First of all lets make sure everyone really understands how things work when everything is working normally. Doctors orders are entered via P.O.M. system. An Order Session Print generates. Requisitions print to departments as ordered and lab labels print. Medication orders cross over to pharmacy, they review and validate them and they cross over to the M.A.K. system. Now lets look at each system having a downtime to when they are all down and what you, the Unit Secretary, need to do.

POM IS DOWN Orders cannot be entered. Doctors orders are handwritten on Downtime Doctors Orders "forms. You will need to have the forms available at your desk. You will need a Downtime Orders Trackerform. This is important to have for a smooth downtime recovery. You will also need Downtime Dept Requisitions and Downtime Lab Requisitions All downtime forms are available to print on the Patient Services website. You should also have a stock in your Downtime folder in the A-Z file.

POM IS DOWN What do I do with the doctors orders? As the doctors orders are written you will fax order forms to pharmacy that include medication orders. Write FAXED on the order sheet. Pharmacy will enter the orders into the Pharmacy system and they will cross over to MAK. Therefore, the R.N. can still continue to administer medications. Send now or stat labs to the lab with a Lab Downtime Requisition and a stamped 1x3 sticky label on the specimen. Order stat and now Radiology and other department tests by faxing the Downtime Dept. Requisition. Write DT under the Action Taken in the Downtime column to the right of the order and initial the By Whom column. Place the Downtime Doctors Orders form in the patients kardex/profile in the Orderssection. Write the patients name on the Downtime Orders Tracker form.

What do I do now? Using the Downtime Orders Tracker form, locate the Downtime Orders form(s) for each patient on the tracker. Enter all orders into the computer by using (32) Enter POM Orders" with the exception of medication and IV orders any labs that were performed during the downtime. Those will be entered by the laboratory department. any radiology or other department tests that were performed during the downtime. They will be entered by the department. If a test has not been performed yet, then you will need to order the test in POM even if you had faxed down a Downtime Dept. Requisition form. POM IS UP

POM IS UP (CONT) T each line in the Action Taken column under Computer Entry " as you enter the orders. Initial each line in the By Whom column as you transcribe. When you have completed the orders, each line should have either DT and initials in the Downtime column or T and initials in the Computer Entry column.

MAK AND PHARMACY ARE DOWN Orders can still be entered in POM but what about medication orders? Print the Downtime MARs You can still print Downtime MARs even after MAK has gone down. You will need to hand- transcribe to the Downtime MARs any medications ordered during the downtime. The R.N. will document medications given during the downtime on the Downtime MARs.

MAK AND PHARMACY ARE UP What do I need to do now? Pharmacy orders will cross over to MAK. The R.N. will need to do a med recovery which includes documenting in MAK any medications administered during the downtime. The Downtime MARs need to be filed in the patients record at the end of the Drs Orders-Section 2.

POM, MAK, AND PHARMACY ARE DOWN Follow the downtime plan for each of the systems. Dont forget, you may not be the person doing the recovery process when the system comes back up. Therefore you want to be sure you follow all the guidelines for addressing the downtime. This will make the recovery process a success as opposed to creating a disaster!

ADT FUNCTIONS ARE DOWN You are not able to perform any transfer and discharge functions. Transfer, discharge, admission status downtime forms are available on the Patient Services Website. Complete the appropriate downtime form for the ADT function and fax to the number on the form. Keep up the Patient Flow Worksheet accurately with times of arrival, discharge, etc. You may need this information when the downtime is over.

SOME TIPS Always be prepared! If a downtime is planned you will have advanced notice so that you can be sure you have all the forms you need. An unplanned downtime can happen at any time. Of course, chances are it will be one of those anything that could go wrong will days! Be prepared. Keep your A-Z file stocked with a good supply of all the downtime forms. They are all available to print on the Patient Services website. Also remember, if for any reason all computer systems go down, including the internet/intranet, you will not be able to get to the website to print the forms. Detailed information regarding the different types of downtimes can be found on the Patient Services Website.