Workgroup Authority ........................................................................................... 3
Definitions .................................................................................................................................................... 3
Development Process ..................................................................................................................................... 4
New Tool Assessment ................................................................................................................................. 4
Request .................................................................................................................................................... 4
Prioritization ............................................................................................................................................. 4
PAT Prioritization Matrix ........................................................................................................................... 5
Review ..................................................................................................................................................... 6
Approval ................................................................................................................................................... 7
Build ......................................................................................................................................................... 7
PAT Approval Process Algorithm ................................................................................................................ 9
Periodic Review Process ........................................................................................................................... 10
Retirement Process ................................................................................................................................... 10
Implementation and Communication ............................................................................................................. 11
Implementation .......................................................................................................................................... 11
Communication .......................................................................................................................................... 11
PAT Documentation ...................................................................................................................................... 11
PAT U-Connect Tracker Page ................................................................................................................... 11
Tool Documentation ................................................................................................................................... 11
Frequently Asked Questions (FAQs) ............................................................................................................. 13
Style Guide .................................................................................................................................................... 14
Naming Conventions ................................................................................................................................. 14
Copyright Information ................................................................................................................................ 14
Resource Guide Content Changes (since last review) .................................................................................. 15







3

Guiding Principles
1. This resource guide only applies to Patient Assessment Tools (PATs) as defined below.
Questionnaires not fitting the definition as outlined are not included as part of this resource
guide.
2. PATs will be reviewed, approved, and built based on the best available evidence
3. PAT approval process will apply to all tools throughout UW Health.
4. PAT approval will be based on a majority consensus within the PAT workgroup
5. PAT HealthLink build will be consistent with current build style guides


Patient Assessment Tool Workgroup Authority
The Patient Assessment Tools (PAT) workgroup is charged with reviewing and approving all Patient
Assessment Tools and has the authority to act by delegation of the Clinical Knowledge Management
Council and the Quality Council.


Definitions
Patient Assessment Tools (PATs) are questionnaires and scales used to screen for symptoms and
disorders or to evaluate the performance status of a patient such as their symptom status, functional status,
quality of life, etc. PATs are validated to ensure clinical relevance and, when applicable, their score can be
used to guide diagnostic and therapeutic decisions.
NOTE: PAT questionnaires that collect patient information used to streamline the process of care (e.g.
intake or pre-operative questionnaire, family history questionnaires, etc) are not considered PATs.








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Development Process
New Tool Assessment
Request
1. Requestor to Identity Tool and Submit Request Form
1.1. Requestor to fill out PAT tool request form in Service Now or through U-Connect
1.1.1. Service Now Catalog  Health Link Tab  PAT Request
1.1.2. U-Connect  Help Desk Service Now  Health Link Requests  PAT Requests
1.2. Request form has 3 sections that need to be completed in full:
ξ Requestor Information
ξ Tool Information
ξ General Information
1.3. Submission of this request automatically creates in Service Now a new REQ#, RITM#, and a new
TASK assigned to CCF.

2. CCF Creates New Service Now Configuration Item (CI) Record
2.1. Indicate Status = Requested (See PAT Configuration Item section for more details)

3. CCF Attaches CI Record to TASK
3.1. In the CCFs TASK, populate the Configuration Item (CI) field with the appropriate CI record

Prioritization
1. Prioritize Requested Tools
1.1. All requested tools will be prioritized for review by having each tool scored via a weighted scoring
matrix. Each tool will be scored based on 7 unique elements with each element scored on a 0-4
point scale. Tools with higher scores will be prioritized for review ahead of tools with lower scores.
1.1.1. Tools that are associated with guidelines may be given special priority so that they can be
reviewed and approved within the guideline review window.
1.1.2. Tools that are associated with projects may be given special priority based on project timing,
duration, and resource availability.
1.2. The prioritization matrix, elements, element descriptions, and anchor scores are outlined on the
following page.




PAT Prioritization Matrix


Last revised: 04/2015
Contact CCKM with questions.
PAT Resource Guide



Review
1. Gather Information From Requestor
1.1. Most of the tool information should be included on the Request Form; however, the following
questions should be answered as well:
ξ What is the purpose of the tool?
ξ Is the tool completed by the patient or the clinician?
ξ What is the workflow for administering this tool?
ξ What areas, floors, departments, etc will this tool be used on?
ξ Who will use this tool (nurses, physicians, therapists, researchers, patients)?
ξ Is training required to administer this tool? If so who will conduct that training?
ξ How do you want this tool built into HealthLink and where do you want it to reside?
ξ How will this tool be deployed and by whom?

2. Identify Collateral Tools
2.1. Many UW Health clinical tools (guidelines, order sets, delegation protocols, etc) may be impacted
by PATs. Collateral tools, in particular Clinical Practice Guidelines, may determine which PATs
are to be used at UW Health; therefore, it is important to identify all collateral tools to ensure
consistency across the organization.
2.2. Ensure all PATs and collateral tools are linked within Service Now.

3. Determine Tool Validation
3.1. Determine if the tool is a validated tool. Typically, if a tool has been validated, there will be journal
articles, related literature, etc. with supporting evidence stating this. PubMed, Mapi Research
Group, Google, and Wikipedia are good places to start searching for information on the tool.
3.2. Most PATs are validated tools; however, some tools have not been validated. In the case of a
non-validated tool, the PAT workgroup will decide whether or not to approve the tool.

4. Establish Tool Copyright
4.1. Determine if the tool is copyrighted. Typically tools are either copyrighted or not copyrighted. If
the tool is copyrighted, permission to use the tool from the copyright owner(s) must be obtained.
4.2. Copyright owner(s) could include but are not limited to: individual person(s), institutions,
universities, organizations, groups, corporations, or publishers.
4.3. Copyright information can be found in a number of ways including: searching in journals, searching
online, contacting the developer of the tool or the author of an article, or by visiting the Mapi
Research Group website.
4.4. Email verification that the copyright owner has granted UW Health authorization to use the tool is
preferred.

5. Define Licensure / Fees (if applicable)
5.1. Determine if the tool has associated fees. If a tool is copyrighted there may be associated
licensure costs or fees. This information can be found in a variety of places such as: the copyright
owner’s website, Mapi Research Group website, or by asking the copyright owner directly.
5.2. If a tool has fees associated with using it, funding for this expense needs to be determined and
budgeted for. Fees of nominal amount and/or one time fees may be absorbed by CCKM. Fees of
large amounts and/or spanning many years will need to be reviewed / approved.
5.3. Consult the UW Health Legal department for any tools that require signature for fees or licensure.

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Approval
1. Review Copyright, Cost, and Build Information with Requestor
1.1. All copyright, cost, and build information should be discussed with the requestor to divulge the
review findings and determine tool build options.

2. Create a Powerpoint Slide For Each Tool
2.1. A slide containing pertinent tool information is created for each tool.



3. Present Tool to PAT Workgroup
3.1. All tools must be presented to the PAT workgroup for review and approval. The PAT workgroup
meets the 1st Thursday of every month.
3.2. All tool information including: tool use location, training, requested tool build, cost, and
implementation is reviewed and discussed. Tools requests are either approved, denied, or may be
asked to be re-presented at a later date with additional information.

Build
1. Submit Tool for Build
1.1. Once the tool has been approved by the PAT workgroup it can be submitted for build to the proper
HealthLink team. Depending on the tool, how it is to be built in HealthLink, build complexity, and
analyst availability the build work may be assigned to any of the following teams: Inpatient IS,
Ambulatory IS, MyChart, or one of the CCKM analysts.
1.1.1. CCF to create a new build TASK on the tool RITM and assign to the proper team listed
above
1.1.2. CCF to attach a document of the tool, outline which Epic functionality should be used to build
the tool, and indicate where this tool should “live” in HealthLink.

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2. Tool Build Review
2.1. Every tool will be reviewed in INT to check for the following:
ξ Content correctness
ξ Language and spelling correctness
ξ Similarity to original tool outlined in literature
ξ Copyright acknowledgements, requirements, agreements, etc
ξ Tool location
ξ Tool usability
2.2. Every tool will be reviewed, approved, and signed off on by the following groups before being
released into PROD:
ξ CCKM representative
ξ HIM representative
ξ Nursing Informatics representative (if applicable)
ξ Requestor
ξ Analyst that performed the build







PAT Approval Process Algorithm

Last revised: 04/2015
Contact CCKM with questions.
PAT Resource Guide



Periodic Review Process

1. Timeline
1.1. All PATs are on a 3 year periodic review process timeline unless otherwise indicated by special
circumstances such as:
1.1.1. Licensure period is not 3 years. Review period is the lesser duration of the two. (i.e. If the
licensure period is 2 years the tool will go through a periodic review every 2 years)
1.1.2. It is noticed that the tool has been updated. Tool will undergo a periodic review immediately.
1.2. The review period starts the day the tool is approved with the next review scheduled 3 years from
that date.

2. Periodic Review Process
2.1. Notify requestor and/or clinical tool champion that tool is due for a periodic review
2.1.1. Evaluate how often tool is used
2.1.2. Inquire about tool usability in HealthLink
2.1.3. Address any unmet needs
2.2. Identify any new collateral work/tools that may be impacted by the PAT
2.3. Check existing collateral work/tools and verify they are still relevant
2.4. Review tool copyright, licensure, and cost agreements (if applicable)
2.5. Verify tool has not had any revisions since the last review
2.6. Update tool CI record

Retirement Process

1. Reasons for Tool Retirement
1.1. Tool is no longer used
1.2. Tool is outdated and evidence supports use of a different tool
1.3. Alternative tool better meets the clinical needs
1.4. Alternative tool is required to meet a metric
1.5. More cost effective alternative tool is found

2. Retirement Process
2.1. Understand why tool is being retired
2.1.1. Who is request coming from?
2.1.2. Does this impact others?
2.1.3. Is the tool being replaced?
2.2. Update CI record to indicate tool has been retired
2.3. Update U-Connect to indicate tool has been retired


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Implementation and Communication
Implementation
Implementation of a new tool needs to be coordinated between the analyst building the tool in HealthLink,
nursing staff and Nursing Informatics (if applicable), CCKM, and the requestor. This includes but is not
limited to: go-live date, staff straining (if applicable), and workflow concerns.
Communication
When appropriate, the release of any new tool build should be accompanied with a PRN.

After a tool has been approved by the PAT workgroup a PDF of the tool and a PDF of supporting evidence
will the posted on the PAT tracker page on U-Connect. Reference the PAT Documentation section for more
details.
PAT Documentation
PAT U-Connect Tracker Page
1. Update PAT Tracker Page
PAT Tracker Page Link: https://uconnect.wisc.edu/clinical/cckm-tools/patient-assessment-tools/

1.1. Once a tool is requested/approved it will be added to the PAT tracker page on U-Connect. This is
accomplished by sending an email to eHealth, via Sara Bennett, with the following information:
ξ Tool Name with link to PDF of the tool
ξ Tool Champion
ξ Tool Status (color) with PAT approval date
ξ Link to PDF of tool validation content
1.2. Tool status should be updated as needed to correlate with the progress of the tool:
ξ Requested = tool has been requested to be reviewed
ξ Approved = tool has been reviewed and approved by the PAT workgroup
ξ Development = tool has been reviewed, approved, and is being built by HealthLink analyst
ξ Available = tool has been reviewed, approved, built, and released into PROD
ξ Declined = tool was declined for use/build by PAT workgroup
ξ Retired = tool has been retired

Tool Documentation
1. U Drive Folders
1.1. All PAT content is housed on the U drive in the Patient Assessment Tools folder. This folder is
located at: U:\UWHealth\CCKM\ShareAll\CCKM Team\Tools\Patient Assessment Tools
1.2. All tool related content will be housed in one of two folders:
1.2.1. “_PAT Tools Working Folders” - For every new tool request a new folder titled with the tool
name will be created and placed in this folder. All content associated with this tool should be
placed in this folder including but not limited to: PDF of the tool, scoring documentation,
validation content, licensing agreements, etc.

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1.2.2. “_Finalized Content” - Once a tool has been approved the tool specific folder is moved
from: “_PAT Tools Working Folders” to the “_Finalized Content” folder. The information to be
uploaded to U-Connect (PDF of the tool, PDF of the validation content) will be added to a
new U-Connect folder that will be created with the “_Finalized Content” folder.

2. Tool Tracker Spreadsheet
2.1. The tool tracker spreadsheet, located in the Patient Assessment Tool folder, contains the scoring
matrix tab and a tracker tab.
2.1.1. The scoring matrix tab will be completed for every new tool to help prioritize tool approval
2.1.2. The tracker tab will be completed for every tool that goes to the PAT workgroup. This
spreadsheet outlines the RITM build number, where in HealthLink the tool is built, and the date
the tool was approved by the PAT workgroup. It also contains a number of other columns that
also need to be completed.

3. PAT Configuration Items
3.1. A PAT CI will be completed for each requested PAT at the time of the request. This CI record will
be added (linked) into the CI field within the CCF’s Service Now TASK.
3.2. Complete all CI fields as information is known. It is important to fill out all sections within each CI.
3.3. CCF’s TASK and CI will be “closed” once the tool is released into PROD.
3.4. See more on Service Now documentation in the following section.

















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Frequently Asked Questions (FAQs)
1. How do I enter a PAT request?
Follow the steps under “Request” in the PAT Approval Process section located on page 4.

2. What types of tools are considered “Patient Assessment Tools”?
See definitions on page 3 of this document. A tool is considered a PAT if it is a validated scoring tool
that produces an outcome metric.

2. Does my tool need to be approved by the PAT workgroup?
If your tool fits the definition of a PAT, then yes, your tool must be approved by the PAT workgroup
before it can be used. If there are any questions about whether the tool is a PAT or not, the workgroup
will make the determination.

3. Why do we need approval to use tools?
The UW Health Legal Department has made a decision that as an institution we will proactively seek the
proper authorization to use PATs. This is due in part to avoid any legal issues such as copyright
infringement.

4. How do I know “how” I want my tool built into HealthLink?
There are a variety of different options for building tools into HealthLink. How the tool is built will be
determined by what type of functionality you want, who is entering the data, where the tool is located,
and how complex it is to build (are there complex scoring algorithms).

5. How long will it take to get my tool approved and built?
This is determined by a number of factors including: prioritization score, difficulty is obtaining copyright
authorization, cost, build complexity, and resource availability.

6. Where can I find a PDF of my tool?
All PATs can be found on the PAT Tracker Page located at the following location:
https://uconnect.wisc.edu/clinical/cckm-tools/patient-assessment-tools/

7. Do I need approval to have my tool built in HealthLink if it is NOT considered a PAT?
Currently there is no process in place or approval body to approve of these types of questionnaires (pre-
operative questionnaires, family history questions, etc). However, in the near future we are looking to
expand the scope of the PAT workgroup to include such items.







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Style Guide
Naming Conventions
1. Every PAT should be titled as required by the copyright owner or as outlined in the literature

2. In the CI record the full name will be spelled out followed by the acronym unless otherwise indicated per
above. (i.e: BRI will be listed as: Bereavement Risk Index (BRI))

Copyright Information
1. All tools built in HealthLink should include a copyright statement and/or have a reference to a journal
article where information on this tool can be found.
1.1. For tools built using flowsheet functionality the copyright statement and/or journal reference should
be included in the “Total Score” cell and thereby displayed in the “Row Information” section.
1.2. For tools built using SmartForm functionality the copyright statement and/or journal reference
should be included on the bottom of the SmartForm.
1.3. For tools built using Welcome or MyChart functionality the copyright statement and/or journal
reference should be included in the Terms and Conditions link. This is to avoid having the copyright
statement appear with each question.













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Resource Guide Content Changes (since last review)

Prior Version Date Change Page Number
4/2015 - Resource guide finalized
and placed on U-Connect tracker