May 17, Volume III, Issue 5

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1 May 17, Volume III, Issue 5 Violent Restraints: Accessing One Hour Face-to-Face Template in EPIC The Joint Commission requires a patient who is placed in restraints for violent behavior to be seen by the patient s Licensed Independent Practitioner (LIP) within one hour of the restraint application. There is a One Hour Face-to-Face template now available in EPIC to assist the LIP in completing this evaluation. 1. Enter into patient s chart through EPIC 2. Select Notes from left hand column 3. Select New Note 4. In SmarText section, type in GEN: RESTRAINT and press Enter. Interventional Radiology Consults There is now a specific order in Epic for consultations to Interventional Radiology. It is CON0019 Consult to Interventional Radiology. When this consult is entered, a transmittal prints to the Special Procedures department and goes to an in-basket pool for the radiologists. Rescheduled Dictaphone Upgrade On Tuesday, June 8, GSH and MVH Dictaphone Dictation systems will be consolidated, but the phone numbers to access GSH or MVH dictation will remain the same. WHEN ACCESSING THE DICTATION SYSTEM, IF THE SAME USER ID# EXISTS AT BOTH GSH AND MVH, YOU MAY BE PROMPTED TO CHOOSE A SITE 1 FOR MVH OR 2 FOR GSH. If you have any questions or encounter any problems logging into the dictation system, please contact the Centralized Transcription Department at ext or Order set Changes The first CPOM order set enhancement has been rescheduled for May 18-20, In addition to OS specific change requests, changes have been made based on physician request to the Level of Preference and Unit selection, Cardiac monitoring including cardiac treatment guidelines and conditional medication orders. Staging the release of orders over a few days was the recommendation of the CPOM Physician committee. The schedule for order set release will be posted in the physician lounge. The first time you use an order set that has been changed, you will receive a reminder that the order set that has been changed and you will be required to reset user defaults for the section(s) of the order set that has been changed. The first enhancement after the initial CPOM go live tends to be more robust than subsequent quarterly enhancements. As we move forward, changes will be made quarterly, unless there is a patient safety or practice reason to expedite order set change. This will reduce the nuisance of having to resave your preferences so frequently. This approach has worked well at MVH. We encourage you to provide feedback regarding this quarterly batching of changes approach to Joyce Hott or Michele Marshall, ext Thank you for your continued support if CPOM. CPOM and DNR Orders The roll-out of computerized physician order management (CPOM) has provided many positive benefits to patients and bedside staff; however, as with any major change, we have encountered some issues that need further clarification regarding current policy.

2 Although there was an attempt to be sure CPOM did not cause confusion with any policy or procedure, we did expect to find some things that needed to be reviewed as they became known. For example, a recent incident that occurred with a patient with a DNRCC order that was confusing to staff. They had been educated to look for the State DNR form on the chart. Because of CPOM, this patient did not have the paper form but did have the physician order entered into the computer. Staff wondered if legally the order was enough. Should they code or not code the patient? So, we took this question to our Legal experts. Our legal department states The Ohio DNR Identification Form (currently in paper) is specifically recognized by the Ohio Revised Code as a means to gain the protection of the Ohio DNR statute. Therefore, the hospital uses it in addition to the Epic order. The need for both steps is being communicated to all staff. We appreciate your efforts to ensure we are giving the best care to our patients in the safest manner that respects our patients wishes to the end. YOU RE INVITED You and your spouse or guest are invited to attend the General Medical Staff Meeting Thursday, May 20, 6 9 pm University of Dayton Arena Please call or to RSVP

3 June Enhancements Medical Staff CHART BASICS 1. Patient Header will have New Orders, New Results & Refresh Icon 2. New Patient Summary Report Dr. Catch All Labs (All Results Accordion Report) 3. Viewing Results Review in Chart Review (Lab Tab) 4. Viewing Nursing Flowsheet Notes NOTES 1. Interval H&P (Up to 30 Days Prior to Admission) 2. (Currently Available) Bridge Note ORDERS 1. Linked Orders 2. Ad Hoc Orders to Order Sets 3. Panels as SmartGroups 4. Frequency on the Fly 5. TPN Orders Summary Report 6. Mixture Medications at Discharge 7. Rounding Navigator > Orders View options: Sort by Type or Sort by Order Set EARLY ENHANCEMENTS (5/10/2010) 1. Routing (Faxing) Notes 2. Inpatient NoteWriter (Medical Staff Progress Notes or H&P) Contact Joyce Hott (GSH x1229) for additional information or to arrange for a demonstration or training, if desired.

4 Dr Catch All Labs There is a new Accordion report titled Dr Catch All Labs, which displays all results, including Pathology, CT, Imaging, Nuclear Medicine, and Ultrasound: Notes: The accordion report has the ability to expand or collapse sections of tests (e.g., Chemistry, Microbiology, Diagnostic X-Ray); but it does not have the ability to select different time increments (e.g., 2 hours, 4 hours, 8 hours). [P] indicates Preliminary result.

5 Save the Bridge Note as an H&P Note Type When creating and saving (Accepting) a Bridge Note, identify the note type as an H&P, so that it gets filed under the H&P tab in the Notes Activity. To indicate that a New Note is an H&P, enter 4 or type H&P in the Type: field of a New Note OR, select H & P Notes from the Direct Admit navigator. From either starting point, using the SmartText template named sur: bridge note will invoke the Bridge Note, as follows: Press [F2] or the yellow, right arrow button changed: to complete the question regarding if the patient s condition has Once you click Accept, the Bridge Note is filed to the H&P tab, along with the H&P:

6 DISCHARGE MEDICATIONS The SmartPhrase (dot phrase).ptmeddischarge will link to the discharge medication list. Make sure you use the SmartPhrase AFTER completing the discharge medication reconciliation.