Nurses of Note Awards 2021: Week One

 

Nurses of Note Yoji Patil

PerfectServe’s Nurses of Note awards program brings focuses on the many nurses who deserve recognition for the dedication, sacrifice, and resilience they bring to work every day. For the inaugural Nurses of Note Awards, we have the privilege of highlighting a new level of commitment, strength, and integrity in nurses from around the country who have battled on the front lines of the still-raging coronavirus pandemic.

The actions of this diverse group of nurses highlight the extraordinary among us. Their stories give us a glimpse into the unique ways our nurses have fought this pandemic and made a difference in the lives of their patients and the communities they serve. Out of hundreds of nominations, we selected three nurses and one team of providers to spotlight as recipients of this award.

Honoree 1: Yoji Patil, MSN, RN, CNOR of Stamford Health (Stamford, CT)

Yojana Patil—who goes by Yoji—believes that nursing chose her. She accidentally stepped into her career when she took an entrance exam to support a friend who wanted to pursue nursing. Twenty-plus years later, Yoji found herself battling on the front lines of the COVID-19 pandemic. In response, she helped to launch the ICU Family Liaison Program at Stamford Health to keep ICU and palliative teams in communication with patients and their families while visitation restrictions were in place.

Yoji was nominated by her Stamford Health coworker Michelle Watson, who serves as Nurse Manager for the ICU and IMCU. Michelle wrote that Yoji’s ICU Family Liaison Program initiation felt seamless, and that Yoji deserves full credit for what the program was able to accomplish.

The ICU Family Liaison Program has kept patients and their families connected in a time when communication is more important than ever. Yoji wrote the training and communication guide for the program, which covers four intensive care units for eight hours a day, seven days a week. She individually called and updated families of patients, organized patient care across multiple specialties, and facilitated conference calls—all on top of her regular nursing schedule.

Her nominator Michelle summed up Yoji’s efforts by saying, “I am proud to work with Yoji and to be a witness to such an important initiative that provides much-needed information and comfort to families.”

Yoji’s service to her patients did not stop when she was tired. Throughout the pandemic, she worked weekends and holidays to provide continuous care. On Mother’s Day, she organized a video call with all of her female patients’ children, allowing them to see their mothers even though they couldn’t be together in person.

Throughout the pandemic, Yoji has been a caretaker and advocate for those who lost their lives to COVID-19. She has held the hands of dying patients whose families couldn’t be there to comfort them. On multiple occasions, Yoji obtained permission to allow family members to visit and say goodbye to loved ones when a patient’s outcome looked grim. Yoji was and remains a steady support system to families facing the bereavement process.

Yojana Patil’s service to her patients, her colleagues, and her community is an emphatic demonstration of character, empathy, and commitment to nursing.

What inspired you to become a nurse?

Sometimes you choose a profession, but in my case, the profession chose me. I accompanied my friend to the entrance exam for a reputed nursing school in Mumbai. The principal was walking by and asked me, “Instead of waiting outside, why don’t you sit in for the exam?” I did end up taking the test, and now I can’t imagine choosing any other profession.

What’s one piece of advice for nursing students entering the field?

Nursing is a work of heART. Nursing is a way of living for the rest of your life. It’s not just a job—once a nurse, always a nurse.

What would you like to see change for nursing in the future?

I would love to see nursing at the forefront of healthcare. I want to see nurses advocating for patients, especially the population that has no voice.

How do you combat burnout in your professional life?

I have tremendous support from my family, friends, and coworkers. I use mindfulness in my daily activities, especially on hectic days. Emotional burnout is a real thing. Nurses around the world are feeling helpless and emotionally drained as an effect of this pandemic. Most of us have PTSD from our experiences and the difficult outcomes we’ve witnessed.

Taking care of your physical and mental health is just as important as taking care of your patients. A quick five-minute deep breathing session before walking into unknowns, such as receiving a new patient or beginning a shift, goes a long way.

What’s your passion outside of nursing?

I love Zumba. I also went skydiving on my 40th birthday! I have traveled to four continents so far and would love to explore Africa next. To sum it up, I enjoy dancing, traveling, and adventure sports. I’m not the best at sports, but that doesn’t stop me from trying!

If you had to pick one song that describes you as a nurse, what would it be?

If I had to pick a song, it would be “Heal the World” by Michael Jackson. But this excerpt from a poem—which I wrote with my coworker and fellow nurse, Seema Pillai—really describes me as a nurse:

Today I feel like a soldier, waging a war,
With limited weapons, I return home each day with many a scar.
But I will fight valiantly and will not despair,
‘Cos I go to work each day with weapons invisible—faith, hope, trust, and a prayer.

Nursing is my calling
And when duty calls, I will not fail,
I know there’s light at the end of the tunnel, I know I’ll live to tell this tale.

Thank you, Yoji!

Your hard work and dedication to exceptional patient care is recognized and appreciated by your colleagues and the team at PerfectServe. We wish you all the best in your continued efforts to make life better for the individuals and families who trust you with their care.

Read the Full Winners List

4 Best Smartphones for Nurse Communication

 

Banner graphic with blog title, "4 Best Smartphones for Nurse Communication," and outline illustration of a nurse using a smartphone.

Nurse Communication: The Best Mobile Devices in Healthcare

Smartphones have the potential to transform workflows for nurses and other hospital caregivers. Rather than carrying around multiple devices, smartphones give clinicians mobile access to the EMR, integration with nurse call and telemetry, and secure clinical collaboration.

Many leading hospitals and health systems have enlisted PerfectServe as a partner in their transition to smartphones for nurse communication and mobility. If you are looking to enhance clinical collaboration and accelerate speed to care, here are some key insights on how to mobilize care team communication by selecting the right mobile devices for nurses.

Effective Communication in Nursing: Top Devices

Zebra Technologies TC52-HC1

Zebra has been in the healthcare space for years, with their MC40 mobile computers and broad range of solutions like printers, scanners, and kiosks. A few years ago, they introduced the TC51-HC and quickly followed it up with the evolved TC52-HC.

The TC52-HC is a healthcare-focused unit that offers strong hardware performance and support for modern versions of Android. The device is protected by a rugged exterior that’s built to survive day to day in a nursing unit.

As an enterprise device, the TC52-HC is available with built-in telephony, barcode scanning, robust battery capabilities, and many more features that come in handy in a healthcare setting. Like the other purpose-built Android devices on our list, the TC52-HC is a hardened device that can withstand repeated drops, exposure to liquids, and frequent exposure to healthcare disinfectants.

Improving upon the TC51-HC, the TC52-HC offers an additional microphone, advanced noise cancellation, and a louder speaker to hear and be heard in noisy environments. Its battery is the largest of our recommended devices, and Zebra includes software tools that ensure the battery will last through an entire 12-hour shift.

Why choose it: Long-Term Quality

Zebra and its partner network are well established in healthcare, offering plenty of resources to help your project succeed. Zebra made sure the TC52-HC is backwards compatible with TC51-HC accessories and future-proofed the device through Android 10 and later.

Honorable Mention: TC21-HC

Zebra also recently introduced a new TC21-HC device, targeted at ancillary healthcare workers like environmental services, transport, and food service staff. The TC21-HC offers most of the same features as the TC52-HC in a slightly smaller, more cost-effective package.

Apple iPhone SE2

As a consumer-grade device, the iPhone delivers leading-edge hardware and software wrapped in a small, sleek package.

Compared to most enterprise-specific devices, an iPhone SE is a low-cost option. However, as a consumer phone, the Apple device will not offer the ruggedness, battery capabilities, native IP telephony, and other enterprise-grade features. Third-party protective sleds and charging solutions are available to make the device hospital ready.

The low cost, form factor, and familiarity of the iPhone make it a good option in the current device market.

Why choose it: iOS

If your organization prefers the Apple mobile operating system, your device choice is clear.

Spectralink Versity3

Spectralink has years of experience providing voice handsets that run on hospital wireless networks. After entering the smartphone market in 2014 with the Pivot, Spectralink rolled out the Versity to customers in late 2018.

Looking at the spec sheet, the Versity checks all the boxes for ruggedness, battery, telephony, etc. Its hardware and Android 8 operating system raised the bar in the enterprise device market.

Spectralink emphasizes voice quality with the Versity, leveraging years of wireless handset experience and advanced audio processing software. The device is available with a scanner or without for a sleeker, lower-cost option.

Why choose it: Form Factor

The Versity is slim and light, as close as you will find to a consumer phone in a rugged package.

Ascom Myco4

Another company with deep healthcare experience, Ascom offers the Myco 3 smartphone alongside its wireless telephone and nurse call products. Although the Myco 2 received mixed reviews, the new Ascom Myco 3 (launched in 2019) shows great potential as a nursing device. The five-inch screen, battery, ruggedness, and operating system are all in line with the Zebra and Spectralink devices.

Ascom has followed a more traditional smartphone form factor with the Myco 3, but they have added some creative functional touches. The device includes a removable clip to attach to a waistband or pocket. When worn clipped to scrubs, the top edge features multi-color LEDs that supported apps can use to signal informative notifications. The dedicated barcode scanner is on the rear, rather than the top, so users can see the screen easily while they point the scanner.

The Myco 3 is the newest device on this list. We had great results testing the device in our certification lab, and now we look forward to real-world feedback from our customers.

Why choose it: The Ascom Touch

Health systems already using Ascom nurse call and wireless phones should certainly consider the Myco 3 mobile device, along with any other team that could benefit from its unique ergonomic design.

The Importance of Nursing Communication Devices

Now is an exciting time as manufacturers continue to bring improved smartphones to the market. PerfectServe is here to share our experience and help you achieve your goals for clinical communication.

If you want more information about nurse mobility, check out our complete guide on clinical collaboration systems for hospitals and health systems.

See the Guide

 

Fighting Alarm Fatigue for Nurses in 5 Steps

Healthcare, We Have a Problem:

Alarm fatigue is a serious threat to patient safety.

The American Association of Critical-Care Nurses (AACN) defines alarm fatigue as a sensory overload that occurs when clinicians are exposed to an excessive number of alarms, which can result in desensitization to alarm sounds and an increased rate of missed alarms. False alarms are a strong contributor, making up 72-99% of all alarms and numbing care teams to signals meant to indicate patient danger.1

Essentially, devices and processes that were designed to protect and support patients in specific ways have compiled over time to create a cacophony of ever-sounding silos in healthcare. Sadly, the discord cannot be safely silenced. Fortunately, it can be well-orchestrated.

Let’s explore how integrating disparate, noisy alert and alarm systems can help fight alarm fatigue for nurses and care teams.

Where is all the noise coming from?

In short, disconnected legacy systems with outdated hardware and devices combine with overlapping, suboptimal workflows to create the noise fueling alarm fatigue. A few factors that add to the chaos and make it difficult for clinicians to determine the relevance and urgency of alarms include:

  • Nurse Call Systems: Patients sometimes use nurse call for non-clinical requests, such as a glass of water, which could be redirected to another team member.
  • Critical Lab Results: Upon notification, nurses in some settings are responsible for tracking down the appropriate physician to relay critical results, pulling the nurse away from the bedside.
  • Patient Monitoring Devices: It can be difficult to infer the risk level and urgency of various patient device alarms, and to know if other team members are responding or can respond more quickly.

Above are just a few of many systems that can trigger nondescript beeping sounds, which all begin to sound alike and blur together. The result? Just to find out where an alarm is coming from and what it indicates, a nurse has to leave the current task to investigate.

The nurse is forced to assign priority (current task versus potential patient threat) based on assumption in an environment where up to 99% of alarms are false, yet assuming an alarm is false puts a patient at risk. Constant decisions like these in a fast-paced, high-stakes environment contribute to mistakes, alarm fatigue, clinician burnout, patient risk, and many other potential consequences.

5 Steps to Fight Alarm Fatigue:

1. Integrate all alerts and alarms to reduce noise.

To start, put all alerts and alarms in one place that nurses and care teams can check on the go—an integrated app accessible from any device across all locations.

2. Increase mobility to decrease footwork.

For organizations that haven’t already deployed a mobile device strategy for nurses, smartphones will greatly enhance the effectiveness of an integrated solution. Being able to check alerts at the bedside and on the move reduces extra footwork and detours for staff.

3. Use shift schedules to inform smart routing.

The ideal solution should also integrate with shift and on-call schedules across the organization, using schedules to route alerts and alarms directly to the right clinicians. Smart routing like PerfectServe’s Dynamic Intelligent Routing reduces irrelevant noise while using built-in escalation policies to ensure urgent alerts are addressed within set timeframes.

4. Delay nonurgent notifications to reduce interruptions.

The ability to delay nonurgent alerts to be delivered at set intervals can greatly reduce distractions for clinicians during patient care. By minimizing multitasking, nurses and other care team members are able to complete tasks more efficiently and maximize their focus on patients at the bedside.

5. Distinguish alert types by tone to simplify recognition.

Alarm fatigue and decision fatigue often go hand in hand. While most care team members wouldn’t actively choose to ignore an alert, the ability to know in an instant based on sound whether or not an alarm is urgent can help them respond appropriately more quickly.

The Bottom Line:

Excess noise makes it difficult for clinicians to administer safe and timely care. (It also does a number on patient experience, but that’s a topic for another post.) Remove the guesswork for nurses around whether to tune out the noise and focus on the patient at hand or interrupt each encounter to assess the latest (likely false) alarm.

Click below to begin fighting alarm fatigue.

 

Resources:
1. Alarm Fatigue: A Patient Safety Concern, American Association of Critical-Care Nurses (AACN) Advanced Critical Care, Sue Sendelbach, RN, PhD, CCNS and Marjorie Funk, RN, PhD, Oct. 2013: acnjournals.org/aacnacconline/article-abstract/24/4/378/14745/Alarm-FatigueA-Patient-Safety-Concern

Real-Time Data Entry for Better Patient Care

Real-Time Data Entry Header

It has always been recommended that charting take place as near to the care event as practical, with the key word being “practical.” In reality, clinicians and nurses often stay after shifts to do their charting because entry is not seamless during patient care.

The more time that passes between the health event and the data entry, the less detailed the data input becomes and the greater its risk of containing errors. Delayed data entry impacts patient outcomes and creates unnecessary administrative overhead.

Benefits of Real-Time Data Entry

“Real-time electronic data is a potential treasure trove of insights, which can be analysed to improve patient care and use nurses’ time more effectively.”
– Helen Glenister, Chief Operating Officer (COO) of The Learning Clinic1

Real-time data entry has been shown to improve patient care (particularly the identification of patients who may be deteriorating), free up more direct-care time for nurses and clinicians, and help hospitals better deploy staff and resources.

According to a study published in Nursing Times, the availability of up-to-date data can help nurses and clinicians spot patterns in data that indicate a patient is deteriorating or may have an infection.1 While some data points may automatically feed into the EHR, vital observational data from nurses and doctors are not automatically entered.

Timely electronic recording of all clinical data—including observations, assessments, and actions—gives the overall picture of a patient and provides a clear data trail in the event of a complaint or incident investigation. Real-time documentation and order entry during rounding also helps speed up care and minimize future interruptions.2

The benefits of real-time data entry are well known, but challenging to achieve in some hospitals.

Challenges to Real-Time Data Entry

Siloed technology systems, device mobility limitations, and logistical issues in some EHRs can be the biggest barriers to real-time charting.

“One nurse believes that since going live, EHRs have added 3 hours to a
12-hour shift.” – Laura A. Stokowski, RN, MS3

In order to chart data that is accurate, actionable, and timely, the care team must be supported with an integrated solution that allows for simplified real-time charting in the EHR/EMR.

How to Achieve Real-Time EHR Data Entry

Healthcare IT integration can be very complex, but the right technology can integrate disparate IT, clinical, telecom, and EMR/EHR systems to allow information to flow freely. The result is a cohesive, integrated communication ecosystem that ensures the right information is available at the right time to support quality patient-centered care.

An ideal solution will support real-time charting with:

  • Intelligent field mapping to reduce duplicate data entry.
  • Voice-to-text capability to speed up and simplify data entry.
  • An easy and elegant interface with all information available on a single platform; no switching between apps.
  • Easy transfer of clinical notes for rapid documentation.
  • Immediate delivery of critical lab and test results to the right clinician with date, time, recipient, delivery status, and read status auto-recorded to the EMR in accordance with Joint Commission requirements.

Next Steps for Getting Started

Explore how your team can combine real-time EHR data entry with seamless care coordination in one integrated solution by speaking with a clinical communication specialist.

 

Resources:
1. How real-time data can improve patient care, Nursing Times, Sep. 21, 2015: nursingtimes.net/clinical-archive/patient-safety/how-real-time-data-can-improve-patient-care-21-09-2015/
2. How Hospitalists Can Improve Efficiency on Inpatient Wards, The Hospitalist, Rajesh Chandra, MD, FHM, et. al., May 2014: the-hospitalist.org/hospitalist/article/126231/how-hospitalists-can-improve-efficiency-inpatient-wards
3. Electronic Nursing Documentation: Charting New Territory, Medscape, Sep. 12, 2013: medscape.com/viewarticle/810573

Managing the surprisingly troublesome impact of real-time healthcare on clinical decision-making

We live in an age of instant gratification. From the texts we send friends and family to the orders we place on Amazon.com, we’ve come to expect immediate results: instant responses, next-day shipping, etc.

The idea of immediacy in healthcare communications is not new. In fact, in 2015, healthcare analyst Gartner outlined a vision for what it dubbed the “real-time health system”—a landscape where healthcare professionals will be constantly aware of what’s happening within their systems and with their patients.

As a person living in the digital age, you’ve probably experienced real-time awareness in other parts of your life: the repetitive dings of received text messages, the intermittent beeps of calendar alerts, the near-constant hum as your smartphone vibrates over and over to let you know your mother, children and cousins have uploaded photos to Facebook, Instagram and Snapchat. In fact, as I’m typing this piece, I’ve heard alerts for two personal text messages that I’ve yet to look at (the temptation is maddening), four work-related emails (that I did have to stop and look at), a notification that someone commented on a thread I replied to on Facebook and more.

While there’s definitely a benefit to each of us knowing what’s happening in our expanded universe in real time—and we can easily draw a direct line to the benefits that doctors, nurses and patients would experience if they could communicate instantaneously while coordinating care—the influx of information is simply overwhelming.

And when alarm fatigue sets in, important messages get missed, the communication cycle breaks down and what was once a valuable resource becomes a liability. Overwhelmed and inundated clinicians cannot optimally use their invaluable expertise to make effective clinical decisions that deliver great health outcomes.

Aggregating, analyzing and managing the distribution of clinical information

Managing the flow of data and alert fatigue is a real challenge that clinicians and the IT teams that support them need to understand. Clinicians need “just the facts, ma’am,” so to speak, and they need to know which set of facts pertain directly to them and the patients for whom they are caring. Receiving more than enough information is not always a good thing, especially when the situation calls for fast thinking and quick decisions.

Investments made in technologies implemented over the past several years have enabled healthcare as an industry to generate very large amounts of digitized clinical information. The challenge is to aggregate this patient data in real time to generate new knowledge about a patient and distribute it in a way that does not inundate the clinician recipients with unnecessary information. Physicians and nurses should receive information they need in order to act in that moment. Everything else is noise.


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Implementing communication-driven workflows

Once new knowledge is made available and deemed relevant to a given clinical situation, it’s important to enable workflows that drive this information to the right care team members, who can take action in that moment. Hospital-based communication workflows must encompass all modalities, adhere to strict security mandates and facilitate reliable exchanges among clinicians across boundaries (e.g., acute, pre-acute and post-acute care settings). This kind of clinical integration is the future of healthcare communications.

If clinicians are inundated with unnecessary information, messages and alerts, combined with a communication workflow that creates barriers to a) finding the right care team member to contact, b) finding the contact method that the clinician prefers and c) knowing whether the intended recipient received the message, the workflow is flawed and is inhibiting the decision-making that leads to higher standards of patient care.

Leveraging clinical expertise

The personal judgment of experienced healthcare professionals is irreplaceable in effective, real-time decision-making. Technological advances are no doubt improving healthcare, but human intuition can never be replaced by a new device or software. However, that intuition can be inhibited by technologies if they are not strategically implemented and managed. In this sense, real-time healthcare could, ironically, be eroding quality.

To truly leverage the hundreds of collective years of clinical expertise housed in the minds of your hospital’s medical staff—the expertise that yields great outcomes—you must remove the barriers to effective communication. Collecting patient data in real time is an important part of that. But analyzing and aggregating that data into digestible, valuable pieces of information that can be easily shared and collaborated on is the follow-through that is often overlooked.

The gravitation toward instant gratification isn’t going away. And it’s important to understand that the concept doesn’t apply simply to generating patient data as healthcare events are occurring, but also to the ability to extract the significant portions and begin collaborating with the broader care team to interpret the data and derive a plan to deliver high-value care.

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The Important Role Nurses Play in Care Transition and Reducing Readmissions

In its simplest form, “care transition” is defined as a hospital discharge or movement from one care setting to another. The risk that readmissions pose to patient safety requires that transitional care processes are under constant evaluation.

Nurses are the linchpin in clinical communication and coordination of patient care and thus are best equipped to coordinate a successful transition. The bedside nurse, for example, may understand a great deal more about the patient’s needs as they travel through the care continuum than other care team members. And when those needs are communicated effectively, the nurse is given the opportunity to extend to the patient high-value care beyond organizational boundaries through clinical communication.

Nurses create transitional care plans by compiling all the pertinent patient information and creating instructions to be followed. Then they share the plan in detail with all members of the new care team so that the handoff is seamless for both the patient and the new unit or facility.

The most important factor in transition of care is communication during the handoff process.

What to communicate and when

The goal of the handoff is to safely transfer the patient from one care setting to another (or to discharge the patient from the hospital completely) by exchanging the necessary information with, and by effectively transferring the responsibility of care to, either a new care team or the patient’s family.

It’s a lot to put on any nurse’s plate, but by standardizing and implementing an effective and comprehensive transition communication process, nurses can elevate patient safety, avoid adverse events that lead to costly readmissions and decrease patient anxiety during the transfer process.

It’s important to remember that the transfer process doesn’t apply only to moving a patient from an acute setting to the home or a post-acute environment. There are many different handoff scenarios within the same organization, unit and floor that need your close attention.

For example, nurses should be prepared to provide handoff communication:

  • At shift change
  • During a break
  • When patients are transferred within the hospital (e.g., from the ER to ICU, from radiology to the OR, etc.)

It’s extremely important for the purposes of continuity of care that the communication between the nurse and either the new team of clinicians or the family prepares them in such a way that they’re able to anticipate the patient’s needs and make timely decisions.

At a high level, to adequately prepare the new care team, the following should be included in the handoff communication:

  • Patient care instructions
  • Treatment description
  • Medication history
  • Services received
  • Any recent or anticipated changes

More specifically, and especially in the case of transfers to a new care team or facility, an effective care transition communication plan will include:

  • Patient’s name and age
  • Reason for admission
  • Pertinent co-morbidities
  • Code status
  • Current isolation or precautions
  • Elopement risk
  • Lab results—including any pending and/or abnormal findings
  • Relevant diagnostic studies
  • Fall risk assessment
  • Any assessment findings that are appropriate to the patient’s current health

Many times, nurses on the receiving team care for patients for whom they lack pertinent health data. For example, EKG results are often left out of the transition communication between hospitals and subacute rehabilitation facilities. In this case, if a patient has an episode of chest pain, the receiving team could conduct an EKG on their own, but without prior results to compare with, they can’t successfully rule out something dangerous, such as angina. So, they may err on the side of patient safety and send the patient back to the hospital, resulting in a readmission. However, if an EKG result is included in the transition communication, the receiving team can conduct an EKG on their own, compare the results with the EKG performed at the hospital, and determine whether there is an emergent need for a readmission or the issue is something they can safely handle in their own setting.

Pay extra close attention to medication communications

While including all pertinent test results in the handoff communication is extremely important, there’s another area that needs special attention, because it causes more admissions than any other factor: medication.

It’s estimated that 30% of hospitalized patients have at least one discrepancy on discharge medication reconciliation. Communicating medication details is an area that poses the greatest risk for error as well as the greatest opportunity to effect a positive outcome. In fact, over 66% of emergency readmissions for patients over 65 years old are due to adverse medication events.

Breaches in handoff, such as failure to include specific details of the patient’s medication history and future dosage needs, have dire consequences.

However, defective handoffs are also known to cause problems beyond adverse events. Issues such as delays in care, inappropriate treatment, and increased length of stay arise when transition communication is not strategically planned and delivered.

There are many root causes of a defective handoff, but since nurses play the most important role in the transition communication process, you must strategically develop and communicate the transitional care plan—not only by considering what information you believe should be communicated, but by extending a dialogue to the receiving team and understanding what information they feel is necessary to provide the best follow-up care possible.

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