cerner lab upgrade with 2hour order entry downtime september 28 th 10-12noon
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Cerner Lab Upgrade with 2Hour Order Entry Downtime September 28 th 10-12noon. Simultaneous implementation of two projects: Cerner Laboratory Information System (LIS) will replace the current GE (LIS) Abbott Diagnostics automated chemistry line will replace the current Beckman instruments. - PowerPoint PPT PresentationTRANSCRIPT
Cerner Lab Upgradewith 2Hour Order Entry Downtime
September 28th 10-12noonSimultaneous implementation of two projects:
Cerner Laboratory Information System (LIS) will replace the current GE (LIS)
Abbott Diagnostics automated chemistry line will replace the current Beckman instruments
ACTIONS NURSING UNIT TO TAKE NOW TO PREPARE
●Staff unit appropriately: (higher than a normal Saturday)●Schedule an MR and ●Schedule one extra nurse
●Make sure Downtime Kits are fully stocked for all types of Downtime documents before September 28th ●physician order (POS) sheets (remove all triplicate forms you
may still have)● lab requisitions
●Look for emails, articles and Nurse Alerts with the latest details prior to the day
Order Ample Supply of DT Lab Requisitions and POS
E-docs link to order downtime requisitions:https://edocsprod.mc.vanderbilt.edu/EDocsView.aspx?EDocsId=3363
PreDowntime – Day of● Providers encouraged to:
● Order routine lab tests prior to 10am● Avoid ordering serial labs prior to 12N
● Nurses to ● Sort Batch print of requisitions to remove those dated and
timed after 12 Noon 9/28/2013. Discard them● Dock Glucometers at midnight as usual then begin scanning
account # on armband instead of MRN● Send specimens prior to 10 am whenever possible
● MR ● Print extra HEO lab labels, have POS ready to stamp for
providers● Sort batch requisitions, shred those timed for after 12 noon
● SSS to round on units to remind about the downtime processes
During Downtime-Provider and Nursing Instructions
● DT Orders entered on STAMPED/LABELED downtime physician order sheet
● New labs sent with STAMPED/LABELED DT paper requisitions● Labs ordered prior to DT will be sent with the HEO/Wiz requisition
printed at order time UNTIL 12NOON● Medications ordered during DT will be faxed to pharmacy per normal
HEO/WIZ DT procedures and will be entered by pharmacy then available in Admin-Rx
● Labs will be resulted as usual though possibly slower● Systems Support onsite for inpatient areas to assist with questions
related to downtime● Clinical Operations Engineers will be onsite to support outpatient areas
using VOOM
During Downtime – MR● Be prepared to assist nurses and providers with stamped/labeled
DT POS, and lab requisitions as needed● Fax medications orders to pharmacy so they can enter into HMM
● Nurses will then be able to administer meds in Admin-Rx● Notify these services by phone of any new orders and a DT
requisition:●Radiology●Respiratory Therapy or Rehab Services ●Heart Diagnostic Test (Echo, EKG)●Lab:
● Labs will continue to be done during the downtime and results posted in StarPanel
● Critical Labs will be communicated to provider/unit per protocol● Questions during the DT can be called to the lab hotline:
After Downtime- Nursing Nursing Instructions:●Charge RN will ensure that remaining HEO
requisitions timed after 12 NOON are thrown away
●SSS/DT Team -Active Lab orders in HEO will be dc’d and reentered starting at 12 noon ●New HEO requisitions will be printed as the
orders are re-entered in HEO/Wiz●Any lab that needs to be sent prior to receiving
the new HEO/Wiz requisition should be sent with a DT requisition
After Downtime-Nursing, cont.Nurse Instructions:Verify labs carefully – the team dc’ing and re-entering the orders will not know what you sent, order changes etc. during the downtimeAsk: ●Was this lab sent during the downtime?●Do we still need this lab? Did it get dc’d on paper or
verbally during the DT●Which requisition should be used? – if you have 2
HEO requisitions, use the requisition with the most recent “request date/time” on the requisition
After DT – MR and PharmacistsMRs (or designee): ●Enter “ongoing non-pharmacy” written orders
into HEO/Wiz●Written completed orders during Downtime will
NOT be back-entered into HEO/WizPharmacists:●enter “ongoing” written medication orders into
HEO/Wiz●Once processed in HMM, medication orders
display in Care Organizer to be verified
After Downtime-ProvidersProvider Instructions:●All lab orders in HEO/Wiz will be dc’d and
reentered to allow HEO to communicate the order to Cerner lab
●Lab orders will be reentered as “written” to avoid multiple co-signatures needed but be prepared as some may occur
After DT cont. Changes for Point of Care Blood Glucose,
GEM, & Hemoglobin A1C Testing
• Inpatient Nurses will now scan patient’s account number and not the MRN
• Outpatient nurses will scan/enter the Epic account number on the label or encounter form
Reference Numbers & Resources for Lab Upgrade 9/28/13
• 3-HELP – HelpDesk will contact lab or support group to assist as needed
• VUMC Lab to see new reference ranges• www.lab.vu.com or click on this StarPanel icon:
• 5-LABS during the DT for lab questions• SSS website for DT Process questions:
• SSS Downtime webpage• Link to order DT Forms from E-docs:
• https://edocsprod.mc.vanderbilt.edu/EDocsView.aspx?EDocsId=3363