Kelly,

My reply here is rather detailed, but it is hard to squeeze my 3hr MUSE
presentation into an e-mail message.

We are about 280 beds with 250 physicians.

We use NPR reports with the DPM of OE.ORD as "custom output formats" in
the OE Procedure dictionary.

Our Patient Teaching materials have names of OE.ORD.zcus.p000 -
OE.ORD.zcus.p999
Our Standing Orders have names of OE.ORD.zcus.001.1 - OE.ORD.zcus.765.1

Among others, we have two categories in OE of "SO" and "PTEDHAND"

An example of a standing order is "701".  The npr reports associated
with it are:
OE.ORD.zcus.701.1 (page 1), OE.ORD.zcus.701.2 (page 2), etc.  The OE
Procedure is 0701, with custom output formats of the NPR reports
associated with that order (i.e. OE.ORD.zcus.701.1).

When they need to be revised, I copy them to "r1" versions (i.e.
OE.ORD.zcus.701r1).  Once the revisions are approved, I delete the ".1"
version, and then rename the "r1" to ".1".

Staff can perform lookups in OE using the standard Meditech routines.
For example, *Insulin<lookup> will search all procedures with "Insulin"
in the name.  

We duplicate the "procedures" in OE for each doctor, so staff can
perform lookups by doctor.

Patient Ed Materials are managed by a secretary in Education Department.
Although we use NPR reports to print them, She actually uses IATRIC's
"Forms On-Line".  

Pt Ed Materials are created in MS Word, and saved as "P0001" through
"P9999".
The NPR reports are OE.ORD.zcus.p0001 - OE.ORD.zcus.p9999.  All of the
NPR reports look exactly alike.  They call the MSWord file with the same
name as the report name.  For example, OE.ORD.zcus.p0423 calls/prints
the MS Word document saved as P0423.  As a result, the secretary doesn't
have to do anything with the NPR reports themselves.

She then edits the OE Procedure dictionary adding the appropriate
"Custom Output Format" to the procedure she is initiating.

Staff can then search the PTEDHAND procedures looking for the material
they need.

The neat thing about this is how we use the above NPR reports (Standing
Orders and Pt Ed Materials) with our other orders.  When staff enter an
order for a "Ultrasound Biopsy", the standing orders and patient ed
materials automatically print because they are also associated with the
OE Procedure US Biopsy.

Most of this information is in the presentations I offered at MUSE.  See
if they are still on the MUSE website.  If not, I can try to dig them
out of my files.

Brian

-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Kelly Lippold
Sent: Thursday, October 26, 2006 3:44 PM
To: Meditech-L (E-mail)
Subject: [MEDITECH-L] Physician routine orders and discharge
instructions


Hello,
 
I'm needing some expert input.  We are a 200 bed hospital with multiple
physicians.  Each of these physicians have numerous routine orders and
discharge instructions creating hundreds of various papers.  How do your
facilities deal with these?  Do you use standardized documents, a
specific program?  How do you keep them updated - do you use a specific
person or do you have a committee that looks at them?  We're moving into
Meditech CS 5.5 and are just wanting to get some current processes
smoothed out.  I would appreciate hugely any input.  Thanks in advance.

Kelly Lippold, RN, MSN
Nurse Informaticist
Salina Regional Health Center
(785)452-4630



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