CONTACTS 

SUBJECTS
Neupogen Side Effects Bone Pain Fatigue No Headache Suffered Today A

1503 -
1503 -    ..
1504 - Summary/Objective
1505 -
150501 - Follow up ref SDS 61 0000. ref SDS 57 0000.
150502 -
150503 -
150504 -
150505 -
150506 -
150507 -
150509 -  ..
1506 -
1507 -
1508 - Progress
1509 -
150901 - Neupogen Treatment at Kaiser Prescribed at UCSF for Clinical Trial
150902 -
150903 - Follow up ref SDS 61 9W9I, ref SDS 57 9W9I.
150904 -
150905 - Background on treatment at UCSF and requirements for Neupogen are
150906 - reported in the record yesterday on 080721. ref SDS 61 9W9I
150908 -  ..
150909 - Hazel was the nurse today for Millie's Neupogen treatment.  She used 2
150910 - injections, implementing Kaiser protocols discussed on 080801
150911 - ref SDS 52 9W9I, originally presented by Laura on 080628. ref SDS 37
150912 - Q74G
150913 -
150914 -
150915 -
1510 -

SUBJECTS
Default Null Subject Account for Blank Record

1603 -
160401 -  ..
160402 - Schedule Neupogen Treatments Extended through August
160403 -
160404 - Follow up ref SDS 61 WJ4O, ref SDS 57 WJ4O.
160405 -
160406 - Treatments for September were scheduled by Donna on 080809.
160407 - ref SDS 57 NQ4O  Yesterday, on 080822 Florida corrected a mistake in
160408 - the schedule for August by adding treatment today, 080823, which was
160409 - missing from the original schedule. ref SDS 61 GW73
160411 -  ..
160412 - Today, Hazel noticed more mistakes in the computer schedule.
160414 -  ..
160415 - Hazel showed on the computer screen that the case management system
160416 - somehow cancelled Millie's treatment on 080905, which was scheduled by
160417 - Donna a few weeks ago on 080809, and is needed to comply with
160418 - Cheotherapy Orders. ref SDS 57 NQ4O  There is also a treatment
160419 - scheduled for 080908 0930 which is not prescribed, and conflicts with
160420 - the Chemotherapy Order received on 080821. ref SDS 60 RU7O
160422 -  ..
160423 - Seem to be falling into a mode of "correcting corrections," also
160424 - reviewed on 080809, ref SDS 57 Y98M, citing continuing computer case
160425 - management problems on 080627, ref SDS 36 RT73, and earlier on 080609
160426 - trying to correct mistakes in the Pharmacy. ref SDS 33 IS4P
160428 -  ..
160429 - Hazel entered in the computer cancelation of treatment on 080908 and
160430 - added treatment for 080905.
160432 -  ..
160433 - Millie explained that the schedule showing a meeting with the primary
160434 - care physician on 080905 is another mistake, since she is scheduled to
160435 - meet with the doctor next Friday on 080829, which is the regularly
160436 - scheduled time, following the doctor's return from vacation, planned
160437 - during the meeting at Kaiser on 080627. ref SDS 36 RT55
160439 -  ..
160440 - Hazel initially indicated that Millie's Neupogen treatment can be
160441 - scheduled on 080905 1200 because correcting the computer mistake by
160442 - cancelling the duplicated meeting with the doctor will open that time
160443 - slot.  She tried to enter this into the computer.  Hazel advised there
160444 - was another computer problem that would not let her cancel the
160445 - duplicated meeting, or would not schedule Millie on 080905 for
160446 - Neupogen.
160448 -  ..
160449 - Hazel said Kaiser is having a lot of problems with the computer
160450 - system.
160452 -  ..
160453 - Hazel advised that since treatment on 080905 must be scheduled to
160454 - comply with the doctor's prescription for patient care, the Infusion
160455 - Clinic has a procedure of referring schedule problems to the Charge
160456 - Nurse, Cisi or Bella.  The Charge Nurse can over-ride the computer to
160457 - correct mistakes so that patient care ordered by the doctor is
160458 - performed in time to be effective.
160460 -  ..
160461 - Hazel asked if there is a requirement on the time Kaiser can schedule
160462 - Millie's Neupogen treatment on 080905?
160464 -  ..
160465 - Millie explained that on Thursday, Doctor Rugo said that Neupogen
160466 - should be given at least 24 hours after chemotherapy. ref SDS 59 4B4L
160467 - The UCSF Chemotherapy Order implements this protocol by prescribing
160468 - Neupogen beginning on "D2," which means the day after chemotherapy,
160469 - reported on 080821. ref SDS 60 RU7O
160471 -  ..
160472 - Hazel checked the calendar; 080905 is Friday, which fits the doctor's
160473 - 24 hour requirement.  Since Millie gets treatment at UCSF from 0900 -
160474 - 1100 on Thursdays, Hazel added a comment on the note to the Charge
160475 - Nurse to schedule Neupogen treatment on 080905 after 1100,
160476 -
160477 -            [On 080913 Toni prepared a letter to Cisi to correct the
160478 -            schedule by changing results of automated computer
160479 -            algorithm. ref SDS 64 LO9K
160481 -  ..
160482 - Additionally, Hazel extended the schedule for Millie's Neupogen
160483 - treatments another several weeks into October.  She explained that
160484 - proactive case management planning ahead, reduces computer problems by
160485 - reducing the number of conflicts that occur between staffing levels,
160486 - meetings, holidays, and a lot of patients dates and times, which the
160487 - computer has to resolve.  The staff in the Infusion Clinic can make
160488 - accomodations to accomplish required care, but the computer can only
160489 - implement rigid rules that are usually, but not always effective.
160491 -  ..
160492 - The schedule Millie received from Hazel today shows...
160493 -
160494 -                                                        UCSF Chemo
160495 -        Date    Time   Provider         Services      Cycle Treatmnt
160496 -        080829  1030   Infusion Nurse   Neupogen        7     2
160497 -        080830  1330   Infusion Nurse   Neupogen        7     2
160498 -     *  080905         Infusion Nurse   Neupogen        7     3
160499 -        080906  0900   Infusion Nurse   Neupogen        7     3
160500 -        080912  0930   Infusion Nurse   Neupogen        7     4
160501 -        080913  0900   Infusion Nurse   Neupogen        7     4
160502 -        080919  0830   Infusion Nurse   Neupogen        8     1
160503 -        080920  0900   Infusion Nurse   Neupogen        8     1
160504 -        080926  0830   Infusion Nurse   Neupogen        8     2
160505 -        080927  0900   Infusion Nurse   Neupogen        8     2
160506 -        081003  1400   Infusion Nurse   Neupogen        8     3
160507 -        081004  0900   Infusion Nurse   Neupogen        8     3
160508 -
160509 -     *  Need time for treatment on 080905.
160510 -
160511 -            [On 080829 Cisi set time for Millie's treatment on 080905
160512 -            1100. ref SDS 62 453L
160514 -             ..
160515 -            [On 080905 Millie's schedule for Neupogen at Kaiser was
160516 -            updated to include October. ref SDS 63 WJ4O
160518 -             ..
160519 -            [On 080913 Kaiser changed the schedule for Neupogen
160520 -            treatments to afternoons on Fridays. ref SDS 64 WJ4O
160521 -
160522 -
160523 -
160524 -
1606 -

SUBJECTS
Default Null Subject Account for Blank Record

1703 -
170401 -  ..
170402 - Exercise Hiking Maintain Fitness Strengthen Immune System
170403 -
170404 - Follow up ref SDS 61 3E4K, ref SDS 57 3E4K.
170405 -
170406 - Millie hiked about 9 miles at Lafayette Reservoir before treatment
170407 - today.
170408 -
170409 -
170410 -
170411 -
170412 -
170413 -
170414 -
1705 -