Vanderbilt Outpatient Order Management Accessing the Staff Worklist Getting Started Setting Up Clinics/Providers Selection Launching from WhiteBoard Staff Worklist Overview Layout Setting Up Label Printer Column Description/Overview Taking Action on Orders In-Clinic Column Schedule Appts Column Schedule Tests Column Contact Patient Column Ancillary Canceled Column Past Due Column Preparing Specimens Collected In-Clinic Changing Dates on Orders Comments Status of an Order Page 1
Each department has their own Staff Worklist that orders will feed to, routed by the Epic Department numbers. Items that will feed this worklist are orderables that need action taken to complete such as scheduling a Radiology test, a return appointment or consult. The Staff Worklist is also setup to notify Staff if a patient did not have their labs drawn or test completed by the designated timeframe. Accessing the Staff Worklist The link to the VOOM Worklist is found in the black menu bar on the left side of the screen in Star Panel. Go to the Red Worklists header and click the arrow to expand the list. Toward the bottom of that list you will find the VOOM wlist, which is the Staff Worklist you will need. Launching the Worklist The first time the Staff Worklist is launched by a user the department will need to be selected. You also have the option to narrow down to certain Providers if you choose. To add clinics to My Clinics click on the +, which will change to a gold star. Page 2
Narrowing your list - Depending on the role, some staff may choose to narrow down their list to show orders for the specific Providers they directly support. Once the department has been selected, click on All Providers to display the list of Providers to choose from for your selected department. You have the option to choose one Provider or multiple at the same time. Please make note that if you choose to narrow your list you will only see orders from those Providers. If you are looking for orders on a Provider that you did not initially include, you will need to access this drop down list again and add that Provider to your choices. Changing Department and/or Provider selection - The Department chosen will display at the top of the screen. You can hover over the department name to see a pop-up with the Providers currently selected. Click on the department name in order to go back to the pop-up which allows you to change either the department and/or Provider selection. Page 3
Launching from White Board By clicking in the VOOM column for a particular patient, you will be rerouted directly to the orders submitted for that patient, which is housed in your staff worklist. Orders in Yellow indicate that there is an In-Clinic order included. 1/1 means there is total of one order and is an In- Clinic order, such as a vaccination 4 means there is a total of four orders but none are required to be completed by the clinic staff at time of visit 2/1 means there is a total of 2 orders, one of which is considered an In-Clinic order Page 4
Staff Worklist Overview Layout Select Label Printer For clinics who collect specimens In-Clinic and has a VOOM printer for lab labels, click on the Select Label Printer link to get a list of printer names and locations to choose from. Once you have selected the one you need hit o.k. You are now set-up to print labels for specimens when applicable. Page 5
Worklist Column Description The Staff Worklist is broken down into columns to distinguish what type of action needs to be taken. Similar to the numbers on the White Board, the numbers in each of the boxes tells how many orders there are in each category. Each column can be sorted by clicking on the column header. In-Clinic Orders These orders will always show up in Yellow, meant to grab staff s attention for items that need to be taken care of prior to the patient s visit ending. An example of an In-Clinic order is a vaccination given by the nurse and/or blood or urine collected in the clinic rather than the lab, etc. All items marked as Nurse will fall into this column. Schedule Appts Return visits and consults that need to be scheduled by staff will populate this column. Schedule Tests Diagnostic tests that need to be scheduled by staff will populate this column. Contact Patient There are 2 scenarios which will cause orders to fall into this column. 1. Providers can create orders outside of the context of an appointment for a patient and need to notify staff that the order needs to be taken care of and the patient contacted. An example after reviewing other test results the Provider decides that the patient needs an MRI. Instead of sending a message basket to staff they will click the check box next to Notify Staff to Contact Patient on the ordering page. These will then populate the Contact Patient column in the staff worklist. 2. In addition to new orders that need to be scheduled, VOOM also applies Order Reconciliation by tracking whether the patient has arrived for his or her test in a set timeframe. All orders initially default to an approximate 10 day window, which can be changed to a new end date at any time. Once the end date has arrived, if the patient has not completed the order, then it will populate the Contact Patient column. Staff will then be required to take action on that order by contacting the patient to remind them of the test(s) needed and any further action needed on the order. Ancillary Cancelled Occasionally there will be orders that will need to be cancelled by the Ancillary department for reasons such as, patient refusal to have test done, test ordered was incorrect, test no longer needed, patient decided to go to outside facility instead, etc. Past Due Once an order has hit the first initial end date, that order is automatically extended for an additional 4 weeks. Once that extended date has past, if the order has still not been completed, the order is considered Past Due and can no longer be acted upon. Page 6
To access the orders for a patient, click anywhere on the line, with the exception of the MRN. Clicking on the Blue MRN Link will take you to that patient s chart Page 7
Taking Action on Orders from the Worklist: In-Clinic Column Immunizations, once the staff member has completed they will hit Done to complete the order on the worklist. Labs drawn/specimens collected in the clinic, the staff member will need to print the labels. If collecting specimens for all orders, hit Print in Clinic Orders at the top right of the screen. If you are not doing all of the tests in the order then you will use the Print Labels button next the individual tests that you are collecting on. Printing the labels will complete the order on the worklist. *** Some orders may require additional information in order to complete, for example many cultures will require a site to be determined. You will be unable to print labels for this order until the required information has been entered. *** Page 8
Schedule Appts Column Orders such as Return Appointments and Consults will fall under this column. Details for when to schedule these appointments for are found in the Information column within the order. Return Appt Orders Once the return appointment has been made in Epic, the staff member will go back to the worklist and hit scheduled. Once the correct appointment has been highlighted, hit ok. Consult Appt Orders Once this has been completed, simply hit Done to finish the order in the worklist Page 9
Schedule Tests Column Items that fall into the Tests Column may include Ultrasound, Mammogram, MRI/MRA, CT, EKG, Colonoscopy, Stress Test, Spirometry; etc The Actions buttons will vary depending on the test that has been ordered. Some will require you to hit the Scheduled button and choose a date from a pop-up calendar once you have taken care of scheduling the test. Others will simply require you to hit Done to complete the order once you have scheduled the test. For those requiring a date, an additional pop-up will appear in order for you to select which location the test was scheduled at. The location field is required. Page 10
Once you have scheduled the test ordered, hit Done to clear it off of your worklist. Patient Going to an Outside Facility For patients who choose to have their tests performed at a non-vanderbilt/non-affiliated location, you have 2 options on how to complete these orders. At the top right of the screen, click on Print/Fax Order Req which will display the below pop-up. Page 11
Fax and Complete- for locations that you and/or the patient know the fax number, this option will provide you with an additional window to enter the location and fax number information. The order will be sent directly from Star Panel to that fax number and will complete the order from the worklist. Print and Complete- this option is best for patients who need to take the actual order with them to an outside facility. This will complete the order from the staff worklist Both of the above options will create a message in the Information column for each order stating that the order will be performed at an outside facility and will now have a Reactivate button. At any point if the order was both printed/faxed and completed by accident or if the patient changed their mind, you can reactivate the order. In addition to having the option to Print Order Summary for the patient, you also have the option to print/fax the requisition without completing it from the worklist. Contact Patient Column When the current date is either on or past the initial End date for an order and the patient has not had the tests completed, they will show in the Contact Patient Column and is need of a reminder call. The order is still valid at this point. The system automatically extends the end date an additional 4 weeks. In order to clear this order from your list you must contact the patient. Once you have done so, click on the blue phone icon, select the statement that best applies and hit OK. A Message Basket will be created in the frame below to be saved to the chart for documentation. Page 12
Ancillary Canceled Column Lab, Phlebotomy or Radiology may choose to cancel an order for various reasons some of which may include Duplicate Order, Patient Refused, Condition No Longer Warrants, etc. By hitting Done, you have acknowledged the cancellation and it will be removed from the worklist. Past Due Column All orders are extended an additional 4 weeks once it has hit the initial End date. If the order has not been completed once the extended 4 weeks has past, then the order will fall into the Past Due Column and is no longer active. In order to see the full list of tests ordered, hit the grey circle on the left. Several actionable options are available for Past Due orders: Done- you have acknowledged that the order is past due and will clear it from the worklist. Reorder- will clear it from the worklist and launch the VOOM Ordering screen for that patient. Msg- launches message basket in the window below with a message regarding the expired order prefilled in the message box. You then have the option to send that to another basket or save to the patient s chart for documentation. This will clear it off of the worklist. Prior to taking action on any of these orders, you can add a note to all by clicking on the Comment button. This will allow you to document information for the orders which will be saved in the order to the patient s chart. Page 13
Preparing Specimens Collected In Clinic For clinics who have the VOOM label printers, when specimens are collected in the clinic for an order in VOOM it is the clinic s responsibility to print the VOOM/Lab labels before sending to the lab. The Provider or Nurse entering the order must hit Nurse under the Performed By column when ordering the test(s). This will force the order to fall into the In-Clinic Order Column on the worklist and will be highlighted yellow. If Nurse was not selected, clinic staff will not be given the option to print the labels. This must be fixed prior to sending the specimen to the lab. To change the Performed By to Nurse on an order that was placed on that same day, you will launch the patient s chart. The best way is to go to WhiteBoard and click on the patient s name so the appointment will be associated with the order and VOOM will know who the ordering Provider is. In the cart you will see the order(s) submitted that day with a Recall link to the left of each order. Once you click on the Recall for the orders you need access to, you will be able to change the status under the Performed By column to Nurse. Once changed, hit Send Orders. You can now go back to the Staff Worklist and see that the option to Print In-Clinic Orders is no longer greyed out. For screen shots of this click here *** Please note, by not taking these above steps to change the Performed By in order for staff to print the labels, for specimens collected in the clinic and sent to the lab, will result in the order remaining on the Staff Worklist. VOOM will view this order as not complete and will follow the same format of falling into the Contact Patient column and eventually the Past Due column. This in turn will create unnecessary work for clinic staff to do. *** Page 14
Changing Dates on Orders All staff has the ability to adjust the dates on any order. Oftentimes the initial dates that an order defaults to will not work for the patient or the facilities schedule. To keep an order from falling into the Contact Patient/Past Due cycle the dates on the order may need to be changed. This can be done by clicking on the end date, which provides you with a pop-up calendar to choose a new date. Comments The Information column is used to display communication and notes regarding either the order or patient. Anyone is able to add comments by clicking on the view/edit link. Page 15
After you have finished the comment, hit ok to save it in the worklist for all other staff to have access to. Status of an Order During the life cycle of an order VOOM will update the current status on the Patient Detail Screen. In addition, on the Patient List Screen VOOM will communicate any directives that need to be given to the patient. In Clinic Order Test to be completed in the clinic and requires staff action. Click here for further instruction Order Sent Order has been sent to the appropriate Ancillary worklist to be completed. No further action required by staff. Completed - Action needed has been completed. No further action required by staff. Canceled If canceled by clinic staff, will display Canceled. If canceled by Radiology or Lab, it will display Rad Canceled, Phleb. Canceled or Lab Canceled. Staff are required to hit Done, which will acknowledge that it has been canceled. Page 16
Past Due- Orders that have not been completed by the patient by the extended end date. Action by staff is required. Click here to route to further instruction Future - Test ordered for a future date. Depending on the order requested, staff may need to take action such as scheduling. Scheduled Shows that an order that requires scheduling and been taken care of. No further staff action is required. Page 17