Health Unit Coordinating

An Allied Health Career

On completion of this chapter, you will be able to:

1. Define the terms in the vocabulary list.

2. Write the meaning of the abbreviations in the abbreviations list.

3. Identify four stages that health professions have traditionally gone through to become a profession.

4. Explain the events that led up to creating the position that eventually became known as health unit coordinator (HUC).

5. List five benefits of being a member of the National Association of Health Unit Coordinators.

6. List five benefits of becoming a certified HUC.

7. List three tasks that the HUC would perform related to each of the following: nursing personnel, doctors, hospital departments, patients, and hospital visitors.

8. Discuss the benefits of using the electronic medical record (EMR), computer physician order entry (CPOE) with e-prescribing, and clinical decision support system (CDSS).

9. Identify four ways to prepare for the changing HUC position with the use of EMR and six things that the HUC can do to stay current in the position.

10. Demonstrate use of the Internet and search engines to locate information on the Web.

11. List three positions in which the HUC may be cross-trained.

12. List two possible nonclinical career choices for the health unit coordinator.

Vocabulary

Browser

A computer program that allows one to search for and view (or hear) various kinds of information on the Web, such as websites, videos, and audio files.

Certification

The process of testifying that a person has met certain standards, or endorsing him or her as having met them.

Certified Health Unit Coordinator (CHUC)

A health unit coordinator who has passed the national certification examination sponsored by the National Association of Health Unit Coordinators (NAHUC).

Clinical Decision Support System (CDSS)

An interactive decision support system (DSS) computer program designed to assist physicians at the point of order entry.

Clinical Tasks

Tasks performed at the bedside or in direct contact with the patient (direct patient care).

Computer Physician Order Entry (CPOE)

A computerized program into which physicians directly enter patient orders; replaces handwritten orders on an order sheet or prescription pad.

Doctor

A person licensed to practice medicine (used interchangeably with the term physician throughout this textbook).

Doctor’s Orders

The health care that a doctor prescribes in writing for a hospitalized patient.

Electronic Medical Record (EMR)

An electronic record of patient health information generated by one or more encounters in any care delivery setting.

E-Prescribing (electronic prescribing)

The electronic transmission of prescription information from the prescriber’s computer (hospital or doctor’s office) to a pharmacy computer.

Health Unit Coordinator (HUC)

The health care team member who performs nonclinical patient care tasks for the nursing unit (also may be called unit clerk or unit secretary).

Hospital Departments

Divisions within the hospital that specialize in services, such as the nutritional care department, which plans and prepares meals for patients, employees, and visitors.

Internet Service Provider

A company that provides Internet connections and services to individuals and organizations for a monthly fee.

Meaningful Use (EMR)

Use of certified electronic medical record (EMR) technology in ways that can be measured significantly in quality and in quantity.

Nonclinical Tasks

Tasks performed away from the bedside (indirect patient care).

Nurses’ Station

The desk area of a nursing unit.

Nursing Team

A group of nursing staff members who care for patients on a nursing unit.

Nursing Unit

An area within the hospital that includes equipment and nursing personnel available for the care of a given number of patients (also may be referred to as a wing, floor, pod, ward, or station).

Patient (pt)

A person who receives health care, including preventive, promotional, acute, and chronic, and all other services in the continuum of care.

Policies and Procedures

Information such as guidelines for practice and hospital regulations found online or in a manual.

Recertification

A process by which certified health unit coordinators exhibit continued personal and professional growth and current competency to practice in the field.

Search Engine

A website that collects and organizes content from all over the Web.

Surfing the Web

Using different search engines on the Web to locate information.

Transcription

A process used to communicate the doctors’ orders to the nursing staff and other hospital departments; computers or handwritten requisitions are used.

Web Address (uniform resource locator [URL])

A series of characters (often preceded by “http://www”) that, when entered into the address bar of an Internet browser will take the user to a specified location, referred to as a website.

ABBREVIATIONS

Abbreviation	Meaning
CDSS	clinical decision support system
CHUC	certified health unit coordinator
CPOE	computer physician order entry
EMR or EHR	electronic medical (health) record
HIMSS	Healthcare Information and Management Systems Society
HUC	health unit coordinator
SHUC	student health unit coordinator
pt	patient
www	World Wide Web

EXERCISE 1

Note: All exercises in this textbook are provided on the Evolve website. To access your student resources, visit http://evolve.elsevier.com/Gillingham/HUC/.

Write the abbreviation for each term listed.

1. certified health unit coordinator

2. electronic medical (health) record

3. student health unit coordinator

4. patient

5. health unit coordinator

6. clinical decision support system

7. computer physician order entry

8. Healthcare Information and Management Systems Society

9. World Wide Web

EXERCISE 2

Write the meaning of each abbreviation listed.

Introduction to Health Unit Coordinating

The health unit coordinator (HUC) is usually the first person encountered when one walks onto a hospital nursing unit. The HUC has always been considered essential to the nursing team and to the effectiveness of the unit. The HUC coordinates activities on the unit, monitors the electronic medical record (EMR), or transcribes handwritten or preprinted doctor’s orders, and functions under the direction of the nurse manager or unit manager. The overall job is nonclinical in nature, and the work area is the nurses’ station (Fig. 1-1). Most everyone who works on or visits the nursing unit depends on the HUC for information and assistance.

Figure 1-1 The health unit coordinator’s work area is the nurses’ station.

Comments often heard in the hospital include the following:

• “We are so disorganized if the HUC isn’t here.”

• “The HUC creates the attitude for the entire unit.”

• “The HUC sets the pace for the day’s work.”

• “Ask the HUC—HUCs usually know everything.”

Working on a nursing unit can be very fast paced and stressful; the HUC must possess a calming, pleasant, and professional attitude, because the HUC sets the tone for the unit. Whether an efficient HUC is working on a nursing unit is usually obvious to anyone who walks onto that unit. If the HUC is having a bad day or is in a bad mood, the whole unit is affected because everyone has to interact with the HUC. It is important for staff members to maintain a positive, friendly attitude when working on the nursing unit. The HUC can enhance or inhibit the delivery of health care to patients on the unit. The position involves many responsibilities associated with assisting the nursing staff, doctors, hospital departments, patients, and visitors to the nursing unit (Fig. 1-2). Many health care facilities require the HUC to wear scrubs, sometimes in a particular color, whereas other facilities opt for professional, nonclinical dress. In some facilities, HUCs may be cross-trained and may alternate working as HUCs, a nonclinical position—away from the patient bedside—and as certified nursing assistants (CNAs; discussed in Chapter 3), a clinical position—at the patient (pt) bedside. HUCs also may be employed in doctors’ offices, clinics, and long-term care facilities to assist with clerical or management duties related to patients’ health records.

Figure 1-2 The health unit coordinator coordinates the activities of doctors, nursing staff, hospital departments, patients, and visitors on the nursing unit.

History of Health Unit Coordinating

Traditionally, health professions have evolved through four stages: on-the-job training, formal education, formation of a national association, and certification or licensure. Health unit coordinating is no exception to this tradition.

On-the-Job-Training

During World War II, hospitals experienced a drastic shortage of registered nurses. To compensate for this shortage, auxiliary personnel were trained on the job. The HUC was trained to assist the nurse with nonclinical tasks, and the nursing assistant was trained to assist the nurse at the bedside.

After World War II ended, the nursing shortage was not as critical; however, as technology advanced and the workload of the doctor increased, many tasks shifted to the nursing staff (e.g., taking blood pressure and starting intravenous therapy). Hospitals were becoming larger and more complex; there were more specialists, who were ordering newly available tests and treatments. Federally sponsored health programs required more detailed record keeping, and nonclinical demands for every hospitalized patient increased proportionately, so the need to employ HUCs continued. Today HUCs remain valued members of the hospital’s health care team, and the role continues to change and expand. HUCs were trained on the job for longer than 20 years (Fig. 1-3, A and B).

Figure 1-3 History of health unit coordinating. A, In 1940, health unit coordinating was first introduced as a health care occupation. The first job title was “floor secretary.” B, In 1962 the more common title was “ward clerk.” More responsibilities were added to the job. C, In 1966 the first vocational educational program for health unit coordinating was established. D, On August 23, 1980, the first meeting to discuss the formation of the National Association of Health Unit Coordinators/ Clerks was held in Phoenix, Arizona. E, In 1983 the first certification examination was offered by the National Association of Health Unit Coordinators/Clerks. F, Logo for the National Association of Health Unit Coordinators. The five outer segments represent doctors, nursing staff, patients, visitors, and hospital departments. The circle that connects the segments is symbolic of the health care coordinator’s role in coordinating the activities of these five groups. In 1990, “clerk” was dropped from the name of the association, which is now known as the *National Association of Health Unit Coordinators.*

FIRST RECORD OF HEALTH UNIT COORDINATING—1940

An article published in Modern Hospital authored by Abraham Oseroff, a hospital administrator, stated, “A new helper was introduced to the nursing unit to take care of the many details of a secretarial nature that formerly made demands on the limited time of the nurse.” The title of the new helper was “floor secretary.” Oseroff wrote, “The idea of floor secretary was first met with skepticism, but it proved to be worthwhile from the beginning.” The hospital was Montefiore Hospital in Pittsburgh, Pennsylvania.

In 1966 a research project led to the implementation of one of the first educational programs for health unit coordinating at a vocational school in Minneapolis (Fig. 1-3, C). An article published in Nursing Outlook authored by Ruth Stryker described the project and recommended that the title “ward” or “unit clerk” be changed to “station coordinator” because the data showed that the unit clerk did a great deal of managing in the form of coordinating activities. Ruth Stryker later wrote one of the first textbooks for health unit coordinating, The Hospital Ward Clerk, which was published by the C.V. Mosby Company in 1970.

Today, before employment, most HUCs are educated in one of the many community colleges or vocational technical schools nationwide that offer HUC educational programs. The individual who completes a program emerges with better preparation for the job and a greater knowledge base on which to build. Educational programs outline the competencies or job skills that students are expected to acquire by the time they have completed the program (Box 1-1, Example of Competencies for an Educational Program for the Student Health Unit Coordinator).

BOX 1-1 EXAMPLE OF COMPETENCIES FOR AN EDUCATIONAL PROGRAM FOR THE STUDENT HEALTH UNIT COORDINATOR

On completion of this program, the student demonstrated the ability to:

• perform health unit coordinator (HUC) tasks and provide accountability to nursing personnel, medical staff, other hospital departments, patients, and visitors

• manage and operate the nursing unit communication systems, including Internet, telephone, scanner, fax machine, intercom (patient call lights), locator, mobile wireless devices, and pager systems

• record diagnostic test values, vital signs, and census data; order daily diets and daily laboratory tests (when required)

• scan reports into the patient’s electronic medical record (EMR) or send them to Health Information Management (if paper charts are used, insert the reports into the patient’s chart)

• transcribe doctors’ orders (when paper charts are used) or monitor patient orders (when electronic medical records are used) using basic knowledge of anatomy and physiology, disease processes, medical terminology, and approved abbreviations

• coordinate scheduling of patients’ tests and diagnostic procedures (when required)

• prepare patient consent forms (when required)

• transcribe medication orders, incorporating concepts of drug categories, automatic stop dates, time scheduling, and routes of administration (when paper charts are used) (most hospitals have implemented e-prescribing, eliminating the transcription of medications by the HUC)

• schedule radiologic procedures that require patient preparation (when required)

• maintain patients’ paper charts, or manage patients’ electronic records

• perform nonclinical tasks required for patient admission, transfer, discharge, and preoperative and postoperative procedures

• plan and execute a daily routine for the performance of nonclinical tasks for the nursing unit

• manage the nonclinical functions of the nursing unit and maintain nursing unit equipment and supplies

• distribute wireless mobile devices at the beginning of shift and collect at end of shift

• communicate effectively with patients, visitors, and members of the health care team

• listen to patient and visitor complaints and concerns, and use problem-solving skills

• practice within the professional ethical framework of health unit coordinating

Professional Association

The HUC position existed and grew for 40 years without the guidance of a professional association. The purpose of a professional association is to set standards of education and practice for peers to be enforced by peers for the protection of the public. Altruistic in nature, it is designed to enlighten its members and guide the profession to better serve the public. The constitution states the basic laws and principles of the association, and elected officers carry out the purpose listed in the constitution. By 1980, several HUC educational programs were well established across the nation, and educators in these programs began to discuss the possibility of forming a national association.

The first organizational meeting was held in Phoenix, Arizona, on August 23, 1980. This date has since been proclaimed National Health Unit Coordinator Day by the national association. The 10 founding members who represented both education and practice (Box 1-2, Founding Members of the National Association of Health Unit Coordinators) declared the formation of a national association for health coordinators to be called the National Association of Health Unit Coordinators (NAHUC) (Fig. 1-3, D). A new title, Health Unit Clerk/Coordinator, was created for the position; the title would be updated and used consistently nationwide. Because “unit clerk” was the most popular title nationwide in 1980, it was included in the title with the intent that it would be dropped when the term “coordinator” became recognized. In 1990, the national association became the National Association of Health Unit Coordinators, after “clerk” was dropped from its name (Fig. 1-3, F).

BOX 1-2 FOUNDING MEMBERS OF THE NATIONAL ASSOCIATION OF HEALTH UNIT COORDINATORS