Iowa Code r. 481-53.8 - Interdisciplinary team (IDT)
The IDT shall establish a plan of care for each patient based on assessments performed by team members.
(1) The interdisciplinary team shall include,
but is not limited to, the:
a. Patient, to the
extent the patient is able and willing to participate;
b. Hospice patient's family, to the extent
the family is able and willing to participate;
c. A doctor of medicine or osteopathy who is
an employee of or under contract with the hospice;
d. Patient care coordinator;
e. Registered nurse;
f. Social worker; and may include
g. A pastoral or other counselor and others
deemed appropriate by the hospice.
(2) Within 48 hours of admission, the
attending physician or registered nurse and at least one IDT team member shall
develop an initial plan based on a preliminary assessment of the patient
needs.
(3) Within five calendar
days of admission, the interdisciplinary team shall assess the needs of the
patient and family. A care plan shall be based on these findings.
(4) Within five calendar days of admission,
the interdisciplinary team shall meet to develop a comprehensive written plan
of care. The plan of care shall:
a. Identify
the primary caregiver or an alternate arrangement for care;
b. List the needs of the patient and
family;
c. List any intervention
planned to meet the needs of the patient and family and the results expected
from each intervention;
d. Indicate
which team member(s) is responsible for each intervention;
e. Indicate the anticipated frequency of each
intervention; and
f. Indicate the
prognosis and expected disease process.
(5) The IDT shall monitor and revise the plan
of care on a regular basis. The team shall meet at least every 15 days and
exchange information regarding the needs of the patient and family. Changes in
the care plan shall be made when the needs of the patient or family change or
when interventions do not result in the expected or intended response.
This rule is intended to implement Iowa Code section 135J.3(5).
Notes
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