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Archive for June, 2012

Extra CSF

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Written by reuben

June 29th, 2012 at 3:42 pm

Posted in Labs

Inpatient Physician Documentation is coming June 10

This affects what you do in Epic, in two ways:

1. You can finally see what the residents and attendings upstairs are charting on that patient you admitted (currently, all you can see are nursing notes – and it’s hard to read between the lines of fall risk assessments).

2. You can see what your consult wrote, without looking for a scanned piece of paper in the “media” tab. Easy-to-read typed out consult notes will appear under Chart Review in the Notes tab

So… has anything changed about ordering a consult? Well, yes:

You now need to order the consult, to make the patient appear on the consultant’s worklist. Sure, you still have to talk to the consultant, and can call AMAC (x43611) to page a consult, AMAC will go ahead and do that, and they will make a note of the time you called. But AMAC can’t place orders – only you can do that. This may seem like a hassle but it’s a good thing, because it will mean the consultant notification time is unambiguous and easily reportable and there will be less tedium about reading MRNs and spelling names over the phone.

You order the consult by going into the patient’s chart, clicking orders, and typing “consult neuro” or whatever service you want. You’ll be presented with a window asking you to choose Neurology, or Neurosurgery, or Neuropsychology, or others… In the order box you can state the reason for the consult (good exercise) and while a callback number is not required to place the order, it’s a good idea.

— in the ED, the consultant may ask you (or a BA) to be marked as “arrived” — this is important for their metrics (we are watching them!). You do this like you always do — go into Communications, click Shared Consult, and then find the specialty of the consultant and click “Consult Arrived” … only now, there’s no sheet of paper to print and hand to the consultant.

— how will you know the Consult note has been entered? In many trackboards, there’s an icon under the “Consults” column — this will change from the blue telephone to something new when the consult note is signed. I’m not even sure what the new “done” icon will look like, but can’t wait to find out. Here’s the “consult order placed” icon:

There’s also a whole “Consults” trackboard, if you want to get a sense of how many Ortho consultations your patient will have to wait through, before getting to yours.

So, that’s it for big changes. I really do look forward to better consult note legibility and better followup on admitted patients, now that we’ll be able to read their notes in Epic — hope you find it useful, too.

Nick

Written by reuben

June 9th, 2012 at 9:20 pm

Posted in Epic