mission of mercy: index
of sample forms/materials
This booklet contains a compendium of information compiled from various Mission of Mercy (MOM) events to help you plan and organize a MOM event in your area. It is intended to supplement the MOM “Model That Made It” implementation guidebook developed by the Virginia Health Care Foundation (VHCF). The sample forms and materials contained here are organized by Committee and correspond to those cited in the MOM implementation guidebook. We hope these materials will be helpful to you in creating your own MOM event. Visit the Virginia Health Care Foundation website at www.vhcf.org to download any of these materials, and to find the MOM implementation guidebook. If you have suggestions for additions or changes to this information, we encourage you to share them. Please email [email protected] with any comments or ideas for improvement. Thank you to the following individuals for contributing to these materials:
Terry Dickinson, DDSExecutive Director, Virginia Dental Association
Barbara RollinsMOM Project Director of Logistics, Virginia Dental Association Foundation
Mary Foley HintermannPiedmont Regional Dental Clinic, Co-Chair Piedmont Regional MOM
Pat YoungProject Director, Roanoke Mission of Mercy
Sandee BaileyWeb Content Manager, Virginia Health Care Foundation
Table of Contents Page
Finance Committee •SampleBudget . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 •SampleReimbursementForm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 •SampleIn-kindDonationTrackingForm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Volunteer Committee •KeyVolunteerPositionDescriptions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-8 •SampleVolunteerApplication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 •SampleVolunteerInformationPacket . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-13
Health Screening Committee •MedicalDirectorPositionDescription . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 •HealthScreeningVolunteerPositionDescription . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 •HealthScreeningStationInstructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 •MedicalSupplyList . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Dental Services Committee •DentalServicesVolunteerPositionDescription . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 •DentalDirectorPositionDescription . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 •BloodBornePathogensProtocol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 •DentalChargeForm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 •Pharmacy/ExitProtocol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Logistics Committee •SampleLettertoProcureVDOTCompressor. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 •PharmacyVoucher . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 •KeyPositionDescriptions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Patient Registration Committee •PatientRegistrationPoliciesandProcedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26-27 •DeemedConsentForm(English and Spanish) . . . . . . . . . . . . . . . . . . . . . . . . . 28-29 •PatientWaiver(English and Spanish) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30-31 •PatientRecord . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .32-33 •KeyPositionDescriptions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .34-35
Food & Beverage Committee •KeyPositionDescriptions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 •SampleFoodList . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Public Relations Committee •SamplePressRelease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .38-39 •SampleTalkingPoints . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .40-41 •PublicRelations101 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42-43 •TipsforHandlingaMediaInterview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 •CommunicationsTechniquesandStrategies . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45-48 •SampleExecutiveSummaryfromPiedmontRegionalMissionofMercy . . . . .49-53
Mission of Mercy: Index of Sample Forms/Materials
Finance Committee – 3
Item/Service Cost Basis Estimated Cost Actual Cost
Volunteers $6,245 $7,341
Hotel Rooms for VCU Students 32 Rooms at Holiday Inn Orange @ $108.90/ea $3,168 $3,703Hotel Rooms 10 Room for VDA Reps @$115/ea $575 $1,500Hotel Rooms 1 Room for 2 Truck Drivers @ $115/ea $115 -T-Shirts for Volunteers 350 shirts of various colors @ $5.25/ea $1,837 $1,874Key Volunteer Travel Expenses Est 5 Key Volunteers @ Avg Mileage 200 x $.55 $550 $264
Dental Services $14,000 $9,555
Dental Supplies - Local $2,000 $665Dental Supplies - VDA 600 patients @ $15/ea $9,000 $6,390Equipment Usage 1 Day (5/1/10) $3,000 $2,500
Medical Services $6,100 $1,630
Medical Supplies $1,500 -Pharmacy $4,500 $1,530Needle Disposal $100 $100
Logistics $7,050 $10,059
Stone Fire Station Deposit and Charge for On-site Staff $250 $250Stone Fire Station Rental (4/30/10) $175 $175Security/Parking $1,890 $500Truck Driver 2 Drivers @ $150/ea $300 $150Truck Mileage Est 200 Miles Each x 2 x $.55 $220 $370Fire Station Useage Event Location (2-Day Cost) $500 $2,000Storage $1,080 $540Trash Clean-up and Removal $300 -Insurance $400 $300Port-a-Pottie Rental 11 Units, 1 Handicapped & 1 Washing Basin $1,000 $1,050Tent 60x40 tent $800 $1,153Generator/Compressor Compressor, 2 Back-up Generators, Diesel Fuel $135 $1,000Dumpster - -OCFC Staff Support Paid 1/2 Salary of Development Asst. Local Free Clinic - $1,421Chair Rental - $275Scanning Equipment & Supplies - $500Light Tower Generators - $375
Public Relations $1,300 $4,201
Gifts to MOM Notables Madison Commemorative Plates $200 $550Postage $300 $503Shipping $250 -Newspaper Ads & Donor Recognition $200 $199Event Photographer $350 -Montpelier Gift Bags/Items - $2,950
Patient Registration $2,400 $6,308
Office Supplies $200 $1,375Printing/Signage/Design/Forms $2,000 $3,519Misc Supplies $200 $1,414
Food & Beverage $3,500 $6,812
Food 250 Volunteers @ Est $14/ea Food/Beverage $3,500 $5,937Ice Reefer Rental - $110Ice & Chest - $390Water Barrel Rental - $200Flowers - $175
TOTAL $40,595 $45,905
Sample Budget (Orange MOM 4/21/10 Version)
4 – Finance Committee
Mission of MercyRequest for Reimbursement
Name: _____________________________________________________________________________________________
Address: ___________________________________________________________________________________________
City, State, Zip: ______________________________________________________________________________________
Amount Requested: _________________________________________________________________________________
Date of Purchase: __________________________________________________________________________________
Please attach all receipts to this “Request for Reimbursement”
Purpose of Purchase: ________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
Signature of person seeking reimbursement: __________________________________________________________
Date: ______________________________________________________________________________________________
Project Manager Approval (signature): _______________________________________________________________
Date: ______________________________________________________________________________________________
Finance Officer Approval (signature): _________________________________________________________________
Date: ______________________________________________________________________________________________
Finance Committee – 5
Mission of Mercy In-Kind Donation Tracking Form
Organization Name Contact Name Mailing Address Good/Service Donated Estimated Value
6 – Volunteer Committee
General Volunteer Job Descriptions
Position Description: Food Volunteer To ensure that volunteers and patients have the food/beverages that they need during project hours
Responsibilities/Activities: •AssisttheFoodandBeverageCommitteeinsettingupfooddistributionarea • Preparefoodforpatients/volunteers •Distributefoodtopatients/dentists
Timeframe: • Four-hourshiftsonprojectdays
Supervision: • FoodandBeverageCommitteeChief
Training: •Anynecessarytrainingwillbeprovidedon-site
____________________________________________________________________________________________________
Position Description: Interpreter Toensurenon-Englishspeakingpatientsgettheinformationandservicestheyrequire
Responsibilities/Activities: •Assistnon-Englishspeakingpatientsthroughtheclinicprocess,providingtranslationservicesas needed
Timeframe: • Four-hourshiftsonprojectdays
Supervision: •VolunteerCommitteeChief
Training: •Anynecessarytrainingwillbeprovidedon-site
____________________________________________________________________________________________________
Volunteer Committee – 7
Position Description: Patient Escort Tomanagepatientflow
Responsibilities/Activities: •Assistpatientsthroughregistrationprocess,medical/dentalscreenings,procedures,andexitingthe clinic
Timeframe: • Four-hourshiftsonprojectdays
Supervision: •VolunteerCommitteeChief
Training: •Anynecessarytrainingwillbeprovidedon-site
____________________________________________________________________________________________________
Position Description: Patient RegistrationTo register patients for services
Responsibilities/Activities: •Answerpatientquestionsaboutregistrationprocess •Collectnecessaryinformationforpatientcharts •Directpatientstoappropriateseatingarea •Collectdataaspatientexits • Ensurecompletedrecordsarefiledproperly
Timeframe: • Four-hourshiftsonprojectdays
Supervision: • PatientRegistrationChief
Training: •Anynecessarytrainingwillbeprovidedon-sitebypatientregistrationleaders
____________________________________________________________________________________________________
8 – Volunteer Committee
Position Description: Parking/Security Volunteer Provide guidance for purposes of parking and other assistance as needed for attendees, staff, and others during MOM project events
Responsibilities/Activities: •Guidanceofvehiculartrafficforparkinginpre-definedandappropriateareas •Oversightofasafeandsecureareaforattendeesandstaffinpre-definedparkingareas •AssistancethroughguidanceandinformationforMOMprojectattendees
Timeframe: • Four-hourshiftsonprojectdates
Supervision: • Parking/SecuritySectionChief
Qualifications: •Abilitytostandforlongperiodsandworkininclementweather
Training: • Tobeprovidedduringorientation
____________________________________________________________________________________________________
Please note:Generalvolunteersareaskedtobeflexible.Duetotheunknownsoftheproject(client numbers),volunteersmaybeusedindifferentcapacitiesdependingontheneed.Volunteerscouldbeaskedtoserveasplaceholdersforclients,tofilepatientrecords,etc.
Volunteer Committee – 9
Mission of Mercy General Volunteer Application
Name:
Organization:
Email:
Shift Available (please circle all available shifts):
Friday (set-up) Saturday Sunday (tear-down)
6:00a.m.-9:00a.m. 4:00a.m.-8:00a.m. 8:00a.m.-Noon
9:00a.m.-Noon 8:00a.m.-Noon
Noon-3:00p.m. Noon-4:00p.m.
3:00p.m.-6:00p.m. 4:00p.m.-8:00p.m.
I am able to stand for long periods of time: Yes No
Iamabletoliftboxesheavierthan15lbs: Yes No
I speak Spanish: Yes No
Piedmont Regional Mission of MercyTriage: April 30Clinic: May 1
Barboursville Fire Station5251SpotswoodTrail
Barboursville,VA22923
ConvenientlylocatedonRt.33betweenRuckersvilleandBarboursville
ThankyouforjoiningusatthefirstMissionofMercyprojecttobeheldinthePiedmont. Weappreciateyourcommitmentoftimeandcaring.
Just for Dental Volunteers
What to Bring
The Piedmont is a rural area and our facilities are small. In order for you to feel as comfortable as possible, we suggest you bring some items of your own, For example: • Lightingisprovidedbutifyouareusedtoworkingwithaheadlight,pleaseconsiderbringingone. • Somedoctorsprefertobringtheirowncompositematerials,instrumentsandburs.Ingeneral,everyeffortwill be made to have the instruments available to do operative procedures. •Scrubsandcomfortableshoeswillbeappropriatetowearduringtheproject. •Ifyouhaveacomfortabledoctor’sseatorassistantstoolthatyouwouldprefertouse,pleasebringit.Youcan unload it at the front of the fire house before you park.
Orientation BBQ
Fridaynight,April30,pleasejoinusat6:30p.m.foranorientation/welcomeBBQattheStonefireStation receptionhalladjacenttothefirehouse.
PleaseverifythatthenumberofBBQattendeesyouindicatedatregistrationisstillcorrect.
Please email any changes to Barbara Rollins at [email protected].
10–Volunteer Committee
Schedule
Friday, April 30 9:00 a.m. Set up begins Noon VDA arrives 2:00 p.m. Triage begins 6:30p.m. Orientation/WelcomeBBQ
Saturday, May 1 5:30 a.m. Firehouse opens 6:00 a.m. Dr. Brooks meeting with VCU students; pre-registered patients seated 6:30 a.m. *Orientation for all dental professionals* *This is an important orientation session including information on the operation of the clinic, how to deal with medical emergencies, patient flow, communications and security. 7:00 a.m. Clinic opens; Same day patient registration begins
Dental Professionals:
Have you faxed a copy
of your license to VDA
at 804-261-1660?
Deadline: April 22, 2010
Volunteer Committee – 11
12–Volunteer Committee
For All Volunteers
Parking:Youmaydropoffandpickupyoursuppliesandequipmentatthemainfirehouse.However,after dropping off your supplies you must move your car and park in the grass field immediatelyadjacenttothefirehouse.Bothparkingareaswillbestaffedbyattendantstofacilitateparkingandtrafficandtodirectyoutheentiretime.
Volunteer Check In:Volunteerentranceisatthecenterbackofthebuilding.Volunteercheckinisstraightaheadofvolunteerentrancejustbeforethefoodtent.CliffDeMersfromRoanokeishandlingnametagsandcheck-inashehasdonesogenerouslyforotherMOMprojects.Allvolunteerswillneedtocheckinandcheckoutatthevolunteercheckindeskeachdayyouwork.T-shirts,badges,instructionsandawarmwelcomeawaityouatvolunteercheck-in.
Reminders: • Foodwillbeprovidedforallvolunteersstartingwithacontinentalbreakfastat5:30a.m.Saturday • Jeansandcomfortableshoesareappropriate • Spanishtranslatorswillbeavailable • Ifitrains,bringanextrasetofshoesforwhenyouareoutdoors. • Pleasecheckinandcheckoutatthevolunteerdeskeachday.It’seasy;it’srightbythefood!
Volunteers can be identified by t-shirt color: Dental–personalscrubsorlavendert-shirt Medical–greent-shirt TeamLeaders–bluet-shirts Translators–oranget-shirts General–yellowt-shirts VCUStudentLeaders–Redt-shirt
Volunteer Committee – 13
Important Addresses and Driving Instructions:
MOM Venue/The Barboursville Firehouse 5251SpotswoodTrail Barboursville,VA22923
Stonefire Station ( Friday night BBQ) 5361SpotswoodTrail Barboursville,VA22923
Holiday Inn Express, Orange 750 Round Hill Drive Orange,VA22960
James Madison’s Montpelier 11407ConstitutionHighway MontpelierStation,VA22957
Best Western Charlottesville Airport Inn & Suites 5920SeminoleTrail Ruckersville,VA22968-0900
From Richmond:Take64WtoUS-15. Exit136towardsGordonsville.Takearight onJamesMadisonHwy/US-15N.EnternextroundaboutandtakesecondexittoUS-33/SpotswoodTrail.Firehouseonyourright.
From Charlottesville:TakeRt20NandturnleftontoSpotswoodTrail/US-33.Drivehalf amileandFireHousewillbeonyourright.
From Culpeper:TakeUS-15StoOrange andthenfollowdirectionsfromOrange.
From Orange:TakeHwy20S.TurnrightontoUS-33/SpotswoodTrail.FireHousewillbelessthanaquartermileonyourright.
Still have [email protected].
14–Health Screening Committee
Health Screening Job Descriptions
Position Description: Medical Director
The Medical Director provides consultation for Health Screening services offered at the Roanoke Mission ofMercyproject.Healthscreeningservicesareprovidedduringtheeventtoidentifypatientswhomaypresentamedicalrisk(s)fordentalprocedures.TheHealthScreeningservicesinclude: •Bloodpressurescreenings •Bloodglucosescreenings •BodyMassIndex(optional and self-reported) •Medicationevaluation • ProthrombinTime/InternationalNormalizedRation(PT/INR) screenings (when indicated) • Post-exposureevaluationforpotentialbloodbornepathogensexposures
Pre-event Activities: •WorkingdirectlywiththechairpersonoftheHealthScreeningCommitteeandtheDentalDirectorto establishacceptable“screeningparameters”fortheaboveservices. •WorkingdirectlywiththechairpersonoftheHealthScreeningCommitteeinapprovingan“Exposure ControlPlanforBloodBornePathogens”and“Post-exposureProcedures”forsourcepatientand volunteers. •Recruitvolunteerphysiciansand/ormid-levelproviderswhoareavailableformedicalconsultation on-siteduringtheevent.Determineorientationneedsforthesevolunteers.AssisttheHealthScreening chairpersonincreatingaproviderworkschedulefortheevent.
Event Activities: • Provideon-siteconsultationwithHealthScreeningchairperson/dentalservices/participantintheevent participantexceedssafemedicalscreeningparameters •ConsultationwithPT/INRstaff/dental/participantintheeventparticipantexceedssafeparameters • Supportandidentificationofactualbloodbornepathogenexposures
Post-event Activities: •Attenddebriefingmeeting
Health Screening Committee –15
Position Description: Health Screening Volunteer
Candidates: RN (Registered Nurse), LPN (Licensed Practical Nurse),EMT(Emergency Medical Technician), FNP (Family Nurse Practitioner), PA (Physician Assistant), CNA (Certified Nursing Assistant)
Note: LicensurewillbeverifiedbyMedicalDirector
Job Description: Tosupportthismissionbybeingabletoprovideallofthefollowingbasicmedicalscreeningsforeachparticipant: • identifyparticipantscurrentlyonbloodthinners • reviewmedicalhistoryfordrugallergiesandcompleteness •bloodpressurereading(use of manual sphygmomanometer/cuffs) •bloodglucosevalue(using lancets and Precision Xtra blood glucose monitor) •pulsemeasurement •highlightandrecordvalues;tobeusedindentaltriageprocess
16–Health Screening Committee
Health Screening Station Instructions – Sample
Function: Tosupportthismissionbyprovidingbasichealthscreeningsforeachparticipant;toincludeblood pressureandbloodglucosescreeningsandtohighlightfordentaltriagethoseparametersbelowthatmaybeofconcernpriortoandregardingdentaltreatment. 1.Anticoagulant Medication Check – Please ask prior to screening participant •AREYOUONANYANTICOAGULANTSUCHASCOUMADIN/WARFARIN?IFYES,documentand highlight name of anticoagulant on registration form AND refer participant to nursing supervisor for PT/INR evaluation before performing any further screening
2.Drug Allergies – ASK, DOCUMENT AND HIGHLIGHT IF ANY DRUG Allergies On Registration Form
3.Blood Glucose – OSHArequireschangeofglovespriortoservingeachparticipant.Placeused lancets ONLY into dirty sharps containers; all other refuse place in regular trash •Documentbloodglucosevalueonparticipantcopy,registrationformandticsheet • 200andabove?Pleasehighlightelevatedvalueonallforms •Below70mg/dl?Toolow,asdefinedbytheAmericanDiabetesAssociation(Diabetes Forecast, April 2009, Checking Your Blood Glucose by Erika Gebel, PhD)Ifcomplaintsoflowbloodsugar symptoms, (shakiness, fainting)pleasenotifynursingsupervisor-snacksavailablebasedon medical need
IFELEVATEDBLOODGLUCOSE,PLEASEASK: •Doyouhavediabetes? •Areyouonanydiabeticmedicines?Haveyoutakenmedstoday?Recordansweronregistration form;example:dxDiabetes,ondiabeticmeds,takentoday,ORondiabeticmeds,nottakentoday
4.Blood Pressure–cleanstethoscopeearpieceswithalcoholwhenpassingequipmentontothenextshift •Documentbloodpressurereadingonparticipantcopy,registrationformandticsheet • 165/100andabove?Repeatbloodpressurereadingafterseveralminutes,documentand highlight all elevated readings on all forms
IFELEVATEDBLOODPRESSURE,PLEASEASK: •Doyouhavehighbloodpressure? •Areyouonbloodpressuremedicine;Haveyoutakenittoday?Recordansweronregistration form;example:dxHypertension,onhypertensionmeds,takentoday,ORonhypertensionmeds, not taken today
5.Pulse – document on registration form and highlight if irregular
Health Screening Committee – 17
Sample Health Screening Supply List (One Day MOM)
8PrecisionXtraGlucometers
83VMedical#2032Batteries
8Boxes/#100(Total 355) Lancets
6Sleeves/#200(Total 12002x2)GauzeSpongesforscreening,recheck
7Boxes/#200(Total 1400)Alcoholwipesforscreening,recheck
7Boxes/#100(Total 700)Band-Aidsforscreening,recheck
Gloves:
•3boxes/#100(Total 300) SMALL
•8boxes/#150(Total 1200)MEDIUM
•3boxes/#100(Total 300)LARGE
8 Dirty Sharps Containers
1EyewashStation(unused/2 bottles)
8 Trash Cans
75 Trash Can Liners
1580zHandSanitizer
9RollsPaperTowels
750PrecisionXtraBloodGlucoseTestStrips(Electrodes)
PDISani-ClothPlusGermicidalDisposableClothCanisters(for wiping blood spills)
Centrifuge (need electrical outlet)
8 Large Adult Cuffs/covers
8 Regular Adult Cuffs/covers
8 Stethoscopes
5boxessealablesandwichbags
18–Dental Services Committee
Dental Services Job Descriptions
Position Description: Dental Services Volunteers
1. Patient Escorts: Assist & direct patients from one service area to another. In Triage Station: •Managewaitingarea.Directpatienttotriage. • Escortpatientfromtriagetox-ray. • Escortpatientfromtriagetodentalhygiene.
In X-ray: •Managewaitingarea.Directpatienttox-ray. • Escortpatientfromx-raybacktotriageortorestorations,surgicalwaitingareas.
In Hygiene: •Managewaitingarea.Directpatienttohygienechairs. • EscortpatientfromhygienetoExit.
In Restoration-Surgery: •Managewaitingarea.Directpatienttodentalchair. • EscortpatientfromhygienetoExit.
2. Sterilization: •Cleanandsterilizesurgicalinstruments.
3. Biohazardous Wastes: •Collectanddiscardliquidandsolidbiohazardouswastes. • PrepareSci-Medwastecontainersforpick-upandtransporttodesignatedarea.
Dental Services Committee –19
Position Description: Dental Director
TheDentalDirectorworksinconsultationwiththeVirginiaDentalAssociationFoundationLeadershiptodetermine:dentalservicesprovidedattheMOMProject,eventlayoutandemergencyprotocols.He/shewillalsoworkdirectlywiththevolunteerchairandtheVDAFtorecruitdentalprofessionalstovolunteerpriortotheevent(eventplanning)andduringtheevent.
Pre-event activities: •WorkingdirectlywiththechairpersonoftheHealthScreeningcommitteetoestablishacceptable outcomelevelsforbloodpressureandglucosescreenings. •WorkingdirectlywiththechairpersonoftheHealthScreeningcommitteeinapprovingan“Exposure ControlPlanforBloodBornePathogens”and“Post-exposureProcedures”forsourcepatientand volunteers. •Recruitvolunteerdentists,hygienistsanddentalassistantstoprovidecareduringtheevent.In consolationwithVDAF,determineorientationneedsforthesevolunteers.WiththeVDAF,createa providerworkschedulefortheevent.
Event activities: • Providedentalcare • Provideconsultationtostudentsandvolunteers •Oversee,withVDAFdentalservices
Post-event activities: •Attenddebriefingmeeting
20–Dental Services Committee
Prevention of Blood Borne Pathogen Exposure
1. Wash hands prior to beginning shift and when ending shift 2. Change gloves with each patient3. Handle waste properly. Use RED BIOHAZARD CONTAINERS for dirty sharps and REGULAR TRASH CANS for used gauze, bandaids and alcohol wipes. 4. Clean spills with germicidal wipes wearing gloves; place that refuse in biohazard container
Definition of regulated waste:liquidorsemi-liquidorotherpotentiallyinfectiousmaterials;contaminateditemsthatwouldreleasebloodorotherpotentiallyinfectiousmaterialsinaliquidorsemi-liquidstateifcompressed;itemscakedwithdriedbloodorotherpotentiallyinfectiousmaterialsandarecapableof releasingthesematerialsduringhandling;contaminatedsharps;anpathologicalandmicrobiologicalwastescontainingbloodandotherpotentiallyinfectiousmaterials.
PROTOCOL FOR TREATMENT FOLLOWING BLOOD AND OR BODY FLUID EXPOSURES
Definition of blood or body fluid exposure: a percutaneous injury (needlestick or cut with a sharp object), contactwithmucousmembranes,orcontactofskin(particularly when exposed skin is chapped, abraded, or afflicted with dermatitis or contact is prolonged and extensive)withblood,tissues,orotherbodyfluids.Potentially infectious bloody fluids include blood, bloody fluids, semen, vaginal secretions, cerebrospinal fluid,synovialfluid,pleuralfluid,peritonealfluid,pericardialfluidandamnioticfluid.
1.Cleanwoundwithsoapandwater2.LABSMUSTBEDRAWNONTHESOURCEPATIENTIMMEDIATELYatbloodbornepathogenexposure station (Roanoke City Health Dept) •Orderexposurepanelonadowntimeform(done at Carilion Clinic) • Getsourcename,phonenumberandaddress.3.Notifythenursingsupervisor4.FilloutemployeeeventformONLYifCarilionEmployee5.Reporttobloodbornepathogenexposurestation/MissionofMercymedicaldirector.6.Ifexposureisdeterminedbymedicaldirector,proceedtoCarilionClinicemergencyroomforfurther evaluationandtreatment.
If Carilion Employee; post exposure counseling is provided thru Employee Health, Occupational Medicine, or the Infectious disease Physician. Follow up with the Worker’s Compensation office is required.
If NOT Carilion Employee;followupwithyourdoctorforpostexposurecounseling.
Dental Services Committee – 21
Mission of Mercy
Patient Name ______________________________________________ MRN # ________________________________
EXAMINATION/DIAGNOSTIC
D0140 OralExam–Limited/EmergencyD0272 X-Ray–Bitewing–2FilmsD0274 X-Ray–Bitewing–4FilmsD0210 X-RayIntraoralCompleteD0240 X-RayOcclusalFilmD0220 X-Ray–Periapical–1stFilmD0230 X-Ray–Periapical–Ea.Addl.FilmD0330 X-Ray–Panelipse
SURGERY
D9110 Palliative(Emergency) Pain TXD7140 Extsimple-eruptedtoothorexposedrootD7210 SurgicalExtractionofEruptedToothD7220 Surg.ExtractionImpacted–SoftTissueD7230 Surg.ExtractionImpacted–PartBoneyD7240 Surg.ExtractionImpacted–CompBoneyD7250 Surg.Extraction–RootRemovalD7310 Alveoloplasty/Quad–W/Extract1-3TeethD7311 Alveoloplasty/Quad–W/Extract4+TeethD7286 BiopsySoftTissue(Code by Site)D4211 Gingivectomy/PlastypertoothD4210 Gingivectomy/PlastyperquadD7510 Inc./DrainabscessD7471 RemoveExostosis PROSTHETICS
D5120 DentureCompleteLowerD5110 DentureCompleteUpperD5211 PartialAcrylicUpperD5212 PartialAcrylicLowerD5213 PartialDent-UpperCastBase/ResinD5214 PartialDent-LowerCastBase/ResinD5410 DentureAdjust–UpperCompleteD5411 DentureAdjust–LowerCompleteD5421 DentureAdjust–UpperPartialD5422 DentureAdjust–LowerPartial DENTAL HISTORY & TRIAGE
UnderDoctor’sCare GumsBleedWhenBrushing/FlossingSensitive to Hot/Cold Wears Partial, Bridge, Dentures
RESTORATIVE
D2140 Amalgam1Surface–PermanentD2150 Amalgam2Surface–PermanentD2160 Amalgam3Surface–PermanentD2161 Amalgam4Surface–PermanentD2330 Resin1surfaceAnteriorD2331 Resin2surfaceAnteriorD2332 Resin3surfaceAnteriorD2335 Resin4ormore/InvIncisalAngleD2391 Resin1surfacePosteriorD2392 Resin2surfacePosteriorD2393 Resin3surfacePosteriorD2394 Resin4ormoresurfacePosteriorD2940 Sedative/TemporaryFillingD2950 CoreBuildup,includingPinsD2951 PinRentention–perToothD2954 Prefab.Post&CoreD9910 AppofDesensitizingMedicaments
PREVENTIVE
D1204 FluorideTopicalApplication–AdultD1110 Prophylaxis–Adult D4355 Full Mouth Debridement D4342 Perioscale1-3TeethperQuadD4341 Perioscale4+teethperquad ENDODONTICS
D3110 PulpCap–DirectD3120 PulpCap–IndirectD3310 RootCanal–AnteriorD3320 RootCanal–BicuspidD3330 Root Canal – Molar
3
3
3
3
3
3
3
TOOTH #s
or QUAD
TOOTH #s
or QUAD
TOOTH #s
or QUAD
TOOTH #s
or QUAD
TOOTH #s
or QUAD
TOOTH #s
or QUAD
Triage Notes:
RX?Name&Amount:___________________________________________
Triage Dentist: ___________________________________________
Date: ___________________________________________
LIST ADDITIONAL SERVICES HERECode Indicating Tooth Number, Surface, etc
Treatment/Comments:Restorative:RecordTooth#andServiceAbove.NoteAnesthesia,andRelativeNotesOralSurgery:RecordTooth#andServiceAbove.NoteAnesthesia,andRelativeNotes
RX?Name&Amount:___________________________________________
Attending Dentist: ___________________________________________
Date: ___________________________________________
22–Dental Services Committee
Pharmacy Duties for Mission of Mercy/Exit Protocol
Attheexittables,pleaseassisteachpatientbythefollowingduties:
Revieweachprescriptionforaccuracy,DEAnotedoneachcontrolprescription,patientallergies,druginteractions.
Notify Terri Bryant for approval for any medication not on approved list: •Amoxicillin •Acetaminophenwithcodeine#3 •Cephalexin •Clindamycin150mg •DarvocetN100 • Erythromycin250mg • Ibuprofen • Lortab5/500 • PenVK500mg •GenericPeridex • Percocet5/325 •VicodinES
Counselpatientsonproperusageofmedications.Noprescriptionrefillswillbeauthorized.The prescriptionexpiresoneweekafteritiswritten.
Offer Medical Center Pharmacy and three CVS pharmacies (Hollins,Towers and 9th Street) as sites of free medications.Providemaps.Please note: Medical Center Pharmacy will honor any prescriptions written as a result of a follow-up visit the week of March 29 to April 2, 2010.
Handoutblankprofilesheetstoshortenwaittimesatpharmacies
AskforMedicaidandVAPremierinsurancecardstopresentatpharmacies.Thesearetheonlyinsuranceswewillinquireabout.Focusisonswiftserviceandeaseforeachpharmacy.
DirectpatientstodisplaytablesuponexitingtheCivicCenter.
Iwillbeavailablethroughoutthetwo-dayeventprovidingpre-opmedicationsandansweringanyofyourquestions.
ThankyouforvolunteeringwithMissionofMercy.Wecouldnotdothiswithoutyou!Callthroughouttheday for questions on my cell (761-1753).
Terri Bryant
Logistics Committee – 23
Sample Letter to Procure VDOT Compressor
January 6, 2010
Mr. Richard L. CaywoodDistrict AdministratorVirginia Department of TransportationP O Box 3071Salem, VA 24153
Dear Mr. Caywood:
IhavebeencontactedbyPatYoung,projectmanageroftheRoanokeMissionofMercy(MOM) projecttobeheldattheRoanokeCivicCenterMarch26-27,2010.Asyouareaware,thesemissionsare held to provide dental care and medical screening to underserved uninsured adults in Southwest Virginia and several other areas in the Commonwealth. The urgency of this type of service was clearly demonstrated in 2007 and 2008 year when over 2000 uninsured adults stood in line for hours to receive dental services in Roanoke. Volunteer dentists expect to serve over 1,000 patients again at MOM 2010.
I understand that VDOT donated an air compressor and fuel to run the dental units at the Roanoke MissionofMercy2007and2008andatsimilarprojects.IwouldhopeVDOTcoulddothesamefornextyear’sprojectinRoanoke.Ms.YoungisrequestingaVDOTcommercialaircompressor,setat 100 psi, with a 100 foot long ½ inch hose and sufficient fuel to allow for continuous running 12 hours each of the two days of the event. The air compressor would be needed the afternoon of March 25 at 1:00 p.m. and could be removed after 5:00 p.m. on Saturday, March 27, or could remain there until the following Monday morning. Arrangements can be made by contacting Bobby Baker at 540-776-4015.
Thank you for your kind attention to this request. I hope VDOT will be able to assist our communities in this very worthwhile mission.
Sincerely,
John S. Edwards
JSE:arb
cc:PatYoung
24–Logistics Committee
Date:
Name:
YouhavebeengivenaprescriptionformedicationinconjunctionwithdentaltreatmentataMissionofMercydentalfair.PleasetakeyourprescriptionandthisvoucherwithinTWO days tooneofthepharmacieslistedontheattachedformandyouwillnotbechargedforyourprescription.Ifyoudonothaveyourprescription,youwillnotreceivemedication.Ifyoudonothavethisvoucher,youwillbechargedforyourprescription.
Designated MOM Volunteer:
This Voucher is good until July 29, 2010
Logistics Committee – 25
Logistics Position Descriptions
Position Description: Parking/Security Volunteer Provide guidance for purposes of parking and other assistance as needed for attendees, staff, and others during MOM project events
Responsibilities/Activities: •Guidanceofvehiculartrafficforparkinginpre-definedandappropriateareas •Oversightofasafeandsecureareaforattendeesandstaffinpre-definedparkingareas •AssistancethroughguidanceandinformationforMOMprojectattendees
Timeframe: • Four-hourshiftsonprojectdates
Supervision: • Parking/SecuritySectionChief
Qualifications: •Abilitytostandforlongperiodsandworkininclementweather
Training: • Tobeprovidedduringorientation
____________________________________________________________________________________________________
Please note: Generalvolunteersareaskedtobeflexible.Duetotheunknownsoftheproject(client numbers),volunteersmaybeusedindifferentcapacitiesdependingontheneed.Volunteerscouldbeaskedtoserveasplaceholdersforclients,tofilepatientrecords,etc.
26–Patient Registration Committee
Patient Registration, Patient Exit, Data Entry Policies and Procedures
Greeting PatientsAllvolunteersareremindedtogreetpatientsgraciouslyandrespectfully.
Patient Registration • 8tablesforpatientregistrationintheSpecialEventsCenter(SEC) (see attached event map) • 2registrationvolunteers/table • 1patientescortvolunteer/table • Seeattachedvolunteerschedule
Patient Flow: • PatientswillbeseatedinthePatientRegistrationWaitingareainnumericorderhoweveronce patientbeginsreceivingservices,thenumericorderisnolongerapplicableaspatient’stimeateach station/serviceareawillvary. •Whileseated,patientswillreceiveaclipboardandbeaskedtocomplete the following: • PatientRecord(demographic information) (available in English/Spanish) • PatientWaiver(available in English/Spanish) • PatientDeemedConsentforTesting(available in English/Spanish) • Patientwillbeescortedtopatientregistrationtableintheordertheyareseated. •Registration volunteers will review for completeness: • PatientRecord(Demographic Information) (English/Spanish) • PatientWaiver(English/Spanish) • PatientDeemedConsentforTesting(English/Spanish) •A patient chart is created.Thepatient’s“lineticket”numberwillbecomethemedicalrecordnumber. Recordpatient’slastnameandfirstnameonthechart’stab. •Verifywhetherthepatientison“BloodThinners”orhasa“LatexAllergy.”Ifyes,attachedared stickeronthechart’stab.
Sticker Color Reason
RED Patient is on blood thinners
BLUE Patienthasalatexallergy
Please note patients on Blood Thinners should be escorted directly to the PT/INR testing table at Health Screenings.
•Patient will receive a wrist bandwiththemedicalrecordnumberonit.Wristbandsarecolor-coded basedondateofservice.(See attached wrist band color codes) •Handicapped/specialneedspatientsmayhaveoneescortaccompanythem.Awristbandwillbegiven totheseescortsthatlinksthemtothehandicapped/specialneedspatient. • Interpretive services (Spanish primarily, sign and limited other languages)areavailableasneeded. •Whenregistrationiscomplete,avolunteerwillescortthepatienttotheHealthScreeningswaiting area.
Patient Registration Committee – 27
Patient Exit • 2patientexittables(2 volunteers/table)
Patient Flow: • PatientswillpresentwiththeircharttoExittableattheendofthedentalvisit. •Volunteerwillreviewchartforcompleteness.Ensuredentalencounterformiscompleteandpatient receivedfollow-upcareinstructionsasindicated. • Patientswhohadextractionsorothersurgicalprocedureswillbegivenapost-surgicalpack(gauze, OTC pain reliever, and follow-up instructions)bythevolunteer. •AllpatientsgivenprescriptionswillbedirectedtothepharmacystationattheExittable. •Volunteerswillfilepatientchartwhencomplete.
Data Entry •Volunteerswillenterpatientdemographics,healthscreeningsanddentaltreatmentdataintoanExcel spreadsheet. •WorkshouldbesavedperiodicallythroughoutthedayandattheendofeachshiftontoaFlashdrive. TheseflashdriveswillbecollectedbythePatientRegistrationChiefattheendofeachday.
28–Patient Registration Committee
Mission of MercyNotice of Deemed Consent for HIV, Hepatitis B or C Testin
IfanyMissionofMercyhealthcareprofessionalvolunteershouldbedirectlyexposedtoyourbloodorbodyfluidsinawaythatmaytransmitdisease,yourbloodwillbetestedforinfectionwithhuman immunodeficiency virus (HIV),aswellasforHepatitisBandC.Aphysicianorotherhealthcareproviderwilltellyoutheresultofthetest.UnderVirginiaCode32.1-45.1(A), you are deemed to have consented to the releaseofthetestresultstothepersonexposed.
InyoushouldbedirectlyexposedtobloodorbodyfluidsofaMissionofMercyhealthcareprofessionalvolunteerinanywaythatmaytransmitdisease,thatperson’sbloodwillbetestedforinfectionwithHIVaswellasHepatitisBandC.Aphysicianorotherhealthcareproviderwilltellyouandthatpersontheresultofthetest.
I certify that I have consented to HIV, Hepatitis B and C testing as described above.
_____________________________________________________________________ ________________________SignatureofPatient,Parent/LegalGuardian Date
_____________________________________________________________________ Relationship (if signature is not patient)
_____________________________________________________________________ ________________________Signature of Person Obtaining Consent Date
Patient Registration Committee – 29
Mission of MercyNotificación of Autorización para Examen de HIV, Hepatitis B ó C
SialgunodelosprofesionalessanitariosvoluntariosdeMissionofMercyfueraexpuestodirectamenteasusangre o líquidos corporales en cualquier forma que se pueda transmitir una enfermedad, su sangre será examinadaporVIH,tambiénHepatitisByC.Unmedicouotroproveedorsanitarioledaráelresultado delexamen.BajoelCódigodeVirginia32.1-45.1 (A), se considera que usted ha dado permiso para dar a conocerlosresultadosdelexamenalapersonaexpuesta.
Siustedfueraexpuestodirectamenteasangreolíquidoscorporalesdeunodelosprofesionalessanitariosvoluntarios de Mission of Mercy, en cualquier forma que se pueda transmitir una enfermedad, la sangre deesapersonaseráexaminadaporVIH,tambiénHepatitisByC.Unmedicouotroproveedordesaludlesdaráaustedyaesapersonalosresultadosdelexamen.
Certifico que he dado permiso para hacer eximes de VIH, Hepatitis B y C, come se describe arriba.
_____________________________________________________________________ ________________________FirmadelPaciente,Padre/Guardián,oPersonaactuandoenLocoParentis Fecha
_____________________________________________________________________ Relación(Si la firma no es del Paciente)
_____________________________________________________________________ ________________________Firma de la Persona Obteniendo el Consentimiento Fecha
30 – Patient Registration Committee
Mission of Mercy Patient Waiver
IMPORTANT NOTICE
Mission of Mercyvolunteersmaynotbeabletoprovideyouwithalltheservicesyouneed,butifyouwouldliketoconsultwithourvolunteerteamandreceivethetypeoftreatmentbeingofferedtoday,PLEASE READ THE PATIENT WAIVER BELOW VERY CAREFULLY, AND SIGN IT.
Whilethevolunteerhygienists,dentistsandoralsurgeonsofferhighqualityprocedureswithgood equipment, I understand that, because of the number of people needing to be seen, I might not receive multipleextractionsormultiplefillings.IunderstandthatImighthavecertainmedicalconditionswhichwouldkeepmefromhavingthetypeoftreatmentIamrequesting.Ialsounderstandthatthedentalcareprovidersarevolunteers,somefromout-of-town,andarenotavailableforfollow-upcareintheeventofcomplications.Iagreetoseekanyfollow-upcareImightneedfrommylocaldentist,familyphysician,or ahospitalemergencyroom.
Inconsiderationofthefreedentalcareservicesreceivedonthedatebelow,I,formyselfandanyoneentitled toclaimthroughme,doherebywaiveandreleasetheMissionofMercyoranypersonororganizations acting on their behalf or sponsoring or volunteering at this clinic, from all claims of liability arising out of my acceptance of such free care including but not limited to medical, surgical, dental, and/or vision care or otherhealthcareormedicaladvice.
I grant to the Mission of Mercy and its agents the right to use my picture, voice and other reproductions of myphysicallikenessinconnectionwithadvertisingorpublicizingMissionofMercyservicesanditsactivitiesinallformsofmediainperpetuity.
Ihaveread,orhadreadtome,andunderstandandagreetoalloftheabove.
_____________________________________________________________________ ________________________Patient signature Date
In case of an emergency, please contact:
___________________________________________________ (________) ________________________ Name Telephone number
Aretheyherewithyoutoday?YesorNo
Patient Registration Committee – 31
Mission of Mercy Patient Waiver
Anuncio Importante
EsposiblequelosvoluntariosdelMissionofMercynotenganlascapacidadesaprovenirtodoslosserviciosdentales que usted necesita, pero si usted quisiera consultar con nuestro equipo de voluntarios y recibir los tiposdetratamientoqueellosestánofreciendohoy,PORFAVORLEELARENUNCIADEPACIENTESABAJOCONMUCHOCUIDADO.
Nota a los pacientes dentales:Mientrasquelosvoluntariosquesondentistas,higienizasycirujanosoralesofrecenprocedimientosdealtacalidadconequipoqueestáenunacondiciónbuena,yocomprendoqueporquehaymuchaspersonasquenecesitantratamiento,esposiblequenopuedorecibirvariasextracciones yvariascalzas.Yocomprendoqueesposiblequeyotengoalgunascondicionesmedicalesquepueden prohibirmederecibireltipodetratamientodentalqueyoestoypidiendo.También,comprendoquelosvoluntarios (algunas que son visitantes de otras regiones) no están disponibles para continuar cuidado, si hay problemasdespuésdelaclínicahoy.Yoaccedoabuscaralcuidadodentaldespuésdelclínico,sinecesito,deundentistalocal,mimédicodecabeceraoelcuartodeemergenciaenelhospital.
Enconsideraciónalosservicioslibresdetratamientodentalquerecibíenlafechaabajo,yo,paramimismoyalguienquepuedehacerunareclamaciónpormi,yosoyporlapresenterenunciayliberaalMissionofMercy,algunaspersonasoorganizacionesqueactúanenrepresentacióndelMissionofMercyylosque patrocinaovoluntaaestaclínica,detodasreclamacionesderesponsabilidadqueprovenirdemiaceptación decuidadogratisqueincluido,peronoestalimitadoa,cuidadomédico,quirúrgico,dentaly/ocuidado visualootrocuidadooconsejosmédicos.
DoypermisoalMissionofMercyysusagentesladerechaausarfotos,mivoz,yotrasreproduccionesde miretratofísicoenconexiónconlapublicidaddelaclínicaootraspublicacionessobrelosserviciosylas actividadesdelMissionofMercyentodaslasformasdelosmediosdecomunicaciónaperpetuidad.
Yoheleído,ohabíaleídoamí,ycomprendoeacedoatodoqueestáarriba.
_____________________________________________________________________ ________________________Firma de paciente Fecha
In case of an emergency, please contact:
___________________________________________________ (________) ________________________ Apellido Telefono
CLEANING ~ FILLING ~ EXTRACTIONPatient ID #:
PATIENT RECORD / INFORMACION SOBRE EL PACIENTEDATE: FECHA:LAST NAME / APELLIDO
FIRST NAME / NOMBRE
SECOND/ SEGUNDO PHONE/TELÉFONO
MAILING ADDRESS/STREET ADDRESS CITY/ CIUDADSTATE/
ESTADO
ZIP / CODIGO POSTAL BIRTHDATE / FECHA DE NACIMIENTO
DIRECCIÓN
SEX MARITAL ESTATUS/ ESTADO CIVILRACE (CHECK ONE) RAZA (MARQUE UNO) HISPANIC HISPANO
MALE / FEMALE/ SINGLE/ MARRIED/ CAUCASIAN YES
HOMBRE MUJER SOLTERO CASADO AFRICAN AMERICAN NO
ASIAN
OTHER
NUMBER OF PEOPLE LIVING ANNUAL HOUSEHOLD INCOME: ___________________________ INGRESOS ANUALES DE LA FAMILIA
IN YOUR HOUSEHOLD: ________CURRENT EMPLOYMENT STATUS: FULL-TIME JORNADA COMPLETA
NÚMBERO DE PERSONAS QUE VIVEN EN SU SITUACIÓN LABORAL: PART-TIME JORNADA PARCIAL
CASA UNEMPLOYED DESEMPLEADO
RETIRED RETIRADO
SEASONAL POR TEMPORADA
DO YOU HAVE MEDICAL INSURANCE? YES NO
¿TIENE SEGURO MÉDICO?
DO YOU HAVE DENTAL INSURANCE? YES NO
¿TIENE SEGURO DENTAL?
REGULAR MEDICAL CARE/ LAST MEDICAL VISIT (WHEN,WHY)/ Dr's Name:________________________________
CUIDADO MÉDICO HABITUAL ÚLTIMA VISITA MÉDICA (CÚANDO, POR QUÉ) Nombre del Médico
YES NO
REGULAR DENTAL CARE/ LAST DENTAL VISIT (WHEN,WHY)/ Dr's Name:________________________________
CUIDADO DENTAL HABITUAL ÚLTIMA VISITA DENTAL (CÚANDO, POR QUÉ) Nombre del dentista: ____________________________________
YES NO HAVE YOU EVER ATTENDED A MISSION OF MERCY? YES NO
LOCATION OF PREVIOUS MISSION OF MERCY: _______________________________________________
¿HA VISITADO UNA "MISSION OF MERCY" ("MISIÓN DE CARIDAD) ANTERIORMENTE? YES NO
DIRECCIÓN DE LA "MISSION OF MERCY" ( LA MISIÓN DE CARIDAD) QUE VISITÓ.
MEDICATIONS YOU CURRENTLY TAKE/
MEDICAMENTOS QUE ESTA TOMANDO
DO YOU TAKE BLOOD THINNERS? YES NO
¿ESTA TOMANDO ANTICOAGULANTES?ANTICOAGULANTES?
MEDICAL HISTORY DRUG ALLERGIES Vital Signs and Lab Findings
DIABETES CURRENTLY PREGNANT NONE
HEPATITIS OSTEOPOROSIS PENICILLIN BP
HEART DISEASE HIV+ TCN/DCN PULSE
ASTHMA WEAR GLASSES/CONTACTS EMYCIN GLUCOSE
ARTHRITIS ANEMIA SULFA FASTING
SEIZURES CHICKEN POX FLAGYL
HEARING LOSS TOBACCO USE CEPHALOSPORIN PT/INR FINDINGS
VISION LOSS RADIATION TX SPECTINOMYCIN
TUBERCULOSIS HIGH/LOW BP FLUOROQUINOLONES
SCARLET FEVER EXCESSIVE BLEEDING LATEX
____________ SHUNTS __________ RHEUMATIC FEVER OTHER/OTROMITRAL VALVE PROLAPSE JOINT REPLACEMENT
DIABETES NINGUNA
CARDIOPATÍA HIV+/ SEROPOSITIVO TETRACYCLINE/DOSICICLINE
ASMA EMYCIN
ARTRITIS ANEMIA SULFA
CONVULSIONES FLAGYL
PÉRDIDA AUDITIVA
PERDIDA DE VISTA
TUBERCULOSIS
ESCARLATINA LÁTEX
____________ VÁLVULA DE DERIVACIÓN __________PROLAPSO DE VÁLVULA MISTRAL
USA TOBACO CEPHALOSPORIN
HISTORIAL MÉDICO ALERGIAS A MEDICAMENTOS Notes
EMBARAZADA
HEPATITIS
USA LENTES/LENTILLAS
VARICELA
OSTEOPOROSIS PENICILINA
PROTESIS ARTICULAR
RADIOTERAPIA SPECTINOMYCIN
PRESIÓN SANGUINEA ALTA/BAJA FLUOROQUINOLONES
SANGRA EXCESIVAMENTE
FIEBRE REUMÁTICA OTROS
32–Patient Registration Committee
Patient Registration Committee – 33
DENTAL HISTORY TREATMENT/COMMENTS:
___ UNDER DOCTOR'S CARE Restorative: Include tooth #, surfaces, material, anesthesia…and any relevant notes
___ GUMS BLEED WHEN BRUSHING,FLOSSING Oral Surgery: Include tooth #, Surgical vs. Non Surgical, anesthesia…and any relevant notes
___ SENSITIVE TO HOT/COLD
___ WEARS PARTIAL, BRIDGE,DENTURES
TRIAGE NOTES:
RX? NAME & AMOUNT:___________________________ RX? NAME & AMOUNT:_______________________________________________________
TRIAGE DENTIST: _______________________________ ATTENDING DENTIST: ________________________________________________________
Date:_________________ Date:_________________
34 – Patient Registration Committee
Patient Registration Position Descriptions
Position Description: Interpreter Toensurenon-Englishspeakingpatientsgettheinformationandservicestheyrequire
Responsibilities/Activities: •Assistnon-Englishspeakingpatientsthroughtheclinicprocess,providingtranslationservicesas needed
Timeframe: • Four-hourshiftsonprojectdays
Supervision: •VolunteerCommitteeChief
Training: •Anynecessarytrainingwillbeprovidedon-site
____________________________________________________________________________________________________
Position Description: Patient Escort Tomanagepatientflow
Responsibilities/Activities: •Assistpatientsthroughregistrationprocess,medical/dentalscreenings,procedures,andexitingthe clinic
Timeframe: • Four-hourshiftsonprojectdays
Supervision: •VolunteerCommitteeChief
Training: •Anynecessarytrainingwillbeprovidedon-site
____________________________________________________________________________________________________
Patient Registration Committee – 35
Position Description: Patient RegistrationTo register patients for services
Responsibilities/Activities: •Answerpatientquestionsaboutregistrationprocess •Collectnecessaryinformationforpatientcharts •Directpatientstoappropriateseatingarea •Collectdataaspatientexits • Ensurecompletedrecordsarefiledproperly
Timeframe: • Four-hourshiftsonprojectdays
Supervision: • PatientRegistrationChief
Training: •Anynecessarytrainingwillbeprovidedon-sitebypatientregistrationleaders
____________________________________________________________________________________________________
Please note:Generalvolunteersareaskedtobeflexible.Duetotheunknownsoftheproject(client numbers),volunteersmaybeusedindifferentcapacitiesdependingontheneed.Volunteerscouldbeaskedtoserveasplaceholdersforclients,tofilepatientrecords,etc.
Food & Beverage Position Descriptions
Position Description: Food Volunteer To ensure that volunteers and patients have the food/beverages that they need during project hours
Responsibilities/Activities: •AssisttheFoodandBeverageCommitteeinsettingupfooddistributionarea • Preparefoodforpatients/volunteers •Distributefoodtopatients/dentists
Timeframe: • Four-hourshiftsonprojectdays
Supervision: • FoodandBeverageCommitteeChief
Training: •Anynecessarytrainingwillbeprovidedon-site
____________________________________________________________________________________________________
Please note:Generalvolunteersareaskedtobeflexible.Duetotheunknownsoftheproject(client numbers),volunteersmaybeusedindifferentcapacitiesdependingontheneed.Volunteerscouldbeaskedtoserveasplaceholdersforclients,tofilepatientrecords,etc.
36 – Food & Beverage Committee
A Summary of Food Consumed by 400 Adults (Volunteers Only!)at the One-Day Piedmont Regional MOM
Food & Beverage Committee – 37
1,000softdrinks
4,000bottlesofwater
14gallonsoficedtea
15lbs.ofcoffee
3boxesoftea(10bagseach)
6qts.halfandhalf
180Bagels
320Breakfastwraps
200Kite’shambiscuits
150cupsofyogurt
200bottlesofassortedjuices
2casesofmelon
1caseofpreparedpineapple
2casesofgrapes
1caseofbananas
3flatsofstrawberries
32lbs.oforanges
50lbs.ofchickensalad
Case of tomatoes
Case of lettuce
2casesofbread
50lbs.ofpastasalad
250hotdogsandbuns
4 jars of relish
Case of mustard
Case of ketchup
Chopped onions
6casesofchips,pretzels
60-70dozendesserts(cookies, brownies, cakes, muffins)
6 gallons ice cream
125icecreamcones
100tootsierollpops
38 – Public Relations Committee
What is the MOM Piedmont Regional Dental Day? MOM stands for Mission of Mercy. The MOM Piedmont Regional Dental Day will provide free dental services
to as many uninsured adults in our area as possible in a one-day dental clinic. The clinic anticipates capacity to serve between 500 and 600 patients.
Where and when will the MOM Piedmont Regional Dental Day take place? TheMOMPiedmontRegionalDentalDaywilltakeplaceMay1,2010,startingat7:00a.m.attheBarboursville
Fire House (5251 Spotswood Trail, Barboursville, Virginia 22923) .
Who sponsors the MOM Piedmont Regional Dental Day? MOM was created by the Virginia Dental Health Foundation (VDHF), an arm of the Virginia Dental
Association (VDA), to serve citizens with little or no access to dental care. The MOM Piedmont Dental Day is co-sponsored by the VDHF, Virginia Commonwealth University, and the newly established Orange County-based Piedmont Regional Dental Clinic (PRDC), with support from area Free Clinics.
What dental services will be delivered? Dental services provided will include: 1) Preventative dentistry—teeth cleaning, fluoride application, sealants, oral
hygiene, and nutritional counseling; 2) Restorative dentistry—fillings; and 3) Extractions, limited surgery. Each patient will receive at least one dental service. If the patient needs more than one service a list of other dental care resources where they may receive treatment will be provided.
Who is eligible to receive free dental services? MOM Dental Days are held in underserved areas of the state to serve working poor, underinsured, and uninsured
people in need of dental care. The Mission of Mercy serves people with no other dental care option. This Mission of Mercy project will serve adults over 18 years of age.
How can individuals receive dental services on May 1? Dentalcarewillbeprovidedonafirst-come,first-servedbasis.Becausethereissuchagreatdemandfordental
careinourregion,itislikelythattheclinicwillreachcapacitybyveryearlySaturdaymorning.It is strongly recommended that those wishing to receive service pre-register on Friday, April 30, 2010, at 2:00 p.m. at the Barboursville Fire House. Friday is for pre-registration only. Pre-registration on Friday does not guarantee dental serviceonSaturdayunlessthepatientisamongthefirst500-600patientsonsite.Nodentalserviceswillactuallybe performed on Friday.
Patientswhohavecompletedpre-registrationwillbeseatedat6:00a.m.onSaturday.Samedayregistrationstartsat7:00amonSaturday.TheSaturdayClinicisfirst-come,first-served.OnSaturdaymorningonceallthe patients who could be treated during the day are in line, the Clinic will be deemed at capacity. Additional patients will be turned away. (This may happen early Saturday morning .) A handout on additional dental resources will be provided to anyone wishing it.
MOM Piedmont Regional Dental Day
FACTSHEET
P.O.Box152•Barboursville,VA22923•540.748.3756•www.vaprdc.org
Public Relations Committee – 39
Who delivers the dental services? All dental services will be delivered by fully accredited dentists, dental hygienists, and supervised dental student
volunteers.
How can I support the MOM Piedmont Dental Day? You can support the MOM Piedmont Dental Day by volunteering in any one of a number of ways. More than
350 volunteers are necessary to make the day run smoothly. Volunteers are needed for many tasks, and any help you can give will be greatly appreciated: dental and medical professionals; patient registration; site set-up and take-down;parkingandtrafficcontrol;trashpickup;Spanishlanguagetranslators;crowdcontrol;fooddonationsanddistribution; records management and transcription, and event planning support. Please register as a volunteer at www.vadental.org for the Piedmont Regional Mission of Mercy.
If you cannot volunteer, you can help by donating money to help defray the cost of the event. Please visit www.vaprdc.orgtomakeadonationtoPRDC/MissionofMercyorsendyourcontributiontoPiedmont RegionalDentalClinic,P.O.Box152,Barboursville,VA22923.
# # #
40 – Public Relations Committee
A nation-wide need… Morethan100millionpeopleintheUnitedStatesarewithoutdentalinsurance.ManysufferfromwhattheU.S.
surgeon general calls “a silent epidemic of dental and oral diseases” caused by “profound” disparities in dental care.
“Those who suffer the worst oral health are found among the poor of all ages, with poor children and poor older Americans particularly vulnerable. Members of racial and ethnic minority groups also experience a disproportionate level of oral health problems,” the surgeon general wrote in a 2000 report.
…Reflected in Virginia The Virginia Employment Commission 2000 Population Projects estimated that one-in-five Virginians live in an
area underserved by dentists. Typically these are rural communities with a significant population living in poverty. Individuals in these areas are often left without any dental care to face extreme pain, discomfort, and embarrassment. They are most often people who are employed but poor, and people who are elderly, disabled, or uninsured.
The Mission of Mercy project In response to this need, the Virginia Dental Health Foundation (VDHF) launched the Mission of Mercy
(MOM) project, and began to “make caring visible.” The Mission of Mercy projects, staffed and organized almost entirely by volunteers, are one- to three-day dental clinics set up to provide a comprehensive range of dental services to those in need in Virginia. Most clinics are conducted in identified underserved areas of the state where there are not enough dentists and hygienists to serve the oral health needs of the community. Targeted to uninsured and underinsured children and adults, any individual who is able to show up on site is considered eligible to receive services. The intention is not to judge, but rather to serve.
To date, 46 MOM projects have been held across Virginia. For each MOM project, there are hundreds of volunteers who participate. To date, thousands of patients have been provided with more than $18 million of dollars worth of free dental care. Virginia’s MOM projects have broken records for the largest two- and three-day dentaloutreachclinicseverconductedintheUnitedStates.
May 1: A Local Mission of Mercy: Piedmont Regional Dental Day In response to the local need, the newly established Piedmont Regional Dental Clinic, along with the Virginia
Dental Association and Virginia Commonwealth University, and with support from area free medical clinics, will cosponsorthePiedmontRegionalMissionofMercyonMay1,2010,at7:00a.m.attheBarboursvilleFireHouse(5251 Spotswood Trail, Barboursville, Virginia 22923) .
Dental services provided will include: 1) Preventative dentistry: teeth cleaning, fluoride application, sealants, oral hygiene, and nutritional counseling; 2) Restorative dentistry: fillings; and 3) Extractions and limited surgery. All dental services will be delivered by fully accredited dentists, dental hygienists, and supervised dental student volunteers.
MOM Piedmont Regional Dental Day
BACKGROUNDER
P.O.Box152•Barboursville,VA22923•540.748.3756•www.vaprdc.org
Public Relations Committee – 41
The Piedmont Regional Dental Clinic The Piedmont Regional Dental Clinic (PRDC) is a new non-profit organization dedicated to providing low-cost
dental services to underserved residents in the Piedmont region of Virginia. The Clinic is modeled after the very successful Augusta Regional Dental Clinic. Although it is just getting started, when fully operational, the PRDC will have permanent offices and a full-time dental staff. The MOM Piedmont Regional Dental Day is the first project of PRDC.
The Virginia Dental Association and Virginia Dental Health Foundation The Virginia Dental Association (VDA) is a non-profit organization, affiliated with the American Dental
Association (ADA),whosevisionistocontinuallyimprovethequalityofdentaleducationandtreatmentwithinthe state of Virginia (www .vadental .org). The Virginia Dental Health Foundation (VDHF) is a charitable and educational organization established by VDA in 1996 to increase access to dental care for Virginians by generating and redirecting resources throughout the Commonwealth.
The VDHF believes that oral health is an intricate part of the overall health and well being of an individual. Neglectedoralhygienehasbothphysiologicalandpsychologicaleffects.Diseasesofthemouthcanleadtoother serious concerns such as diabetes and cardiovascular disease. Individuals who suffer from medical complications suchascancerandAIDSareatanincreasedriskfordevelopingoraldisease.TheprogramssupportedbytheVDHF help to alleviate individuals of pain, discomfort, malnutrition, embarrassment, low self esteem and depression that often result from poor oral hygiene.
MOM Dental Days in Virginia Thusfar,atotalof46MOMprojectshavebeenheldinWiseCounty,theEasternShore,NorthernVirginia,
Martinsville,Norfolk,Grundy,Roanoke,Emporia,Goochland,Petersburg,andNewOrleans,LA.Todate,33,897patients have been provided with more than $18 million worth of free dental care. In 2008, the Foundation spent $254,000 on its Missions of Mercy projects. Other states have used the Virginia Mission of Mercy as a model:Texas,Kansas,Arkansas,Nebraska,Colorado,WestVirginia,Connecticut,andNorthCarolina.
SomepastMOMProjectsinclude: •GoochlandMOM,2009:207patientsreceivedanestimated$134,893infreedentalservices •EmporiaMOM,2009:958patientsreceivedanestimated$545,352infreedentalservices •GrundyMOM,2004-2007,2009:2,773patientsreceivedanestimated$1.6millioninfreedentalservices •WiseCountyMOM,2000-2009:12,191patientsreceivedanestimated$6.7millioninfreedentalservices •NorthernVirginiaMOM,2002,2004-2009:4,667patientsreceivedanestimated$1.3millioninfreedentalservices •EasternShoreMOM,2001-2009:6,213patientsreceivedanestimated$2.7millioninfreedentalservices •PetersburgMOM,2003,2005,2007:249patientsreceivedanestimated$80,407infreedentalservices •RoanokeMOM,2007-2008:1,965patientsreceivedanestimated$985,746infreedentalservices •MartinsvilleMOM,2003:876patientsreceivedanestimated$288,145infreedentalservices •NorfolkMOM,2003:305patientsreceivedanestimated$85,619infreedentalservices
Donations To make the Piedmont Regional Mission of Mercy event possible, financial support is needed. Donations to
support the Mission of Mercy projects may be made online at www.vaprdc.org or mailed to: PiedmontRegionalDentalClinic/MissionofMercyProject POBox152 Barboursville,VA 540.661.0008
42–Public Relations Committee
PublicRelations101
Publicrelationsistheartofusingvarioustechniquestocommunicatewithvariousaudiencesaboutyourproject.
Steps for Success
Step 1:Identifyyourkeyaudiences. • Projectpartners? •Donorsorpotentialdonors? • Patients/clients? • Localorstateofficials? •Generalpublic? •Other?
Step 2:Determinewhatinformationyouwanttocommunicate. • Projectimpactandvalue(data re: patients served, money saved and/or generated, health
outcomes, other project achievements). • Featurestorydescribingsomekeyaspectsofaproject •Generaldescriptionofproject(what it is/does, target population, hours, community partners/
supporters) • Specialeventsfortheproject(dedication, grand opening, etc.)
Step 3: Select the most effective medium for communicating the topic to the targeted audience • Television •Newspaper •Radio •Newsletter •Magazine
Step 4:Makecontactintheappropriateway •MediaAlert • PressRelease • Phonecalltoreported • Lettertotheeditor
Step 5:FOLLOWUP.Itisveryimportanttobuildrelationshipswithmediacontacts.Makesureyou alwaysfollow-upwithaphonecallaftersubmittingapressreleaseormediaalert.
707EastMainStreet,Suite1350•Richmond,VA23219
Phone:(804)828-5804•Fax:(804)828-4370•email:[email protected]
www.vhcf.org
Helpful Hints
•Alwaysknowthemessagethatyouwanttogetacrossthrougheachmediaactivity.Usedata tomakeyourcasewhenpossible.
•Recruit college students majoring in communications, local ad agencies, or public relations professionalstohelpyouwithyourefforts.
•Respondpromptlyifareportercalls.
• Follow-upwithreporterswhoarenotabletoattendtheevent.
•Duringaninterview,providethereporterwithrelevantdata,facts,andstatistics.Stay focusedonthepoint(s)youwanttomake.Youcanoftenshapeastory.
•Usetelevisionwhenyouknowyouwillhavegoodvisuals.Bepreparedtoonlyget10-15 secondsofcoverage.
•Whenusingthenewspapersenddigitalphotoswithpressreleasesandincludethefullnames oftheindividualspictured.
•Useanygoodpresstohelppromoteyourproject. • Sendcopiesofarticlestodonors,communitypartnersandothersignificantplayersinyour project.
•Keepanotebookorfileofallofyourpresscoverage. •Createan“IntheNewsPage”onyourwebsite.Postallpressreleasesandprovidelinksto publisharticlesorvideohighlightingyourproject.
• Sendcopiesofarticlestofundersassoonasyougetthem.
Public Relations Committee – 43
44 – Public Relations Committee
TipsforHandlingaMediaInterview
•Beknowledgeableabouttheissue.Anticipatelikelyquestionsandhaveanswersready.
•Wheneverpossible,supportyourstatementswithfacts,statistics,quotesfromexperts, comparisons,orpersonalexperiences.
•Talkfromtheviewpointoftheaudience.Don’tusejargonor“insider”terminologysuchas acronyms.
•Speakinpersonalterms.Tobemorebelievable,use“I”not“we.”
•Listencarefullytothequestionandalwaystellthetruth.
•Don’tbeevasive.Neversay“nocomment.”Ifyoucannotansweraquestion,alwaysgiveavalid reasonfornotbeingabletoanswer.
•Don’tspeculate.Ifyoudon’tknowtheanswer,sayso,thenoffertofindout.
•Don’tanswerhypothetical“whatif”questions.Say“Wedon’tspeculate”andbridgetothereal issues.
•Ifyoudon’twantastatementquoted,don’tmakeit.There’snosuchthingas“offtherecord.”
•Don’tloseyourtemperorarguewithareporter.Youmaywinthebattle,butlosethewar.
•Ifaquestioncontainsnegativelanguage,don’trepeatitinyouranswer.
•Ifaskedseveralquestionsatonce,picktheonequestionyouwanttoanswer,answerit,andlet thereporterre-asktheothers.
•Withaforced-choicequestion,youdon’thavetoacceptthereporter’schoices,butyoucan offerathirdalternative.
Dealing with the Media: Know Your Rights!
When responding to media inquiries, you have the right to: •Knowwhoyou’retalkingto–askthereporter’snameandpublicationorstation. •Knowthetopicorstoryanglethereporterwantstopursue. •Changethelocationoftheinterview. •Haveaquestionrepeatedorclarified. •Sayyoudon’thaveananswerathand,butwillgetbacktothereportertoclarify.Findoutthe reporter’sdeadlineandhonorit. •Directareportertotheappropriatespokesperson.Besuretoalertthespokespersontoexpect acallfromthereporter. •Betreatedwiththesamecourtesyyouextendtothereporter.
707EastMainStreet,Suite1350•Richmond,VA23219
Phone:(804)828-5804•Fax:(804)828-4370•email:[email protected]
www.vhcf.org
Public Relations Committee – 45
Communications Techniques & Strategies
I. Why do you want the media to talk to you?
•Morepeoplewilllearnaboutyourproject
•Moredonations
•Morepartners
•Morevolunteers
• Publicitywillhelpyousucceed
II. Who are the media?
•Broaderdefinitionof“media”thaneverbefore
• Traditionalmediaoutlets,suchasnewspapers,radio,andTV,arebeingincreasingly supplementedby,andoftenreplacedby,web-basedcontent,includingnewswebsites andblogs.
•Despitedropinsubscriberbase,newspaperscontinuetoattractkeyaudiencesandare important to cultivate
•Newspapersubscriberstendtobeolder,moreeducatedandhigherincome,andare goodtargetsforprojectsupportinitiatives.
•Younger,educated,affluentindividualsmaynotsubscribetoprintversionsofdaily newspapers,buttendtokeepupwithlocalnewselectronically,throughnewspapers’ websites. III. How do you reach the media?
•Createamedialistthatisbothcompleteandaccurate:
•Currentcontactinformationforeachmediaoutlet(update twice per year)
•Correct spelling of reporter/editor
•Morethanonecontactperoutlet
•AssignmentEditor
• FeaturesEditor
• Forblogs,specialtyradioandTVshows (e.g. Good Morning Richmond) and local/regional magazines,identifytheproduceroreditorinchargeoffeaturesandbreakingnews.
IV. How do you create a comprehensive media list?
•GotothelibraryandcheckforeitherBacon’sorBurrelle’smedialist(Online access to each can also be obtained for a fee through http://us.cision.com or http://www.burrellesluce.com)
707EastMainStreet,Suite1350•Richmond,VA23219
Phone:(804)828-5804•Fax:(804)828-4370•email:[email protected]
www.vhcf.org
46 – Public Relations Committee
In the hard copy versions media outlets are listed by city – simply copy the pages you need andcalleachmediaoutlettoconfirmtheinformationiscorrect.
•UseGoogle.Searchwww.google.comusingthefollowingkeywords“medialisting(name of city/state)”–againyou’llneedtocalltoconfirmthatinfoiscorrect.
• Identifyblogsthatarerelevanttoyourprojectandbecomeanactiveparticipant
•Onceyouhavecreatedyourlistmakesureyouupdateiteverysixmonths(a great project for a volunteer or intern).
V. Now you have their names, but they need yours too!
•CreateaSourceSheetforusewiththemediathatincludes:
•Alinktoyourorganization’swebsite,ifyouhaveone
•Yourproject/organizationprimarycontact(includeworkandcellnumbers)
•Briefdescriptionoforganizationandmission
•Keystatisticsaboutyourproject(hours/daysofoperation,servicesprovided,demographic profileofindividualsserved,dataonnumberofpatientvisits,numberofpatients,etc.)
VI. Next Steps
• Makepersonalcontactwithout“selling”
• Lookforcommoninterests
• Providesourcesheet
• Encouragecallorvisittoyourorganization
•Contactthemediawhenyouhaveanewsorfeaturestorytopitch
•Newsistimesensitive,important,hasabroadappeal
• Featuresareinterestingoruniquestories,mayhaveaseasonaltie,canbe“pitched” wellinadvance VII. How to handle a media interview
•Beagreatresource
•Bringsupportingdataandinterestingexamples
•Keepyouranswersbrief
•Relax,Smile
• Takeasmuchtimeasyouneed
• Ifyouneedtocorrectananswer–stop,pauseandstartfromthebeginning.
• Ifyoudon’tknowtheanswer,sayso–thentrytogetthereporterincontactwithsomeone whodoes.
• Ifyouarenervous…
• Practiceinfrontofamirror
•Avoiddistractinghabits,clothesorvocalizations
• Printcopiesofanyprintorwebstoriesorblogsandgettranscriptsofanyradio/TVinterviews
•Send copies of all media coverage to VHCF and to your employees, volunteers and supporters
Public Relations Committee – 47
News Rules
1. Be brief and be gone! Media Alerts and Fact Sheets are the best tools
Media Alert
•Who,what,when,where,why
• Shouldbesentinadvanceofevent
•Grabstheirinterest
• Listsacontactperson(important to have 24-hour contact phone, preferably cell as well as office)
Fact Sheet
•Bulletedsummaryofkeyfacts
• Includesonlyessentialinformation
• Indicateswhyyourstoryisimportant
•Containsharddata
• Providesanecdotaldatainbriefform
• Listsacontactpersonandcontactinformation
2. Give them what they want!
•Whentheycall,meettheirdeadlines
•Makesuretheyhavewhattheyneedtocoveryou 3. “Pitch” to the right person
• Isitavisualstory?
• Ifit’semotionalorcompellingandhas“action”thatwouldmakegoodvideo,pitchlocal TVusingafactsheet.
•Makesureyouworkwiththeassignmentdirectororhealthreporter.
• Ifit’slessinterestingbutstillvisual,goforaphoto…
• Takeityourselfusingadigitalcamera
• Sizeto5x7andsaveathighresolutionasaJPEG
• Emailasacolorphoto(the editors can change it to black and white if they choose to use it).
• Includeacaptionwhenyousenditincludingthedateoftheevent,thenamesandtitles ofthepeoplefeaturedabriefdescriptionofwhatwentonattheevent,andthecontact person’sname/number/emailaddress.
• Emailittothephotoeditoratthelocalnewsletterandincludeitwithcopiesofyournews release
48 – Public Relations Committee
• Sendanewsreleasetimedforreleasethedayoftheeventgivingthedetailsofthenews you’dlikepeopletoknow
• Sendthenewsreleasebothelectronically,viaemailtoyourcontacts,aswellasviathe mail – particularly if it includes visuals (photo)
• Inadditiontoannouncingyournews,includebackgroundinformationonyourproject (a copy of your fact sheet)andcontactinformation.
• Someideasfornewsreleasesare:
•Atie-inthatyourprojecthaswitha“day”or“month”–e.g.cancerscreeningsavailable atyourfreeclinicaspartofNationalCancerAwarenessmonth.
•Asignificantnewdonationtoyourproject
•Amilestone,suchasopeninganewfacility,addingnewcaregivingstaff,expanding hoursordaysofoperation,orexpandingservices
•Othermilestonescouldincludeachievinganewlevelintermsoftotalpatientscared for(ortotalpatients)eitherduringtheyearorduringyourproject’shistory
4. Follow up!
•Alwayssendafollow-uptothereporter/mediathatcoveredyourstory,thankingthem fortheirinterestandofferingtobearesourceforthemonfuturestories.
• Iftheygotsomethingwrong,neverbecritical.Ifitwasaseriouserror(for example, saying that your project served 250 people last year, instead of 2,500),askprint/websourcesifthey wouldmindcorrectingthefiguresothattheinformationiscorrectforthefuture.
•Newspapersandmagazineswillprintan“errata”correctingtheinformationandwill usually change the back copy online to correct it, so that future stories concerning that issuewillbecorrect.
•RadioandTVsourcesdonotaircorrections,sodropthemapolitenoteviaemail(or in the mail),thankingthemfortheirinterestandkindlycorrectingthefact/sinquestion.
Getting publicity is important to the success of your project. Make the commitment. You’ll see the results!
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Public Relations Committee – 49
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Public Relations Committee – 51
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52 – Public Relations Committee
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