Last week, our cardiology anticoag team became concerned about a patient whose INR came back critically elevated, first at 5.3 and a week later at 7.2. Despite repeated attempts, we were unable to reach the patient or her emergency contact via phone or my care message. The patient did not have access to a working phone or computer, creating significant barriers to communication. After discussing options with Social Work, and without clear office procedures for this type of situation, our team escalated the issue to leadership for guidance. That's when Janet stepped in.

Upon learning that the patient had a primary care provider within the RRH system, Janet, who serves as a care manager at the OPD/TWIG location, received a call from her leader. Janet was not managing this patient but volunteered to conduct a wellness check and headed straight to the patient's home. When she arrived at the patient's home, she had to bang on multiple windows, which were boarded up, to get the patient to the door. At the same time, her son was pulling into the driveway, returning from paying the phone bill. Janet not only addressed the immediate concern but also checked in with the patient about her dog alongside her, making sure she felt safe. After leaving the home, she followed up with an email with Social Work to explore available resources, ensuring this type of situation can be handled more smoothly in the future.

Janet's ability to pivot and demonstrate flexibility to ensure our patient was safe and had a venue to communicate with our anticoag team truly displays one of our core values of Caring like Family.