Computer Scene Investigation (CSI):OE/RR

Crime SceneInpatient 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 SceneI 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 SceneHow 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