SOURCE T T RGORY BY D D - Sault Area Hospital QA Website.pdf · SOURCE T T R GORY BY D D ? General...

September 18 2019

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Complex Care

Complex Care Workflow

Session (May 27)

SOAPE documentation – need re-education across the hospital, possibility

of an LMS?

this will be covered in the training for all staff, an LMS will

be developedGap H. Hickey

X


Session (May 27)

Mobility assessment (new) - needs to be implemented prior to go live

(paper version – Leslie/Lindsay), make it look like the same format as

Meditech so familiar on go live

Senior Friendly working group has plans to work on

implementation. Date TBD

Gap L. Burtch


Session (May 27)

Blaylock (which standards of care is this tied to?, rename – not Discharge

Blaylock just Blaylock) DoneGap J. McEachern

X


Session (May 27)

Would be nice to book housekeeping/portering through the Meditech

system, or alert them of a discharge automatically

Functionality does not exist in Meditech Today but this can

be looked at in the future.

Gap E. MrowiecX


Session (May 27)

IV Assessment – check why it’s not auto-populating on interventions after

IV ordered It's working now. Gap J. McEachern

X


Session (May 27)

24 hour review – what happens if day nurse doesn’t acknowledge then

night nurse can’t acknowledge and double check his/her own work

process issue, organization will need to determine if ok to

have a nurse acknowledge and review same order

Gap J. McEachernX


Session (May 27)

What will the physical chart look like for the organization? File folder?

Will it be the same throughout the organization so that it is consistent?

(ie – I transfer you a patient, I get the patients file folder and I give you a

blank one in return)

See similar question in General with recommendation to

maintain status quo for now.

Gap M. Lindstedt


Session (May 27)

Phone system - end of life with current option, what will this look like?

Any way to integrate to Meditech

Seeking further clarification regarding the question -

Darlene

Phone system was upgraded in 2018 and is not end life.

Please clarify if there is something specific.

Update C. Carter

X


Session (May 27)

Need a separate Allied Health session – how were OT/PT/AH minutes

assigned (if all going to be standardized to meet patients care

requirements) Session with Allied Health was held.

Gap V. Robson

X


Session (May 27)

Nurse/allied health/physician – messages, how to ensure they were read

and acknowledged, what if someone is away/not online

Similar to today if a nursing/allied does not receive an

answer from the physician in a time frame they would

expect they would need to call the doctor. There is no

“read receipt” in Meditech.

Gap J. McEachern


Session (May 27) Med2020 - do we still need this? Or can everything be done in Meditech? We still need Med2020 but not MedWorxx.Update J. McEachern

X

Complex Care Future State

Process Mapping (July 19)

No more calls to Admitting notifying them that a patient has been

discharged In the new system, Admitting will receive a notification

Update J. McEachern

Complex Care Future State

Process Mapping (July 19)

Assessments done in Meditech Expanse - does it calculate any scores?

E.g. Braden assessment for pressure ulcers Yes scores are calculated

Update J. McEachern

X

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Emergency Department

ED Workflow Session (May 24) LWBS - can this flow to the ED call back list automatically? We are currently reviewing options in the system. Gap J. WilletX

ED Workflow Session (May 24) Public Health forms - who will fill these out? How will we

ensure all physicians flag/help to complete? Will the clerk

help?

Process shouldn't change from current. Gap J. Willet

ED Workflow Session (May 24) DI discrepancies - how can this flow to the ED call back

list? How does this change things with PACS discrepancy

list and clearing them there?

Same as current process. Gap J. Willet

X

ED Workflow Session (May 24) ED snapshot - what all should be on this and how should it

look?

This is done Gap J. McEachernX

ED Workflow Session (May 24) ERNI data - how is this captured and reconciled? Currently

a manual process with clerk input

We are trying to get as much information to flow to ERNI screen

as possible but some will still require manual entry

Gap J. McEachernX

ED Workflow Session (May 24) Nursing notes - important for findings outside of normal Will forward to trainers. Teaching Point J. McEachern/

D. Osborne

ED Future State Process Mapping (June 14) Isolation training (in eCTAS)? Pt triaged and sent to registration. Once registered they will

receive arm band and sheet of stickers. We will add a coloured

facesheet to all registrations and on this sheet we can add

isolation/violence etc. R. Joanisse to review new workflow with

her staff.

Gap J. Willet

X

ED Future State Process Mapping (June 14) eCTAS - icon on all computers/globe on MEDITECH Completed Gap J. Willet X

ED Future State Process Mapping (June 14) Public Health forms - flag to do with collection An order still needs to be entered in Meditech so nursing will get

a flag to collect

Gap J. McEachernX

ED Future State Process Mapping (June 14) Orders/ instructions from DI? Instructions? Protocols?

(e.g., blood thinner discontinued)

Generally speaking, process will stay the same for instruction. For

blood thinner discontinuation, there is no Regional interest in

changing the process.

Gap N. Chapman

X

ED Future State Process Mapping (June 14) From ED - default to nurse to collect (mobi-lab) Yes this can be done based on different locations for ED

outpatient and ED Inpatient

Gap I. WhetenSep. 4

ED Future State Process Mapping (June 14) Admitted ED - default to phlebotomy (mobi-lab) Yes this can be done based on different locations for ED

outpatient and ED Inpatient

Gap I. WhetenSep. 4

ED Future State Process Mapping (June 14) IPAC/VAT stickers on chart? No longer required as there is no longer a chart. Gap Suzie Hanson x

ED Future State Process Mapping (June 14) Pt. armband - new stickers - timing of changing armbands Registration staff will be printing armbands at time of

registration. When ED is admitted a new inpatient armband label

will be printed.

Gap S. Hanson x

ED Future State Process Mapping (June 14) Sub-acute/See & treat/crisis --> all on one - difficult to see These are separate in Expanse Gap J. McEachernX

ED Future State Process Mapping (June 14) Patients via EMS - how to get patients on tracker? Level 1

check them in … looks different --> address in training

This is very different Teaching Point J. McEachern

ED Future State Process Mapping (June 14) Serial trops - Pt. admitted - goes to phlebotomy … a

manual process/ does time restart at admission? Flow of

orders/ meds once admitted

This will be discussed during training Gap J. McEachern

X

ED Future State Process Mapping (June 14) Medications - transfers/ how does that transferred/ new

order?

This will be included in training Update J. McEachernX

ED Future State Process Mapping (June 14) Air transfer package Transfer report can be printed there may be mandatory ministry

forms that still need to be manaully completed

Gap J. McEachernX

ED Future State Process Mapping (June 14) Stickers from registration for ECGs/consents/urines/etc.

(Acute/SA/…)

We are printing a sheet of 30 for Acute and Sub Acute. Fast track

can print as many as they need.

Update S. Hanson x

ED Future State Process Mapping (June 14) Armband colours - falls/ DNR Yes these still exist Gap J. McEachern X

ED Future State Process Mapping (June 14) Tracker for clerk - flag for DI, etc. Will this be available in

the new system? And at what point in the process? What

will it look like?

Yes this is built Gap J. McEachern

X

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General

General In what will remaining paper elements of the health record be kept? E.g.,

smaller binder, file folder?

**Recommendation - What about using the same binders

until we know how reduced the paper elements of the

record will be? And can make a more informed decision?

(From Julie M. and Darlene O.)

Gap R. Hurley

General What is the process for pulling staff from training shifts (when required

for patient safety) to cover overcapacity issues and who is accountable

for the decision and communication.

Develop approval process that includes director approval

and VP notification. After hours Manager on Call and then

Sr. Leader on call

Update E. Ferguson

X

General Where would staff look for various forms in the EMR? Health Records will be providing a scanned document EMR

location guide … more communication forthcoming by

September.

Gap N. Buzanko -

Project Lead

HIM

X Sept.

General What is the process for sick call rescheduling for staff scheduled to attend

training? This question answered on the training FAQ

Update R. Naslovar

General How are we addressing the design/content of discharge packages across

Inpatient areas?

We are currently reviewing the functionality within

Meditech with several other regional clinical teams

including Nursing, Allied, Physicians and Pharmacy. We

hope to have that work completed shortly.

Teaching

Point

J. McEachern

X

General Electronic system does not replace verbal conversations with the care

team

Will forward to trainers. Teaching

Point

H. Hickey

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ICU

ICU Workflow Session (May

22)

Device strategy still pending in ICU – issues with wall

space, physician WOW’s with two screen requested

In room workstations were planned for ICU. Recent discussions with the

ICU team has resulted in WOW options being considered to address both

BMV, Documentation, and Med delivery. Ergotron has been onsite and

providing a demo WOW for evaluation. Concerns around wall space in

the ICU rooms and Med delivery. Dual screen WOW option also being

provided as a demo. Concern around ability to move a dual screen WOW

around the ICU as two monitors will result in significant width - Chad

Gap J. McLaughlin


22)

Many people will be trying to document electronically

during interdisciplinary rounds (physician, nursing, allied

health, RT)





the ICU rooms and Med delivery - Chad

Gap J. McLaughlin


22)

Big change from current documentation (paper), need to

still look for opportunities to get staff comfortable with

current electronic system so that it’s not all new for

them






Gap J. McLaughlin

ICU Future State Process Mapping

(June 13)

Paper rounding sheet? Clinical panel available for viewing by physicians and nursing where all the

data flows.

Update J. McLaughlin


(June 13)

Post PCI documentation - What about admitted patient

work? Can we scan?/ for HREC

intensivist working on post PCI order set won't be ready for go-live. PCI

admit to ICU and will fall under ICU order set.



(June 13)

Physician print out - currently paper (RT reqs) Presently orders for service are printed out on dept. printer. Will this

continue? How will RT be told of orders unless called? Also, need req bar

code for certain procedures in order to bill and l link physician

interpetation. Nancy Chapman aware of bar code issue and is looking inot

it.

Gap J. McLaughlin


(June 13)

RT charting for CCRT - how? When RT's are involved in CCRT calls they will document specific

interventions in Meditech PCS, unless there is specific CCRT interventions

that have been built.



(June 13)

More consent forms ICU (e.g., blood) - might need some

small binders (1") NOTE: speaks to how to collect

smaller set of paper records

Consents will be kept in small binders and these binders will follow the

patient's throughout their hospital stay. Upon discharge the consents will

go to Health records to be scanned in.



(June 13)

Portable vent in ED - ability to download data? ICU Vent equipment will connect via Philips patient monitors to flow vent

data to Expanse. Need to validate process for portable ED vent - Chad

Update C. Carter

X


(June 13)

Dedicated WOW for RT/ in ICU rounds If this is a requirement then it should be brought forward by the

department to fund the WOW.

Gap E. MrowiecX


(June 13)

Orders from one area that can't be carried out (med

directive) in the other - grayed out?

No they will need to be completed. If they can't be completed prior to

transfer the Physician needs to be made aware and an order will have to

be entered

Update J. McEachern

X


(June 13)

Communication with pharmacy? phone, email, ask pharmacist Update A. Haddy


(June 13)

RT workstations - VDI In room workstations were planned for ICU. Recent discussions with the





Update C. Carter


(June 13)

RT/ not always on the computer/ current process/ Unit

Assistant - nurse to ask UA to call?

The process remains the same. A call is still required. Validation J. McLaughlinX


(June 13)

RT NICU charting? there are RT invasive and non invasive ventilation interventions….are the

RT's looking for something else specific?

Gap K. MacdonaldX


(June 13)

Pt care monitor - scanner? What if we type in wrong SA? There is no ability to scan the monitor will require more then on identifier

I believe the second one is the Medical Record Number (currently SA) if

these items do not match the information will not flow

Update J. McEachern

X


(June 13)

ECG strips need to be scanned? We are working on incorporating telemetry strips but ECG's will need to

be scanned

Update J. McEachernX


(June 13)

12 lead ECG- will there still be a paper? Yes Update J. McEachern X


(June 13)

Communication vent/ in MEDITECH Yes vent information will flow to Meditech Update J. McEachern X

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Medical

Med Future State Workflow

(May 21)

How do we ensure all nurses are adding the appropriate care plans if not? it is part of the standard of care that will be taught to all

nurses. Audits will be completed to make sure that staff

understand how to do this

Gap H. Hickey

X


(May 21)

Allied Health currently not using a lot of interventions – need to do this

for the summary

Allied Health were encouraged to use interventions in our

current system; they will be encouraged to do so in the new

system; more interventions were built in the new system

which will hopefully capture information more efficiently

than in the current system

Gap V. Robson


(May 21)

Scales for weight - comment section to specify, have to use the same

equipment all the time as not all are calibrated equally

Done Update J. McEachernX


(May 21)

Keep having to push refresh to update status board and other areas, is

there a way to get an automatic refresh option?

It does auto refresh Gap J. McEachernX


(May 21)

Still need to figure out messaging system between (physicians – nurses –

allied health)

Region is looking at using Meditech's "messaging'

functionality which is essentially email within Meditech that

is attached to a patient

Gap J. McEachern

X


(May 21)

Discharge sheet to nursing home – does it have the necessary

information that we currently provide/that they expect (can we build this

almost like an order set?)

Still need to review Gap J. McEachern

X


(May 21)

Nurse has to go in and add care plan, is there the possibility of adding the

care plan based on the diagnosis (ie – COPD, CHF)? Can physician hit

check box to add care plan to nurse’s worklist?

Still reviewing Gap J. McEachern

X


(May 21)

Allied Health – usually chart at the end of the day but physicians/nursing

will need information closer to the time of care, how can this be done

differently in the new system?

There will be more workstations available, including many

at the bedside; however, the reason most of the charting

occurs at the end of the day is that patient care involving

assistants is limited by their part-time hours; assistants will

now be required to document which will reduce therapist

documentation time and may assist in redistributing

documentation throughout the day

Gap V. Robson


(May 21)

Discharge sheet for patient – does it capture everything our current

discharge sheets have?

We are currently reviewing this functionality with region Gap J. McEachernX


(May 21)

Red/green colour coding – red something pending, green nothing

pending… can we make it so that all items are colour coded like this?

Yes Gap J. McEachern

Med Future State Process

Mapping (June 18)

Verbal report/does not replace TOA correct TOA is reviewed/covered in the General training and

re-emphasized in day 3

Update H. HickeyX


Mapping (June 18)

What is the new hardware allocation for M. Kevill's department? 3ABC workstations have been installed in nursing stations

and work rooms. Patient room workstations are ready for

installation and we will require clinical team involvement to

relocate patients while this work is completed. Hallway

workstations are also being installed in the built in desk

areas of the hallways

Update C. Carter

X


Mapping (June 18)

Patient bracelet + education - colour coding? DNR/code status Bracelets remain as is Gap J. McEachernX


Mapping (June 18)

Admitting - flagged that discharge occurred (currently a printout

notification)

Massage task will be sent to Admitting Gap S. Hansonx


Mapping (June 18)

Will there be a computer at every accudose Med rooms will be furnished with a workstation. Update C. CarterX


Mapping (June 18)

Rejected specimens - how do we log them back in MEDITECH? Rejected specimens are typically cancelled and will need to

be reordered. Lab staff will cancel the specimen and

comment on the deficiency.

Gap M. Rivers


Mapping (June 18)

Computers in FT? FT workstations have been installed. Two hallway mounted

workstations are planned but on hold based on Physician

feedback on use.

Update C. Carter

X


Mapping (June 18)

Hourly rounding? Tracking? Still reviewing Gap J. McEachernX


Mapping (June 18)

In house appts./ambulatory, e.g. - with time? There is an appointments tab in the EMR summary page

that contains appointments that can be viewed

Gap J. McEachernX


Mapping (June 18)

DI discrepancies and how to track This will remain as is for inpatient units, ED has opportunity

to use "Call backs" but that process will need to be decided

by the program

Gap J. McEachern

X


Mapping (June 18)

Discharge/patient transfer to other facility/nursing home Transfer report can be printed Gap J. McEachernX


Mapping (June 18)

Printed package in future - what's included? We are currently reviewing this functionality with region Gap J. McEachernX


Mapping (June 18)

Trillium/funeral director - form Will remain on paper Update J. McEachernX


Mapping (June 18)

Senior friendly, is all current work captured in new Meditech? Yes Gap J. McEachern


Mapping (June 18)

CDU times/ requirements/manual tracking Yes manual tracking will remain Gap J. McEachernX


Mapping (June 18)

Meds that need to be crushed? Yes nursing will need to bring a pill crusher to the bedside

should a patient require meds crushed. (Extra crushers are

being purchased.)

Gap J. McEachern

X


Mapping (June 18)

titrated medication doses (i.e., morphine) Yes the region has developed a process for this. Nursing will

scan the 1st dose all subsequent doses of the same vial will

be manually barcoded

Gap J. McEachern

X

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Mental Health & Addictions

Mental Health Future State

Workflow (May)

We need to reinforce that physician to physician requests for consults are

done verbally versus just sending electronic requests (ie – floor wanting

psychiatrist to see patient)

* TEACHING POINT Teaching

Point


Workflow (May)

Will staff have access to the test system to learn functionality? If so,

when?

Access to the test environment will be provided in time for

classroom training and will be ongoing from there. We're

exploring opportunities to provide end users with "play"

patients they can work with without disrupting ongoing

training or build activities.

Update B. Lawson

X Sept. 3rd


Workflow (May)

Status board - important to have legal status/forms there Already incorporated Update J. McEachernX


Workflow (May)

Specific MH discharge plan still to be added Completed Update J. McEachernX


Workflow (May)

Rights adviser is offsite (current process) – how will this change or not?

How do we ensure this is done when kardex is electronic? Currently fax

confirmation in chart is the indication

Execution of the Rights Adviser process is documented in

EMR

Update J. McEachern

X


Workflow (May)

Do we still need CRMS? North Bay isn’t using this and able to do all

reporting through Meditech

H. Hickey is exploring this option for SAH … following up

with North Bay

Gap H. HickeyX ?


Workflow (May)

Community treatment orders – will this be accessible for everyone (e.g.,

offiste programs) on initial implementation

H. Pritchard will confirm with CTO Coordinator Update H. PritchardX Aug. 12


Workflow (May)

Seeking more information re: RAI codes Heather Pritchard to follow up with Sarah Albert Update H. PritchardX Aug. 12


Workflow (May)

Will information that populated from Admissions to the RAI going to flow

into a specific care plan?

Heather Pritchard will follow up Update H. PritchardX Aug. 12


Workflow (May)

TOA - defined process (sending versus receiving), process may be slightly

different in MH – on WOW, no bedside computer

Heather Pritchard will follow up Gap H. PritchardX Aug. 12


Workflow (May)

Snapshot - launch tracker (add) J. McEachern to check Validation J. McEachernX


Workflow (May)

Comment sections in MH Assessment – do we need this or just remove,

most people will just read note that is linked

J. McEachern to review Gap J. McEachernX ?


Workflow (May)

Medications on passes/prescription needed?/nurse to dispense? Need to follow guidelines - covered prior to training? Gap H. Pritchard/H.

HickeyX


Workflow (May)

Order for passes/auto-populate with the current standard times No Validation J. McEachernX


Workflow (May)

Work around for arm bands, many pts won’t keep them on TBD Gap J. McEachern/

H. HickeyX ?


Workflow (May)

ED tracker currently flags care plans - need to have this in Expanse We confirm this functionality is there Validation J. McEachernX

MH Session with HealthTech How will documenting changes in legal status be done? Information is captured in Progress Notes as well as on

paper form. Distribution of form stays the same. Change in

policy required.

Update H. Pritchard

X

MH Session with HealthTech If a patient returns early from LOA, how are meds handled in the EMR? Meds go on hold once the patient departs on LOA. When

the patient returns, there is an LOA function that takes

Meds off hold. If patient returns early, Meds can be

reversed out.

Gap J. McEachern

X

MH Session with HealthTech Will the physician's documentation for a patient's legal status change

(new/renewal) change?

Physician documents in Progress Note that patient has been

placed or renewed on a Form 1 AS WELL AS completing it on

paper. Physician gives copy to patient. Nurse will go nto

EMR to check that the legal status has been updated

Teaching

Point

MH Session with HealthTech Phone in order for retraint requires sign off within 24 hours by physician Policy change … Teaching

Point

H. Pritchard

MH Session with HealthTech Further discussion required re: how to capture LOA passes in EMR …

policy change required?

Worked on by H. Pritchard Gap H. PritchardX Aug. 12


Mapping (June 27)

Currently ++ auto printed documents (ie. Cencus) what will print - if

anything? Where will this information be?

Already incorporated … Heather Pritchard will add more

context

Update Heather

PritchardX Aug. 12


Mapping (June 27)

CTO office has ++ paper - Currently in Meditech for inpatients and on

paper for outpatients. + Ministry forms

CTO is not in scope for this phase of implementation.

Ministry form documentation continues in paper.



Mapping (June 27)

damaged equipment is currently tracked in Meditech. Will this remain

the same?

Heather Pritchard will check H. PritchardX Aug. 12


Mapping (June 27)

Will the referral form for STEP be in Meditech? IF it's already there. Need to confirm. Gap J. McEachernX


Mapping (June 27)

Admissions are from Psychiatrist to Unit then the

Manager/Supervisor/AAR calls FLOW office to notify them of admission.

Will this change?

Psychiatrist will have to enter the admission orders into the

system. There will be a notification to Admitting.

Update J. McEachern


Mapping (June 27)

How will paper scripts be addressed for the Medication clinics? The written order will be transcribed in the EMR and then

scanned.



Mapping (June 27)

Discharge referrals process - Refer to many community agencies. Will this

be in Meditech and then send automatically

This is in the EMR but cannot be sent automatically.

Continue with same process.



Mapping (June 27)

Will Crisis notes be available in Meditech now? Yes Validation J. McEachernX


Mapping (June 27)

Will alerts from MT transfer from medical stay to MH stay? When AC

account is D/C'd current orders are printed from MTG and re-entered.

How will this change?

Yes alerts will stay. The AC account will flow to MH through

the Transfer Discharge functionality.

Update J. McEachern

X


Mapping (June 27)

Mental Health Act status is currently tracked in EMR and alerts are sent.

Will this stay the same in the new system?

Yes, relatively the same … depends on physician

documentation. Policy will change to reflect that physicians

must enter legal status into EMR.

Validation J. McEachern/

H. Pritchard X

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OR Surgical

OR Surg Future State

Workflow (May 23)

Eye medications that come directly from supplier (by-pass pharmacy

currently) – how will these be in the system?

If pharmacy is not aware of a medication (ie. it bypasses

pharmacy) there is a strong chance it is not built in the

system. Non-formulary medications can still be ordered. If

requiring documentation on the eMAR, then pharmacy

would need to be made aware of these products to have

them built.

Gap A. Haddy


Workflow (May 23)

Stores items versus items from pharmacy? Barcoding? Items with barcodes will be added to PHA drug dictionary. If

an item doesn't scan there will be a workflow to collect

these items. In the meantime, a manual override would be

necessary.

Gap A. Haddy


Workflow (May 23)

Patient barcode in the OR – not always accessible, will we have 2

armbands (1 on patient, 1 to scan in the event the arm is not easy to

access or manually enter)

Julie stated that 2 armbands will need to be printed. Gap S. Hanson

X


Workflow (May 23)

Meds that are to renewed/accountability – what happens if it expires?

Will pharmacy no longer send? Worried about physicians not always

renewing orders

Medications requiring a renewal will display on the

physicians worklist, it will display on the patient current

orders for the physician as well. It will display on the nursing

MAR. If a medication is not renewed it will fall off the MAR

and pharmacy will not be prompted to send.

Gap A. Haddy


Workflow (May 23)

Issue with new locum physicians showing up 15 minutes prior to surgery

in current state – must ensure locums come in day prior for new locums

to be trained on system

This will have to be addressed with physician

recruitment/medical affairs

Gap K. Wooten


Workflow (May 23)

All follow up visits to OP clinics will be requested as they currently are (ie

– fax sent to Ortho clinic)

Yes that’s correct Update J. McEachernX

OR & Surg Future State

Process Mapping (June 17)

Confirm distribution of Surgery Day Sheet via printer? Currently it batch

prints to various depts. at 1 pm the day before

further clarification for question…if this is the OR schedule

for the next day this can be set up to autoprint at a selected

time each day

Gap K. Wooten



How is the UA notified of timing of follow up appt. by surgeon? Currently

done verbally/paper)

if this is related to an inpatient unit the surgeon would be

able to fill this out on the discharge plan regarding follow up

appts

Gap K. Wooten



Histology & pathology moving to MEDITECH? The process will remain the same as our current

environment.

Gap M. Rivers



Does MEDITECH have the copyright for the Aldreti scoring system? This is still in the works and is on the list of copy rights for all

sites that are required

Gap K. Wooten



Do codes remain on paper post go live? At least initially Yes all codes remain on paper Update J. McEachernX

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Superuser Sessions

Superuser Bootcamp

(June 4 - 6)

Is Crisis Services “In Scope”?

Yes all Crisis Staff should already be scheduled for their training

Gap H. HickeyX

Superuser Bootcamp

(June 4 - 6)

Why is it ok for superusers to see patient information when they’re not in

the circle of care?

During Meditech Go Live, Superusers are authorized by SAH

and permitted under PHIPA to use personal health

information as required for their role in order to provide

support for service improvements and education to staff.

All Superusers are expected to understand and follow the

Confidentiality Agreement and Privacy Policy at SAH.

Update H. Hickey

X

Superuser Bootcamp

(June 4 - 6)

Will this initiative result in changes to work hours? AC/Ophthalmology- we do not anticipate any changes to

the schedule work day but there may be more hours

available in the week through the transtion phase

Validation Manager of

each Unit X

Superuser Bootcamp

(June 4 - 6)

How difficult will it be to make changes in the new system (compared to

the current one)?

All changes will need to be reviewed/approved by Regional

governance.

Validation E. MrowiecX

Superuser Bootcamp

(June 4 - 6)

What will the grace period/timeline be for physicians to do their own

electronic orders?

At go live Validation D. Garniss

Superuser Bootcamp

(June 4 - 6)

Will there be additional training after the rollout for staff that are really

struggling?

Both during training and following go-live we will be

gathering information from learners/end users about how

confident they are in using the new system, and we will use

this information to determine what learning needs remain.

So, yes, there will be further learning opportunities based

identified needs.

Update B. Lawson,

Training Lead

XStarts

Oct. 29

Superuser Bootcamp

(June 4 - 6)

Will there be one device available for each bed, or will one device be

shared by two beds?

Device deployments are different depending on the unit.

We have provisioned a device at each bed in most cases on

3ABC. 1ABC/2ABC will remain WOW based with no devices

mounted at the bedside. This was based on feedback from

each area.

Update E. Mrowiec

X

Superuser Bootcamp

(June 4 - 6)

What will happen when the system goes down, or when it has to be

patched or upgraded?

For patching activity we are looking at a solution so that

downtime will be avoided. If the system does become

unavailable we have an alternate downtime solution that

provides much of the information and can be used while

Meditech is not available.

Gap E. Mrowiec

X

Superuser Bootcamp

(June 4 - 6)

For hospitals that are currently using Expanse, what are the clerical

duties/functions for inpatient units?

I am in the process of reaching out to other hospitals to see

how they transitioned clerical duties for inpatient units. Will

report back in early August.

Update D. Osborne

X

Week of

Aug. 6

communi

cation

Superuser Bootcamp

(June 4 - 6)

Will the new eMAR indicate how a patient takes their medication? I.e.

“Mix into patient’s food”

it’s a manual entry by nursing but remains on the associated

medication until the med is discontinued


Superuser Bootcamp

(June 4 - 6)

What are we using for Kardex’s? Meditech has new functionality called the snapshot that

pulls the most up to date information from a variety of

sources that will be used as the kardex

Update J. McEachern

X

Superuser Bootcamp

(June 4 - 6)

For the Lab, specifically Blood Bank, could we have an “orders” on the

status board? This would help for homecare patients.

More clarification is required - are you asking from a nursing

perspective? Which status board?

Gap I. Wheten

Superuser Bootcamp

(June 4 - 6)

Will SAH upstaff during the transition period when ONE is initiated so that

patient care isn’t compromised? (We have difficulty staffing units as it is)

ONE Playbook? Update L. Mattila

X

Superuser Bootcamp

(June 4 - 6)

Will all types of patient information be carried over to the new system or

just certain kinds?

Only Demographic information is carried into the new

system. There will be a button that links to the old Meditech

system to view patient history.

Update E. Mrowiec

X

Superuser Bootcamp

(June 4 - 6)

How far into the past are we pulling patient information from the current

system?

Only Demographic information is carried into the new

system. There will be a button that links to the old Meditech

system to view patient history.

Update E. Mrowiec

Superuser Bootcamp

(June 4 - 6)

With BMV, will the patient ID bracelet format be compatible with our

current barcoded state? We, in certain areas, use this barcode for

Mobilab collections (Lab, ICU, ED).

Pharmacy and Lab have tested the armbands and they work

properly.

Gap J. McEachern

x

Superuser Bootcamp

(June 4 - 6)

How will DI images be affected with Thessalon/MMH hospital? Same process as current system until these hospitals

implement ONE.

Gap N. Chapman

Project Lead DI X

Superuser Bootcamp

(June 4 - 6)

When the project launches, how will staffing ensure support staff is

available?

The assumption is that "support staff" refers to the

availability of superusers to assist coworkers. There is a

commitment from SAH that superusers will be available for

two weeks following Oct. 29.

Validation D.Osborne

X

Superuser Bootcamp

(June 4 - 6)

What will the labels look like for specimens? Currently the time that it is

ordered is what is on the label, which isn’t the time it was collected. Will

that change or stay the same?

the labels have not changed unfortunately. But if the nurse

"documents" the specimen collection in PCS then the

collection details (time and person collecting) will default in

upon scanning the specimen label within lab.

Update I. Wheten

X

Superuser Bootcamp

(June 4 - 6)

Once live and after the 2 week activation support period, where do staff

and physicians go with questions about orders? Will it be clear who they

should call?

There will be dedicated support for physicians beyond Nov.

11. We are still in the process of determining precisely who

or how many supports there will be, but physicians and staff

will have dedicated experts that they will know they can call

for support.

Update B. Lawson,

Training Lead

X Sept. 3rd

Superuser Bootcamp

(June 4 - 6)

Will additional devices be made available when there is overflow, such as

when private rooms become semi-private?

Unfortunately we do not stock additional devices for

deployment in these situations

Update E. MrowiecX

Superuser Bootcamp

(June 4 - 6)

Will screens in the live environment be blue (like our current test-green,

live-blue contrast)?

Unsure of the colours but yes easily differentiated Update J. McEachernX

Superuser Bootcamp

(June 4 - 6)

What are we going to use for infant/baby ID bands? How will nurses in

mat/NICU do barcode medication on babies when their bracelets are so

small?

Waiting on Manager decision. The bracelets will not be too

small.

Gap S. Hanson

x

Superuser Bootcamp

(June 4 - 6)

What kind of job impact is this going to have, particularly for clerical

staff?

We are still figuring this out, starting with understanding

what the change impacts are through identifying future

state. A sample of clerical volunteers are time tracking their

activities so we can gauge how much capacity will be freed

up ... this assessment is underway.

Gap M. Linstedt

X

Next

communi

cation to

clerical

staff is

week of

Aug. 6

Superuser Bootcamp

(June 4 - 6)

Why were SAH, NBRHC, and WPSHC picked out to lead WAVE 1 of the

Initiative?

We were 3 hospitals that were upgrading our HIS system.

Since the government mandate was that hospitals could not

update their HIS system alone we decided to move

together. We became Wave 1 when the NEON group of

hospitals saw the benefits of having a shared patient record

and wanted to join us. It was at that point the term Wave 1

was coined.

Update E. Mrowiec

X

Superuser Bootcamp

(June 4 - 6)

How can I be a superuser and work at the same time? When you are scheduled for work during that two week

period starting Oct. 29, you will be acting as a superuser not

fulfilling your routine role.

Validation D. Osborne

X

Superuser Bootcamp

(June 4 - 6)

Once orders are “acknowledged”, can there be a way to “complete” the

order so that the next shift doesn’t have to check if and when the order

was carried out by the previous nurse? This would eliminate pages of

acknowledgements & detective work?

Yes only one acknowledge is required (currently 2nd check)

all orders must then be reviewed within 24 hours of the

entry (3rd check)

Update J. McEachern

X

Superuser Bootcamp

(June 4 - 6)

Will there still be paper requisitions for emergency for DI orders? How

will the radiologist see Hx/bloodwork to proceed with a test?

Yes the requisition will now print automatically from

Meditech. However, it will include order and history from

the physician, and relevant bloodwork if its been completed.

Gap J. McEachern

X

Superuser Bootcamp

(June 4 - 6)

Will triage in Labour & Delivery be entered electronically? Yes triage is all electronic Validation K. Macdonaldx

Superuser Bootcamp

(June 4 - 6)

Will the armbands coincide with the mobi-lab? YES!!!! Gap J. McEachernx

Superuser Bootcamp

(June 4 - 6)

Will there be other training sessions geared more toward disciplines

other than nursing?

Yes, superusers will receive training appropriate to their role

and or to the roles of those they will support, and all end

users within the scope of the implementation will be trained

in their respective roles. More detail about training by role

can be found in the training plan posted on the ONE

website.

Update B. Lawson,

Training Lead

X

Superuser Bootcamp

(June 4 - 6)

Will we still be able to print Kardex’s as “worksheet” as we do now? Or

how will shift handover look in the future?

You cannot print off the "snapshot" in Meditech, which is

essentially the new kardex. Nursing will need to review the

patient information on Meditech at handover. We are

trying to move away from paper processses and outdated

information as things can change after the kardex is printed.

Teaching

Point

J. McEachern

X

Superuser Sessions (Aug 8) Will there be a process for staffing on units where there is a superuser

there to support the staff? What does that look like? Will Superuser be

pulled to patient care?

Develop approval process that includes director approval

and VP notification. After hours Manager on Call and then

Sr. Leader on call

Update E. Ferguson

x

Superuser Sessions (Aug 8) Will Out-patient staff who pick up shifts in Phase 1 areas be able to have

access to training?

They have to have the training prior to any shifts worked Update E. Fergusonx

Superuser Sessions (Aug 8) Who will manage any changes needed for the training schedule? This question answered on the training FAQ R. Naslovar

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Women & Children's Health

Women & Ch Health (May 27) Stillborn births – need to be registered with a registration number so that

blood info associated with a registration

all info for stillbirths stay on the moms chart, stillbirths are

registered with Service Ontario but not in the REG system…Suzie

is that correct?

Gap K. MacDonald/

S. Hanson

Women & Ch Health (May 27) SOC - birthing unit disposition in two places – which area is best? birthing unit disposition is to be completed each time the patient

changes status during the labour process however UA's also have

access to do this-where do you suggest it should be?

Gap K. MacDonald

X

Women & Ch Health (May 27) Specific information required in discharge packet (can we add document

in the system to print with packet?)

I believe the discharge packet is still being worked on Gap K. MacDonaldX

Women & Ch Health (May 27) Specific maternal discharge form still to be added it has been added for maternal patients and a newborn discharge

for newborns

Gap K. MacDonaldX

Women & Ch Health (May 27) Maternal triage assessment – deceleration (typo), deceleration – need

“heard” check box

OK will check the typo and review the doc for "heard" Gap K. MacDonaldX

Women & Ch Health (May 27) BORN data – is everything included that is required? Will this eliminate

the need to enter in BORN? How do we ensure the EDB is recorded on

first instance so that it can all pull over automatically? Separate

intervention?

we are still working with MT and BORN to get the items to cross

over properly….i will keep everyone up to date as I get more info

Gap K. MacDonald

X

Women & Ch Health (May 27) Fetal position - asynclitic what doc section is this referring to…as this is in one of the asmts Gap K. MacDonaldX

Women & Ch Health (May 27) Pre-natal – too many choices and most unsure, can there be a generic? What query is it? If it is a BORN query it cannot be changed Gap K. MacDonaldX

Women & Ch Health (May 27) Newborn medical directive – nurse to enter, how can we do somethings

now but others later (access to medications for example)

when you acknowledge the orders you can select only the ones

you want for now and acknowledge the rest at a later time…or

acknowledge all and only use the ones you need

Gap K. MacDonald

X

Women & Ch Health (May 27) Need to add a physician notification box (time recorded) where would you like this added?? There is one on the triage

asmt

Gap K. MacDonaldX

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