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Clozapine Start Form

  • Updated

Contents

Overview
Form Features
Launch the Clozapine Start Form
Clozapine Start Form
SAM Clozapine Status
SAM Tool Screening Summary
Clozapine Offer History
Complete Assessment Tools
Clozapine Community Initialization
Clozapine Start Details
Clozapine Optimization
Clozapine Discontinuation Details

Background

As part of the TOP Collaborative Initiative, the Clozapine Start Form has been developed to seamlessly integrate with the SAM Tool Screener. This form comes into play after a client successfully meets the criteria for Clozapine treatment in SAM Tool Screener Form.

The Clozapine Start Form was created to streamline the document process when recording crucial information such as assessing readiness to start (Offer History), capturing initiation details, specifying medication type/brand, and documenting dosage and optimization information.

Form Features

The Clozapine Start form has been designed to assist users with documentation. Below is a list of features built into the Form to streamline the documentation process.

  1. Mutual Exclusivity
    • Only one of two (Sam Tool Screener or Clozapine Start) forms can be opened or active at a given time
  2. The Form Status
    • Field options: Parked or Complete
  3. Sequential Flow
    • Form follows a predetermined order
    • Users must answer questions sequentially
  4. Conditional Logic
    • Availability of subsequent questions depends on responses to previous ones
  5. Save and Resume Functionality
    • Allows users to save progress
    • Permits the resumption of the form at a later time
  6. Documentation Tracking
    • Users name and time stamp are documented when a question is answered
  7. Mandatory fields
    • The form will not save until the mandatory fields are complete.  A prompt will appear to notify you of the field that needs to be completed in order to save form.

Launch the Clozapine Start Form

The Clozapine Start Form can be launch using two methods:

From New Encounter using a Typing Template

  1. Click on the New Encounter Icon from the toolbar
  2. In the body of the New Encounter, type in cloz\
  3. The form will appear.                               

Note: The Client must have a completed Sam Tool Screener Form and met the criteria to be on Clozapine to be able to launch this form.  Once a Clozapine Form has been create and is it Parked Status, the same form will continue to appear until the Clozapine Form is completed. 

From the Sam Tool Screener Form

The following condition must be meet in order for the Clozapine Start Form button to appear in the Sam Tool Screener Form.

  1. If a client has been diagnosis with Schizophrenia or Schizoaffective and
  2. The client on Clozapine. 

Note: Intervention button are seen throughout these forms.  You will notice that there are due date and frequency fields that have been set by default.   When you click on the Intervention button, you will see a pop up that will confirm that the Intervention has been created and the option to go to the Intervention Set module to review and modify the Intervention if applicable.   Please note that in order to see the new intervention that you created, you will need to click on the refresh button. 

Clozapine Start Form

Help Button

Similar to the Sam Tool Screener, there is a help button located beside the title of the Clozapine Start Form. This button will trigger a window to appear with the relevant resources for this tool.  Ensure you review all appropriate resources prior to completing the screener.

 

SAM Clozapine Status

The first section the user will encounter is the Sam Clozapine Status. This section of the form is where the user will fill out the following information

Form Type:

  • Select the appropriate clozapine form type, there is 3 options in the picklist to choose from:  
    1. Clozapine Start - A client has never been on this medication and you are trialing it for the first time.
    2. Clozapine Re-Start - A client has been on this medication and you would like to start them on it again.
    3. Currently on Clozapine - A client is already on this medication.
  • This field indicates the specific type of clozapine form that is being used for documentation.

Clozapine Status:

  • This field reflects the ongoing status of the clozapine trial associated with this form.
  • It is automatically updated to reflect the Clozapine Status of the client based on the entries made in the form
  • This field is read only.

Recorded By:

  • Enter the name of the individual who initially created the form.
  • This field will become read only after first save of the form.

Last Updated By:

  • Automatically captures and displays the person who last updated the form.
  • This field is system-generated and reflects the most recent user who made changes to the form.

SAM Tool Screening Summary

This section will pull the corresponding field information form the most recent SAM Tool Screener:

  1. Initial screening date
  2. Diagnosis
  3. Screener Outcome
  4. Screener By 
  5. Two Trialed Medications

NOTE: The client may have tried more than 2 antipsychotic medications, however the screener only captures the most recent two (those entered in the screener), to see full list of all medications review client's medications as per your teams process.

 

Clozapine Offer History

This section is dedicated to capturing the client's history of clozapine offers. The Clozapine Offer History Entry Form is freshly generated for each occurrence. It's perfectly acceptable if users don't complete all entries every time. The goal is to monitor the client's progression in the Client Offer History Journey. To facilitate this, the section is designed to be newly created with each entry, accompanied by a historical display in the table below, enabling users to observe developments over time.

NOTE: If you have selected the Currently on Clozapine form, this section is optional for use.

 

Record a Clozapine Offer History: 

  1. Click on the Create New button in the Clozapine Offer History section.Note: Whether the offer history is net new or there has been a change in the offer history, users will always click on 'Create New' to generate a fresh entry. This ensures that clinical information about the client remains current and up to date.  For instance, if the client initially declined the offer and later accepts it three months later, click on the 'Create New' button and complete the questions again, indicating the updated status.  Each time a new Clozapine Offer History Entry is initiated by clicking the Create New button, the entry form will start afresh (this is by design).
  2. The Entry form will be displayed on the screen, with the "Recorded By" field automatically filled with the name of the logged-in clinician in a read-only format. The "Date Recorded" field, by default is set to auto-populate with today's date and is editable.
  3. Notice that only the first question in the entry form will be accessible. Depending on the radio button selection, the following question or guidance may or may not become available. To proceed, fill out the entry form in the provided sequence. These questions are meant to be reviewed on an ongoing basis to ensure the offer history is current and up to date.
  4. While progressing through each question, feel free to save and close the Entry Form whenever necessary. Clicking the Save and Close button will safeguard your selected answers, and they will be displayed in the Clozapine Offer History table for reference.

View Details Button

Once a Clozapine Offer History Entry has been created and saved, it will appear in the Clozapine Offer History table.

To View the Details of a Clozapine Offer History Entry:

  1. From the table, select the entry you would like to review.
  2. Then click on View Details Button, the saved entry will appear in read-only mode.

The Table View illustrates all entries create after the Clozapine Start Form was created, providing a comprehensive overview of the client's offer history. On saving an entry the table is update in real time to ensure the most current information is available for review.

 

Complete Assessment Tools

The Complete Assessment Tools section serves as a comprehensive hub, enabling users to launch various assessment forms vital for tailored care of clozapine clients. This dynamic section provides quick access to assessment tools such as CGI-I (Clinical Global Impressions-Improvement), CGI-S (Clinical Global Impressions-Severity), PANSS-SV (Positive and Negative Syndrome Scale - Short Version) Assessment Forms, and the Honos (Health of the Nation Outcome Scales): Adult and 65+ Assessment [MMR]. This integrated approach ensures a holistic understanding of the client's condition, facilitating informed decision-making and personalized care strategies.

Important Note: Typing templates have been created for each assessment tool if you would like to use them from outside of the Clozapine Start Form.    To use from a new encounter, type the following:

Name of Assessment Tool Typing Template
CGI-I cgii\
CGI-S cgis\
PANSS-SV panss\
HONOS honos\

 

Assessment Tools

The Assessment Tools section serves as a pivotal hub for conducting evaluations using the CGI-I, CGI-S, and PANSS-SV assessment tools within the Clozapine Start Form. This streamlines the process of recording and managing patient assessments.

Note: In the PANSS-SV assessment tool, the Results/ Outcome section is free text. Feel free to document any outcome in order to see it in the table view or it can be left empty and filled in as applicable.

Record an Assessment:

  1. Select the assessment tool you want to fill out, from the dropdown menu in the Assessment Tools section (CGI-I, CGI-S, or PANSS-SV).
  2. Click on the "Create New" to launch the corresponding assessment form. 
  3. Complete the Assessment Form, then click "Save and Close".   
  4. The system will save the entered data and redirected you back to the Clozapine Start Form.
  5. Notice the entered data will now appear in the Assessment Tools Table.

Note: The Assessment Tools Table has been designed specifically to display Completed Assessment Forms after the creation date of the Clozapine Start Form.

Viewing Cumulative Summary

Understanding the longitudinal trends and cumulative data for a particular assessment tool is crucial for gaining comprehensive insights into a client's progress. The Cumulative View feature within the Assessment Tools section allows healthcare providers to analyze patterns and observe changes over time.

Display a Cumulative View of a Specific Assessment Tool:

  1. From the Assessment Tools dropdown menu, choose the assessment tool you want to analyze.
  2. Click on the "Cumulative View" button to generate a summary based on the selected assessment tool.
  3. The Cumulative View will appear, offering an aggregated summary of Assessments Completed for the selected Tool. Use this visual representation to identify patterns and changes over time.             

Modify an Existing Assessment Tool 

If you need to view  or change the Assessment Tool you created. Highlight the corresponding row in the table, then click on the Modify button. 

Record a Honos Assessment:

  1. Click on the "Create New" button to initiate a new Honos assessment entry.
  2. Complete the necessary fields in the assessment form, then click "Save and Close."
  3. The system will save the entered data and you can view the recorded assessment in the Honos Assessment Table.

View Details of a Recorded Honos Assessment:

  1. In the Honos Assessment Table, click on the assessment you want to view.
  2. Click on the "View Details" button.
  3. The system will display the assessment details in read-only mode, allowing you to review the information without making changes.

Important Note:  If you have entered an assessment tool form in error and need to delete this documentation. Users must go to the Forms Module in the Client Medical Record to Delete the form.
**Do not delete from encounter note as this will not delete the form. **

Clozapine Community Initialization

In the Clozapine Community Initiation section, each selection holds critical significance in providing comprehensive care. Initiate by determining the suitability of a community-based clozapine initiation for the client, essential for tailoring treatment plans. Clearly specifying reasons if the initiation did not occur in the community adds valuable context. Selecting the initiation location and detailing it ensures accurate tracking of treatment settings. Understanding nicotine usage and extended leave status is crucial for a holistic approach to mental health care.

NOTE: If you have selected the Currently on clozapine form, this section is optional for use.

Clozapine Start Details

This section focuses on entering crucial details regarding the initiation of clozapine for the client.

Follow these steps to accurately input the required information:

  1. Clozapine Start Date:
    • Enter the date when the client is expected to commence clozapine medication.
    • Click on the dropdown to access a calendar for date selection.
    • Note: If the client is already on clozapine, and you've selected the relevant form, two additional checkboxes allow you to indicate estimated or approximate start dates if the exact date is unknown. If 'Estimated Start Date?' is ticked, ensure you still entering a start date to proceed.
  2. Medication Brand:
    • Click on the dropdown and choose from the provided options to specify the brand of clozapine medication.
  3. Clozapine Registration Identifier:
    • Enter the unique Clozapine Registration Identifier assigned to the client for their clozapine initiation.

Clozapine Optimization

The Clozapine Optimization section has two essential functions. Firstly, it serves as a dedicated space to record the regular assessment and adjustment of your clozapine dosage (an integral step toward achieving optimal therapeutic outcomes). Simultaneously, this section offers a comprehensive table for an effortlessly review of the past history of the client's optimization journey.

Record a new Clozapine Optimization Entry

  1. Click on the "Create New" button.Note: Whether the Optimization Record is net new or there has been a change in the record, users will always click on 'Create New' to generate a fresh entry.
  2. The Optimization Entry form will be displayed on the screen, with the "Recorded By" field automatically filled with the name of the logged-in clinician in a read-only format. The "Date Recorded" field, by default is set to auto-populate with today's date and is editable.
  3. Notice that only the first question in the entry form will be accessible. Depending on the radio button selection, the following question or guidance may or may not become available. To proceed, fill out the entry form in the provided sequence. These questions are meant to be reviewed on an ongoing basis to ensure the offer history is current and up to date.
  4. While progressing through each question, feel free to save and close the Entry Form whenever necessary. Clicking the Save and Close button will safeguard your selected answers, and they will be displayed in the Clozapine Optimization table for reference.

View Details Button

Once a Clozapine Optimization Entry has been created and saved, it will appear in the Clozapine Optimization table.


View Details of an Entry:

  1. From the table, select the entry you would like to review.
  2. Then click on View Details Button, the saved entry will appear in read-only mode.

The Table View illustrates all entries, providing a comprehensive overview of the client's offer history and ensuring that the form stays current with the latest information.

 

Clozapine Discontinuation Details

The Clozapine Discontinuation Details section is the dedicated for recording essential information about a client who is no longer taking prescribed clozapine medications.

Note: Only one active parked Clozapine Start Form is permitted at any given time. This means that if there is already an existing active parked form, any attempt to launch a new Clozapine Start Form will automatically open the existing form until it has been officially discontinued. This ensures a singular and focused approach, allowing for seamless management of Clozapine Start Forms without the confusion of multiple concurrent active forms.

To create a new Clozapine Start Form, the discontinuation date and reason must be entered and saved.  Completing these two field will automatically mark the form complete so you can create a new Clozapine Start Form. 

Follow these steps to accurately input the required information after your client has stopped their clozapine trial:

  1. Clozapine Discontinued on Date:
    • Select the date the client stopped taking the prescribed clozapine medication.
    • Click on the dropdown to access a calendar for date selection. Note: If this field is greyed out, ensure you have entered a clozapine start date above. If your Client type is Currently on Clozapine, and you selected the currently on clozapine form, and you tick 'Estimated Start Date' you are still required to enter a date in order to move forward.
  2. Reason for Ending Clozapine:
    • This field will become enabled and mandatory once the Clozapine Discontinued On Date has been selected. 
    • Select the reason the client stopped taking the prescribed clozapine medication. 
    • Click on the dropdown to access a list of reasons for reason selection.
    • NOTE: If your client has been lost to contact, moved out of health authority, or has died and you need to close the form in order to discharge your client, you would select ADMINISTRATIVELY DISCONTINUED in the Reason for ending clozapine and Save and Close the form.
  3. Clozapine Discontinuation Details:
    • Click into the text box to enter additional information as to why the clozapine medication was discontinued.