Computer Scene Investigation (CSI): OE/RR

Crime Scene Inpatient sig codes are not expanding like they do for outpatients The Pharmacist calls to report that the codes used to build the sig in the orders expands properly on the outpatient side but is NOT expanding on the inpatient side...for example, “BID” will show on the outpatient label as “two times each day” but still says “BID on the inpatient MAR that was printed form RPMS. What is wrong?

Sig code expansion Solution: – This is intentional…expansion is needed on the outpatient side since these need to be “patient- friendly”. – Inpatient instructions will be used by other medical personnel, who should be familiar with the abbreviations used, and it will save space and formatting issues on the printed MARs Pharmacy package set up of these codes should take into account the “approved abbreviations” and/or “unapproved abbreviations” lists for the facility Non-standard abbreviations should be avoided (e.g. “BTID” to mean “two to three times each day”)

A User calls and states that “Delayed Orders” now shows at the top of the list of options on the orders tab…what is it? Can you move it to the bottom because I don’t like it there… Crime Scene: A new option suddenly showed up in the orders tab called “Delayed Orders”

Delayed Orders Solution: – “Delayed Orders” is related to admissions, to allow the provider write orders that will not be active until the patient is actually admitted to the unit – It will always occupy the top position

A provider calls stating that he is admitting a patient who is on several medications that were obtained from another pharmacy, and which our pharmacy does not stock. They need to be continued during the admission, but he cannot figure out how to order them…can you help? Crime Scene I need to order a medication the patient will be supplying, not the pharmacy

Patient supplied medications Solution: – The pharmacy can add several entries to the drug file as “Patient’ own med” Will need entries for different dosage forms (tablet, capsule, ointment, etc.) May need more than one entry per dosage form if it is possible the patient might have more than one medication The actual agent will need to be added to the comments by the provider Will NOT participate properly in order checks – Pharmacy can add the actual agent to the drug file Will need to go to POS and mark them as “unbillable” May need to add a suffix to the drug name indicating it is a patient supplied item Will participate in order checks if matched to NDF, etc. Can cause confusion to providers thinking it is a stocked item

The pharmacist making the inpatient quick orders calls with the above question…what is the difference between these types of quick orders and which one should be used when? Crime Scene: I can’t tell if I should make quick orders as type “Inpatient Medications” or “Unit Dose”

Quick Order types for Inpatient Medications Solution: – There is no functional difference between the two types Sites may choose to use either type for all non-infusion quick orders Sites may decide to locally determine which type should be used for which item – Would only be useful if using Quick Order Wizard or performing Fileman searches for specific types of quick orders

Crime Scene How do I view JUST the discharge medications in EHR? The billing office calls stating they need to get a list of medications that ONLY includes those ordered at discharge…how can they get such a list?

Custom order views Solution: – Users can customize the ORDER view to show only outpatient pharmacy orders from a certain date or date range