Clinic day procedures -- user defaults, check-ins, deferrals, and after care

 

User Default settings for vaccination appointments

At the start of each working day in the clinic, you will be required to set your user defaults.

For Pharmacy Admins:

1. Click on the App Launcher in the top, left corner of the screen.

2. Select the In-Clinic Experience app. You will be directed to the In-Clinic Experience User Defaults page, where you will need to set up your user defaults.

3. Select the Clinic Location by entering the name of your clinic and selecting from the list that displays. 

4. Complete Provider Type. Select either: ImmsBCProvider: A provider that regularly works at the Clinic; or Non-ImmsBCProvider: A Non-ImmsBC Provider someone who is helping at the clinic.

5. Include the Provider Name. The Designation will be populated according to the Privacy Acknowledgement completed when first signing into ImmsBC. If the Designation is not correct, you will need to contact your system administrator to correct it.

6. Click on Advanced Settings. Here, you can set your lot numbers and injection sites. Select the lot number The Agent will be pre-populated according to the Lot that was selected. You can only have one lot number per agent. Select the Injection Site (not mandatory).

7. Click Save. A User defaults successfully updated message displays for few seconds.

8. Click Home.

For Clerks and Clinicians:

1. Ensure that the date matches today’s date. You cannot save a date in the future.
2. Select the Clinic Location by entering a part of the name of your clinic and selecting from the list that displays. If the clinic location does not appear you can click on the magnifying glass in the same field in order to search for it.
3. Click Save. A User defaults successfully updated message displays for few seconds.
4. Click Home.

 

Watch the How to Set up User Defaults video for further review.

 

 

Checking-in a Client with a Booked Appointment

1. Once your user defaults are set in ICE click on the “Client List” tab and select “Today’s Appointments” to view your booked appointments for the current clinic day.

2. With individuals now able to hold multiple appointments simultaneously, an immunization record is no longer automatically created for an individual who books an appointment at your pharmacy.

3. To create an immunization record you must click on the “Check-in Client” button. Once clicked, you will be taken to the pathway to complete the client’s vaccination record. Note that each time the “Check-in Client” button is clicked it will create a new immunization record.

4. If you do not complete the vaccination record immediately and return to “Today’s Appointments” you will see that the “View” button is now active, and the “Pathway Status” is set to “New” meaning there is a vaccination record awaiting completion. Clicking on the “View” button will take you to the vaccination record pathway that is awaiting completion (see image below).

 

5. If you have created multiple vaccination records for the same client, you will now see the “Pathway Status” now states “Multiple”, indicating multiple vaccination records exist for today.

6. Clicking on the “View” button will open a pop-up that displays all the vaccination records created for today for that client. Clicking on the “View” button again from the pop-up screen will take you to the vaccination record pathway for that record.

Checking-in a Client without a Booked Appointment

1. Search the client through the Home Tab or by the Search Engine on the Navigation Bar. You will be directed to their profile.

 

2. Click on the blue Check-in Client button on the right side of their profile page and you will be directed to the Identification section of the vaccination process.

 

Watch the How to Manage a Walk-in video for further review.

 

Completing the Identification section of the vaccination process

1. Review the information in the Identification Information section. If an update is needed, click the Edit link to make the necessary updates. Enter a comment in the Accommodation Needs field if you need to add any comment.

2. Once you have confirmed or updated the client’s identification information, click Save.

 

3. Confirm the information in the Appointment Details section are correct.

4. When you are ready to send the client to Vaccine Administration, click Confirm & Save Identification at the bottom right-hand corner of the page. The client will be sent to Vaccine Administration where they will be vaccinated.

Note: If you selected the “Proceed directly to Vaccine Administration from Identification” checkbox during your User Defaults set up, you will proceed to the Vaccine Administration step. If not, you will return to the Home page and can proceed to checking-in the next client.

Please note: if you find that a client does not have a profile in ImmsBC, you must register them yourself. Please review Registering and booking patients in pharmacy for instructions.

 

Complete a Vaccine Administration in ImmsBC

1. Using the Client’s Reason for Visit if applicable, and evaluating the previous forecast and immunization information, select an Agent from the drop-down to document (Note: walk-in appointments will never have a Reason for Visit populated here.) You must select an Agent before proceeding to consent.

2. Select the Provider Type (ImmsBC or Non-ImmsBC Provider) and populate the User if not auto populated from your User Defaults already.

3. Select the appropriate option under Informed Consent for Series Obtained from. Select the Consent Effective To Date up to which the Consent has been Obtained.  (This date will auto-populate for Influenza.)

4. Click the blue Save Consent button.

5. Once Informed Consent has been gathered, you may move to complete the Immunization Information section.

 

6. The Provider, Clinic Location, Route, Reason for Immunization, and Site will need to be entered unless you have these filled in your User Defaults then they will auto-populate.

7. Select a Lot # (which comes from the Agent you had previously selected). This will cause the Trade Name to auto-populate. Ticking Show depleted lot numbers will display existing lot # that have run out of supply which you may use for recording purposes. The Dosage for the Trade will auto populate when you select the Lot#.

8. Add any comments you would like to specify for this Client’s visit, these will be specific to their Immunization Record. If you would like to leave information about the Client holistically, do not use Comments, use Notes. If it is a safety concern, create an Alert.

9. Click the blue Save button.

10. To Complete Vaccination Record scroll to the bottom of the page and select one of the Green buttons in the bottom right:

• Confirm & Save Administration
• Save Administration & Record Another Vaccine
• Confirm, Save Administration & Print Record

 

Defer an immunization appointment

If you need to Defer a vaccination, you can do so from the Vaccine Administration screen. Deferrals should only be used in cases where the patient has arrived at the clinic and for reasons that need to be documented and shared with other healthcare professionals. If the patient does not show up for their scheduled appointment or decides not to proceed with vaccination or you don’t have vaccine supply, a deferral is unnecessary.

Reminder: do not complete the vaccine administration process in ImmsBC until after the vaccination administration has actually occurred. Unlike PharmaNet, you cannot reverse this record if a client changes their mind prior to being vaccinated. If you start an immunization record in error please follow the procedures for deleting an immunization record. Please contact immunizatonsupport@bcpharmacy.ca if you need support.

1. From the Vaccine Administration section you must select an Agent before proceeding to deferral. Once the agent is selected you will be directed to the Informed Consent section.

2. From the Informed Consent section click on the Defer without Consent button which will auto-direct you to the Deferrals section. You can also scroll down to the bottom section and click on the Deferrals Tab.

3. Click the Deferrals list to open any existing Deferrals. Review existing Deferrals, if these are not sufficient, click “Add” to add a new one. Complete the required fields including a comment in the Add New Deferral pop up. Effective To is optional as a Deferral can be ever-lasting. Click the blue Save button.

4. There will now be an Alert banner at the top of the page stating an active Deferral for the client.  You can view and edit the details of the deferral as well.

5. If the Deferral information is correct then click the green Defer Vaccination & Save button to finalize the deferral of this Client’s visit today.

 

For clients with an existing deferral that are now ready for a vaccination, their existing deferral must be end dated before a vaccination can be recorded.

To end date a deferral:

• Go to the patient’s ImmsBC profile in CIB or ICE
• Go to the ‘Related’ tab
• Scroll down to the Deferral section and select ‘edit’ from the dropdown beside the deferral of interest
• Add an ‘Effective to” date that precedes the current date and update the comment section and save the changes

You can now proceed with completing a new vaccination record for the same agent.

 

Managing After-Care in ImmsBC

After the client goes through the Check-In and Vaccination Administration processes, the two chevrons at the top of the screen is green and marked as completed.

1. If medical intervention is required after the vaccination, click on Edit (pencil icon) to record the medical intervention.

2. Select Provider Type (ImmsBC Provider/NonImmsBC Provider) and include the Provider’s name.

3. Select Yes/No in the Intervention Necessary field. Enter any additional comment in the Intervention Notes field and click Submit.

4. Click X to close the Information Updated message. Even if you don’t close it, it disappears automatically after few seconds.

5. To complete the process, click Save and Return to Search. You will be redirected to the Home screen and the process is completed in the system. If no medical intervention is loaded within 15 minutes of the client moving to AfterCare in ImmsBC, the case will automatically be closed in the system and their vaccination will be deemed complete. The time of administration will be auto-populated in the appointment details.