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EMERGENCY DEPARTMENT

VOLUNTEER SERVICES

AMBASSADOR PROGRAM GUIDE

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Table of Contents

VOLUNTEER SERVICE DESCRIPTION ........................................................................................................................... 3

ED AMBASSADOR PROGRAM --- COMPETENCY CHECKLIST ...................................................................................... 4

ED AMBASSADOR PROGRAM --- CHECKLIST with DESCRIPTION ............................................................................... 5

Suggestions on organizing activities as an ED Ambassador ..................................................................................... 11

Transportation Options ............................................................................................................................................ 15

TV CHANNEL LINE UP ............................................................................................................................................... 16

Connecting to the MMC Internet; Mac & Windows ................................................................................................ 17

FACTS ABOUT FALLS & RESOURCES FOR PREVENTION............................................................................................ 20

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VOLUNTEER SERVICE DESCRIPTION

VOLUNTEER SERVICES MAINE MEDICAL CENTER

AREA: Ambassador-ED PURPOSE: To welcome patients and their families to the Emergency Department at Maine

Medical Center, and provide them with information on hospital services, as well as to serve as an avenue for the expression of any special needs.

KEY RESPONSIBILITIES: - Report to ED Coordinator upon arrival.

- Communicate with courtesy, compassion and in accordance with Ambassador Script.

- Act as Patient/Medical Center liaison by reporting concerns back to the ED Coordinator.

- Educate and promote patient awareness of Patient Rights, Patient Handbook, location and use of call bell, TV remote, and orientation to the room.

- Orient families to the ED vending area and restrooms. - Reinforce visiting policy, HIPPA and why room doors are kept closed. - Explain Clergy resources. - Loop around ED with comfort cart for patients/families/staff. - Perform other duties as needed or assigned.

QUALIFICATIONS: - Mature, sensitive volunteers with good communication skills.

- Patience and empathy for patients and families in unfamiliar circumstance - Ability to work cooperatively with staff - Understanding of and strict adherence to the hospital confidentiality ethic

- Understanding and practice of patient safety as discussed at orientation and stated in Volunteer Guidelines

RESTRICTIONS: - Volunteers may not counsel patients

- Volunteers may not visit with patients on precautions - Volunteers may not give a patient anything to eat or drink without the

primary nurse’s permission. TIMES NEEDED: Sunday-Saturday 12:00 noon-11:00 pm. Hours flexible. TRAINING: Orientation to Volunteer Services Department and Maine Medical Center

arranged by Volunteer Services staff. Orientation to Ambassador Program and additional ED training provided.

SUPERVISORS: Joy Moody, Nursing Director 662-4265 Karen Taylor, Nurse Manager 662-4803 Open Position 662-4255 Mindy Young (Training) YOUNGM8@mmc.org 662-0520 Manager, Volunteer Services 662-4769 Revised 3/10/11 h\service descriptions\ Ambassador-ED

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ED AMBASSADOR PROGRAM --- COMPETENCY CHECKLIST

Ambassador Name: _____________________________________

Issues to Review Date ED Lead Signature

Check in with ED Coordinator X 3980

Tour of Emergency Department/Fire Alarm Pulls

Assignment sheets and phone numbers

When to notify staff of need for assistance

Safety initiative: Hand washing expectations

HIPAA Reminder

No patient lifting

Safety initiative: Fall Risk

Geriatric Referrals

Precaution Rooms

Patient fears/experiences/expectations

Identifying patient needs

Stretcher operation for comfort

Wheelchair operation

Bedside table operation

Room lighting

Bathroom locations and use of pull cords

Phone operation and long distance calls

TV operations

Nurse call light

Ways to summon assistance

Spiritual Care

Safety initiative: Fall Risk

Stop Signs on Doors when exams in process

Amplifier check out

Geriatric cart

Companion for confused/lonely patients

Discharge of patients via wheelchair

Patient Transportation

Patient belongings

Linen cart locations

Food/fluid intake

Comfort Cart

Orient to Customer Service Reps & Registration Staff

Introduce to Care Coordinator (12-4) folks

Community Group Volunteers (TIP, SSR)

Ambassador Log Sheets

EMS Run Sheets

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ED AMBASSADOR PROGRAM --- CHECKLIST with DESCRIPTION

ED Issues Description

Check in with ED Coordinator X 3980 This is the nurse that is in charge of the shift----if working the 12-4 shift, there may be a change of nurses/staff and so you will need to make sure the incoming nurse knows you are the volunteer on duty

Tour of Emergency Department/Fire Alarm Pulls

Includes the supply rooms, kitchens, linen carts, Triage rooms, Critical Care unit, CDU, East Wing, light switches, TV controls, room thermostats and location of Fire Alarm Pulls

Assignment sheets and phone numbers Assignment/Roster includes the nursing staff for all of the A & B rooms, Triage, etc. --- if you need to contact a nurse to see if a patient can have fluids or food, etc. simply call the nurse (662 + extension) from the phone across from the Front Desk (across from Room A01); the whiteboard located in the patient room may also have the RN name but you still need their extension from the assignment sheet

When to notify staff of need for assistance Staff should be called to find out if a patient can have fluids or food; push the call button or suggest the patient do this if they need to use the bathroom (even though they may appear to be able to get out of bed and go by themselves, the staff determines if they can do this unattended); staff may also want to assist them to the bathroom or monitor them

Safety initiative: Hand washing expectations When escorting families/friends, please use the moment to teach them about washing/using gel before entering rooms and when exiting to assist in infection prevention.

Hand gel should be used before entering and upon exit from a patient’s room; there are also sinks where hands can be washed with soap and water; visitors should be encouraged to use the hand gel upon entering/exiting a room; in addition, there are gloves that can be used to pick up patient items (e.g., shoes, clothes, etc.)

HIPAA Reminder Patient information is confidential and cannot be shared----the same information covered in Volunteer Orientation applies in the ED

No patient lifting If a patient wants to get up or needs to be moved in their bed, push the call button and let the staff know and they will respond

Safety initiative: Fall Risk Bed should be in low position if patient will be getting out of bed for any reason, call bell with patient, instruct to call for assistance, slippers, positioning of items on bedside table.

Geriatric Referrals Dr. Rob Anderson and team have been working on improving our identification and referral of geriatric

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patients that have experienced a fall to his home visit program. Fall prevention is a primary cause of injury and accidental death in the elderly. MMC and Maine Health have this as a top priority this year. Beginning Wednesday, December 7th, there will be some new resources that I want you to be aware of. The information sheet (see page 21) that will be available in the department for you to use to discuss resources with patients, families and caregivers. Our experience with the home visit program and our geriatric transitions pilot suggests that older adults may be worried about the objectives of the home visit and the associated costs--hopefully the handout will allow us all to provide consistent messages to patients. The cost issue isn't as simple to answer. After much discussion, the recommendation is that the costs are handled by Medicare and insurances much the same as office visits and other services. Our ED Social Worker, Ellen Zimmerman will be assisting with case finding and referral. Ellen works Monday through Friday, 12 noon to 8:30 pm. Our ED Ambassadors will ask patients two questions when they are rounding: 1) In the past year have you had two or more falls? 2) Have you had any falls with injury? If the patient answers yes to either question, the Ambassador will let the primary RN or Ellen Zimmerman (when she's here) know that they would be a candidate for referral to Rob's home visit program.

Precaution Rooms If a room has a yellow or orange precaution card on the door, you should not visit the patient in that room

Secure Rooms A patient may be in a “secure” room with hospital security stationed outside the room based on indications that they could harm themselves or staff----before entering these rooms, check with the nurse to see if the patient can have anything (food, water, magazine, etc.)

Patient fears/experiences/expectations Patients admitted to the Emergency Department have had their problem classified according to priority ---- what they often do not understand is that the most critical patients are seen first and even though they may be next on the list to be seen by a doctor, if a more critical patient arrives then that patient takes priority. If you can explain this to them, it helps them understand that they are important but someone else may have a more critical or life threatening ailment that takes

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priority-----they often become impatient when they have to wait a few hours and understanding the priority system may help

Identifying patient needs When you enter a room, it is best to introduce yourself as a volunteer---explain that until a doctor has given approval, you cannot get the patient anything to eat/drink but you can help them with the TV, get a magazine, dim the lights, etc. If the patient wants food/drink, then check with the nurse to see if they are allowed to have either and then let the patient know the decision----if they have not been seen by a doctor or are scheduled for tests, they will quite likely not be allowed to have food/drink. If there are family members present, you can offer them a drink (coffee, tea, water, ginger ale, sprite)---let them know you will be circulating in the area and if they decide they need something, they can let you know. In addition, there are vending machines in the ED lobby that have food (including baby food) as well as a cafeteria that is open 24 hours.

Stretcher operation for comfort The stretcher back can be raised/lowered by squeezing the yellow handle on either side of the head of the bed; also, the stretcher can be raised and lowered to make it easier for patient to get out of bed and reduce the risk of fall

Wheelchair operation Before a patient gets out of or into a wheelchair, make sure the wheels are locked. If you are moving a patient and are using the elevator, back into the elevator vs. going forward into the elevator; use the ceiling mounted mirrors to ensure that the hallway is clear of traffic

Bedside table operation The table can be raised and lowered by squeezing the button under the top on the side of the pedestal at the same time you push/pull the table top down/up

Room lighting Light switches are inside the door and can be used to turn off all or some of the lights

Bathroom locations and use of pull cords

Bathrooms are located next to Rooms A01, A09, B13, C28, across from Consult Room immediately inside the entrance to C/K rooms and there are 2 bathrooms in the CDU----each of the patient bathrooms has a pull cord that the patient can use if they have difficulty while in the bathroom; there is a restroom for staff use in the hallway immediately behind the ED Lobby (a key is located in the closet opposite the restroom)

Phone operation and long distance calls Patients can make calls from their room by dialing 9 and wait for dial tone; if they need to make a long distance call, they should dial 662-0111 for hospital Operator

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TV operations If a patient wants to watch TV, find the control unit---it may be looped around one of the connectors on the wall or laying on the vanity table----just show them how to use the controls and put it within their reach; a list of the channels is attached and this list is on the Comfort Cart;

Wi-Fi Access Patients can call 662-6400 and the IT help desk will assist them in connecting to the internet

Nurse call light If a patient cannot find their call button, locate it and clip it to the bed (it may be hanging from the bed or looped around one of the connectors on the wall. If a patient has accidentally pushed the button, the call light can be turned off by pushing the wall button to cancel it ---the staff at the Front Desk can also turn them off

Ways to summon assistance The patient can press the call button in their room or you can call a nurse’s extension (check the assignment sheet to identify their extension)

Spiritual Care If a patient would like to request a Spiritual Care visit, you should ask their denomination (Catholic, Protestant, Jewish or other) then call 662-2951 and place the request for the patient (by name and room number); also, notify the patient’s nurse that they have requested a clergy visit

Safety initiative: Fall Risk Beds in low position, call bell with patient, instruct to call for assistance, slippers, positioning of items on bedside table.

Stop Signs on Doors when exams in process Trying to get clinical staff to use. Meanwhile, please knock and wait for response prior to entering room

Amplifier check out For hard of hearing individuals. You get them from the ED Reps and they are to be checked back in when the patient is discharged

Geriatric cart Has items like clean, new underwear and clothing, large print magazines, glasses, resources for geriatric persons and caregivers. Located in Acute B across from Linen Cart.

Companion for confused/lonely patients The nursing staff may request that you stay with a confused/lonely patient until a family member or caretaker arrives or until they are ready for discharge----many of these patients just need a friendly face and someone to talk to.

Companion for a family member Periodically a patient arrives with a family member and children----you may need to sit with the children in a family room or the waiting room until someone comes to be with them (versus having the children in a critical care area or the patient’s room while they are being

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treated)---this happens most often when the patient is a child and the siblings are present and waiting for a friend or relative to arrive to take them home or wait with them and getting them some pictures/crayons or a book is usually sufficient to keep them occupied and take their focus off their sibling

Discharge of patients via wheelchair The nursing staff may ask you to help move a patient from their room to the lobby via wheelchair (you may need to get a wheelchair from the lobby and take it to the room first); the person picking them up should come to the Emergency entrance and the patient can wait in the lobby until they arrive; the patient’s family or other person meeting them is responsible for getting the patient into their car

Patient Transportation MMC does not have a patient transport service. If a patient needs transportation, please refer to the Transportation Options sheet in this guide

Patient belongings If a patient has belongings (clothes, shoes, etc. ) you can suggest that they put them in one of the pink plastic bags in the cabinet in their room (or on the comfort cart)----this helps ensure that they don’t get lost if they are sent to another area for testing or to a room in the hospital---in both cases, the bag goes with them

Linen cart locations Across from A04 and B23 (behind nursing station) and in the supply room for C/K rooms; The linen warming units are in the Supply rooms for A/B and C/K and blankets can be taken from these units and given to a patient if they are cold

Food/fluid intake Obtain nurse’s approval prior to giving a patient fluids/food even if the patient says it is ok; if the family needs more than coffee/tea or soft drink they should be directed to the ED Lobby vending machines or the cafeteria (the vending machines contain drinks and food (including baby food)

Family Rooms There are family rooms next to CC and between the entrance to C/K and front desk for A/B; these rooms are used to house family of patients that are in one of the CC units; once you escort people to those rooms, you will need to inform the nurse for the specific CC unit that a family member is in the family room for the patient (be sure to tell them which family room, i.e., 1, 2,3)----the nurse will then communicate with the family member and escort them to see the patient or will inform you that it is ok to bring the family member into the CC area

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Patient Visitors MMC prefers that only 2 people be in a ED patient room at any point in time and only 1 person be with a patient in the hallway----if visitors are present they will need to take turns visiting the patient/waiting in the lobby

Comfort Cart The comfort cart is stocked with magazines, word puzzles, crayons and coloring pictures and various other information; candy on the cart is for the Staff in the ED---NOT for patients; money collected from the Staff is turned into Joy Moody at the end of the shift

Orient to Customer Service Reps & Registration Staff

Make sure you check in with the CSR’s who are staffing the Emergency Room Entrance---they can give you a “heads up” on any situations that are occurring or may be imminent so that you can assist people in family rooms, etc.; Registration staff will be meeting with patients to get critical personal information (address, phone, insurance, etc.)

Introduce to Care Coordinator (12-4) folks The Care Coordinator has responsibility for transfer of ED patients to other facilities (nursing home, mental health facility, etc. outside of MMC)

Community Group Volunteers (TIP, SSR) In some situations, the ED Medical Staff will call in Community groups to support the patient and their family (e.g., a situation where there has been severe injury/death, abuse, etc.)

Ambassador Log Sheets Log sheets are used by the Ambassador to log the services provided to a patient/visitor; these are helpful to understanding the needs and requirements of patients/visitors and the volume of visits made ----they also make it easy to jot down what is needed by a specific room since you may get interrupted between the request and getting the requested item; the log sheets are in the binder on the comfort cart (more copies can be made on one of the copier machines in the ED)

EMS Run Sheet A wooden box with EMS run sheet label has been placed across from Triage 5. We are asking that as you round in the department, please check this box for papers, go to PCR desk and identify patient location and place in appropriate chart rack.

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Suggestions on organizing activities as an ED Ambassador

Start of your shift

1. Check in with the front desk in the ED Lobby so the Staff there knows you are on site (if they are short on staff you may need to assist them in escorting family members, returning wheelchairs, etc.)

2. Get the Comfort Cart from the storage area behind the Clinical Decision Unit nursing station----check to make sure you have the following

a. An assortment of magazines b. Children’s books c. Coloring book pages and crayons (both available in the Volunteer office and pages can

be copied) d. Pick up the candy containers from the storage in the ED lobby --- the keys are in the CSR

desk 3. Kitchen areas in B and C areas

a. Rinse the coffee pots and brew fresh coffee Make sure that the refrigerators are stocked (you may need to move items from one kitchen to another one)

b. Open the frozen containers so that it is easy for you or staff to grab an ice cream or popsicle for a patient

c. Make sure that all of the other items in the cabinets or on the counters are stocked ---- utensils, cups, lids, sugar, sweetener, crackers, peanut butter, etc.so that it is easy for the you or staff to grab these items for a patient

4. Start a log sheet for your shift 5. Make a copy of the roster/assignment sheet that is on the counter at the front desk in the ED

(across from Room A01); copier is behind their desk 6. Check in with the nurse supervising the shift

During your shift

1. Linens----you may want to check the blanket warmer and add more blankets if it is getting low 2. Check the family rooms to make sure that they have a box of tissues and if there have been

family members in the room, remove/toss anything they left behind 3. Return any wheelchairs that are not needed to the ED Waiting Room 4. Visit patients (except those with precaution)---if they have a doctor or nurse present, check

back with the patient when they are out of the room 5. Escort family to a patient’s room or the family rooms 6. Sit with a lonely /confused patient 7. Sit with a child/children while a parent is attending to another family member or sibling 8. Show visitors how to get to other areas of the hospital---cafeteria, ASU, etc.

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9. Clean the coffee pots----1) get the DipIt from the cabinet above the refrigerator in the A/B kitchen or the cafeteria mgmt., 2) empty and rinse a coffee pot and the filter container, 3) place 1.5 teaspoon of DipIt in the coffee pot and run a pot of plain water thru the filter holder into the heated pot and once it is finished brewing the clear water, use the brush to do some additional scrubbing, rinse the pot and make coffee in the normal manner

At end of shift

1. Return the candy buckets to the ED lobby storage 2. Turn in any candy money collected (place in a blue interoffice envelope addressed to Joy

Moody and drop in the box outside her office) 3. Return the Comfort Cart to the storage area behind CDU 4. Place your completed sheet in the binder on the comfort cart and place the assignment sheet in

the confidential bin across from the nurses’ station in the CDU Places where you can login/logout at the beginning/end of your shift:

Volunteer Office

South Entrance

Reception Desk on the walkway from the parking garage on Level 8 If you are going to be absent, you should send an email to:

Joy Moody (moodyj@mmc.org, Christine Ellis, (ellisc2@mmc.org)

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How to get something fixed at MMC (please dial 662-xxxx (plus the extension below)

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Unit Map

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Transportation Options

Maine Medical Center, like many hospitals, does not have a transport service. We are unable to pay for transportation or to provide transportation. We know this can be a challenge. This information may help you in getting a ride home.

1. You may use the phone in the Emergency Lobby kiosk. For local calls, dial “9” and wait for the dial tone. The hospital operator can help you make long distance calls.

2. Start with family and friends. Families often tell us they are distressed to learn

a family member didn’t call them for a ride home because they didn’t want to be a bother.

3. Bus information is located in the phone kiosk in the Emergency Lobby. More

information is available at the Customer Service Desk.

4. Local taxi information is posted in the phone kiosk in the Emergency Lobby. You may make arrangements with a taxi service from this area and wait in the Emergency Lobby for the taxi.

5. Current RTP clients (active MaineCare clients) can arrange a ride within

Cumberland County during regular business hours: (Monday – Friday, 5:30 AM to 5:00 PM). Call RTP directly at 774-2666.

6. If you arrived at MMC by ambulance, but don’t meet medical necessity to

return home by ambulance, you may be able to get a ride from a non-emergency ambulance transport service. They may have a wheelchair van available. Our staff can help you explore this option; we are not able to determine if your insurance will cover this service. This cost would be your responsibility.

7. Please feel free to use the Vending Café and public restrooms in the

Emergency Lobby while you are waiting for your ride.

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TV CHANNEL LINE UP

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Connecting to the MMC Internet; Mac & Windows

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FACTS ABOUT FALLS & RESOURCES FOR PREVENTION

Falls are a primary cause of injury and accidental death in the elderly

Falls become more common and the results more serious as we age

Falls are common not only in the frail elderly but also in those older persons who appear

strong and healthy

The Fear of Falling can lead to isolation, decreased mobility and depression

Falls are both Predictable and Preventable

The ability to successfully manage concerns about falling can have a positive impact on emotional

health and well being. Taking steps to prevent falls ensures the ability to engage in daily routines and

activities with confidence and improved safety. Maine Medical Center offers two programs designed

specifically to evaluate and address this pervasive and common issue:

MMC Physician House Call for Older Adults

Within a few days of a visit to the Emergency Department, you may benefit from a medical evaluation

in your home. The visiting physician will evaluate your risk factors associated with falling such as

medication side effects and interaction, effects of underlying diseases (such as arthritis or stroke), assess

your environment and recommend resources as needed. For more information or to make an

appointment please call: (207) 662-4544

MMC Geriatric Center Falls Clinic The goal of the Falls Clinic is to prevent as many falls as possible through the management of

identifiable and modifiable risk factors. Staffed by a Geriatrician and a Physical Therapist, this clinic is

appropriate for you if you have a history of frequent falls or if a care provider has identified you as

someone at risk for falling. For more information or to make an appointment please call: (207) 662-2847

For those patients who have already been evaluated or would like to become more active, Southern

Maine Agency on Aging offers:

A Matter of Balance

A Matter of Balance is an award-winning time-tested program for people over 60 designed to help you

manage falls and increase your activity levels. Classes are two hours in length and are held twice a week

for four weeks. These classes you will help you learn to view falls and fear of falls as controllable, set

realistic goals for increasing activity, make changes to reduces falls at home and exercise to increase

strength and balance. For more information please call Southern Maine Agency on Aging: 1-800-427-

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