SHW Workflow

General

• Please take shifts sitting at the front desk when needed. While we do not have a permanent front desk worker, we want to make sure clients are properly greeted as they arrive. This role falls to everyone.
• Your primary responsibility is your own client, but if you are on a free block, help your fellow interns by welcoming people in, letting them know who they are working with, and following up with something directive (e.g., asking them to fill out paperwork, suggesting they take a seat, or suggesting they start warming up).

Initial Evaluation / First Visit Procedure

• Welcome the client in. Let the PT evaluating them know the new client has arrived if they don’t already.
• Give them the clipboard on the front desk with the appropriate paperwork.

Students

• Release Form: once signed, place it in the Medical Record box (tan bin) to the right of the computer.
• Patient-Specific Functional Scale: requires explanation and examples. Provide only when they are early (otherwise we can ask in the exam room), and only if they didn’t fill it out on their own (ask the PT to check Medicat).
• For Jeff CARES concussion clients, see the protocol found separately.

Outside clients

• Stack of outside-client paperwork if they didn’t complete it on Acuity Scheduler (ask the PT to check). This includes email consent, chief concern, medical history, etc.
• Patient-Specific Functional Scale: requires explanation and examples. Provide only when they are early.

• After greeting the client, check that the exam room is set with the proper number of stools and cleaned from prior visits.

On the front desk there is a bin designated for files that need to be scanned into a client’s Medicat chart. Consent forms, radiologist reports, referral notes, etc. should be placed in this bin (make a copy for the client’s folder if it informs the plan of care).

Eval note-taking and folder creation

• For students, notes are taken in Medicat plus one paper short-form eval for handwritten notes.
• For outside clients, use the full evaluation packet.
• Each client folder should have a communication sheet stapled to the front left.
• Have your own clipboard for shadow charting and note practice if you are not taking the formal note (or sit quietly and don’t take notes).

Paper charts

• All follow-up appointments are documented via paper charts.
• When a client is discharged, place their folder in the medical records box to have their exercise programs scanned into their Medicat chart.

Progress notes

Progress notes are created when someone is in for a follow-up session and there is a change in status or a re-eval is advised. After the progress note is locked, print and staple it to the exercise session it pertains to, and note the changes on the communication sheet.

Please return folders to the proper cabinet and bin, with the name tag facing the right direction.

• Cabinet 1: Student clients
  • with a separate filing for Jefferson CARES clients
• Cabinet 2: All non-student clients (aka outside clients)
  • with a separate filing for Open Gym clients

At the end of the workday (or within 24 hours of an appointment), interns may pull charts for the following day. Do not pull charts more than 24 hours in advance, as appointments may be canceled.

First, ask an Admin to print the next day's schedule. Then check the first two locked cabinets:

• Cabinet 1: Student files (initial and follow-up visits, shown in orange) and Jefferson CARES patients (blue).
• Cabinet 2: Outside clients (pink), Special clients (yellow), Hoo's Well patients (pink), and all Open Gym clients (pink).

Using the patient's initials on the schedule (or the full names listed below the schedule if needed), locate each file and place it in the white box. Once all charts have been pulled, return the white box to one of the opened cabinets — with the schedule in the box as well — so the AM shift can easily access it.

Lock the first two cabinets before leaving, after the charts from the current day are filed.

Codes for both cabinets are 000; to lock them, twist the lock and scramble the numbers.

• Independent interns have key card access to The Fried Center and can access the gym during all hours.
• If you access and use the gym during off hours, respect the space and equipment and keep the clinic clean.
• You are not permitted to bring non-interns into the space unsupervised. This is a serious liability concern.

• Student employees and wage employees who live in town: we do not have designated parking spots. Student employees are expected to treat shifts like classes at UVA — if you want to drive, you’ll have to find (likely paid) parking for the duration of your shift.
• SHW offers free P1 student parking for 1.5 hours. There is a QR code at the front desk to register your car — note the duration limit and allow an extra couple of minutes to register when you arrive.
• Wage employees / non-student parking: we are looking into a shared parking pass for FCAP apartment employees.

Client front lockers lock

• Reset the code with 12345.

• If you're scheduled for the clinic's opening or closing, make sure you learn the opening/closing to-do's.
• Come in at least 15–30 minutes early to review your client's chart.
  • This gives you a full understanding of how to treat them, and time to ask tenured interns questions if you're unsure.
  • Think of exercises you'd include and pitch them to the intern you're working with!
• Be ready to greet your client.
  • Don't wait for them to come back into the gym. If you're unsure, ask their name; if they're not your client, let the intern working with them know they've arrived.
• Stay on topic with your clients.
  • It's great to chat and build the trainer–client connection, but don't let it get in the way of giving them a good session.
  • It's your job to stay on time and on track. When time is limited, choose the program items that are most impactful for the client's presentation.
• If you're shadowing or transitioning to leading, don't talk only to the intern as if the client isn't there.
  • Remember that your clients are paying to be here, and they deserve your 100% full attention during the session.
• The words you use matter for the healing process!
• If you don't know, ASK!
  • It's far more important to ask than to go through a program with the wrong form.
• Fully fill out your client's session follow-up sheet — don't leave anything blank. If you ran out of time, note that; leave a note at the bottom if something changes. Bigger changes or progress-note updates should be included in the front communication notes.
• Clean up after you're done with your clients (equipment, folders). Exception: if you're slammed with back-to-back clients and need help from others, it's okay to ask!
• There's no check-out process, so you can leave once you finish with your last client and your closing duties and charts are complete.
• Review the policies related to scheduling so you know the process for:
  • requesting time off
  • who to contact in the case of scheduling concerns
• Communication within the internship:
  • Check Slack regularly.
  • Check the Communication Board once a week, at the beginning of the week.