clinical & business systems operations standards and

CLINICAL & BUSINESS SYSTEMS OPERATIONS STANDARDS AND PROCEDURES

TITLE:

AM/PFM DOWNTIME PROCEDURES (SCM04) EFFECTIVE DATE: REVIEWED:

PAGES:

05/10/04 01/09/18 1 of 16

ISSUED

FOR:

Clinical & Business Systems Team, Nursing Units, Registration, Nursing Administration, ECC, Patient Placement, and Ancillary Departments

RESPONSIBILITY: Nursing Units, Registration, Patient Placement, and Ancillary Departments

AM/PFM DOWNTIME PROCEDURES

Description

Users are unable to access AM/PFM to enter admissions, discharges, and transfers or to make changes to patient demographic information.

Length of Downtime 15 minutes to 45 minutes Level 1 45 minutes and greater Level 2

Level 1 AM/PFM Downtime Procedure ‐ Supported by AM/PFM – No Command Center At 15 minutes

Notify MOC, Call Center, CS Support,Registration (use Voalte), Patient Placement, and Scheduling(day time only) Email to Interface Contacts (during the day) Page Pharmacy SA, so Pharmacy can place ECC/NP Pyxis on Override Notify Radiology via email group called RAD DOWNTIME

At 30 minutes

Update NP and SMH Campus Registration and confirm they are using downtime numbers.

Contact ECC (x6846 or Voalte), Patient Placement (x1440), North Port (257-2801), and Scheduling (x4225) Notify Urgent Care Centers (8am – 8pm)

Heritage Harbour x6440 University Parkway x1234 Stickney Point x5678 Venice 952-4250 Bee Ridge 952-4944 St Armands 952-4751

DT Numbers: \\smhfile01\infosys\Ad_team\DT_Procedures\Downtime numbers & MRN's OneNote Downtime OneNote Downtime Log to track patients during downtime: Reference

Group 1: Patient Care Areas – Hospital Main Campus and North Port Emergency Care Center The guideline is, if you have a pharmacy Pyxis station you are in Group 1.

Emergency Room Admissions – if Needed

Use accessANYware to check if the patient has an existing medical record number. Contact the Call Center at x6107 with a Stat Request if the patient does not have an MRN and a number will be assigned by a Clinical and Business Systems (AM/PFM) Analyst.

Use downtime packets that include downtime numbers and downtime registration form.


Once the downtime number has been assigned, contact the Clinical and Business Systems (AM/PFM) Analyst.

This information will be logged by the Clinical and Business Systems (AM/PFM) Analyst. Please be prepared to provide the following information: Admission, Discharge or Transfer, Patient MRN, Patient Downtime Visit Number, Patient Date of Birth, Patient SSN, Visit Type, Date/Time, Physician, Location, Service Area, Room/Bed.

Use EasyID downtime icon to create labels

Once all clear has been called, enter the visits into AM/PFM with the Downtime Visit Number o See ‘Recovery’ section of this policy if needed.

Discharges – if Needed

Continue to use the Teletracking (Patient Transport) system for discharge pickups. If the patient is unavailable in the system, contact the Clinical and Business Systems (AM/PFM) Analyst.

Immediately notify the Clinical and Business Systems (AM/PFM) Analyst of the patient discharge and the Clinical and Business Systems (AM/PFM) Analyst will enter the discharge information on the Downtime Activity Log.

Transfers‐ if Needed

Limit intra‐unit moves or non‐essential transfers. ECC and Nursing Adminisitration should consult to determine when it is essential to transfer patients from ECC.

For essential transfers call Patient Placement at x 1440 for a bed assignment.

Note, if the AM/PFM system is down and the patient is not in Teletracking and an urgent transfer or admission is required, then ECC Administration, Nursing Administration, and Patient Placement will work to move the patient if deemed urgent/critical.

Continue to use the Teletracking (Patient Transport) system for transfer pickups. If the patient is unavailable in the system contact the Clinical and Business Systems (AM/PFM) Analyst

When the patient is transferred the sending unit will immediately notify AM/PFM Support and the Clinical and Business Systems (AM/PFM) Analyst will enter the transfer information on the Downtime Activity Log.

Direct Admissions

Wait for AM/PFM to be available to admit patients

Patient Identification‐ if Needed


Orders

Continue order entry on all patients available in the order entry system.

For STAT orders on a new admit (unable to find patient in the order entry system), use a manual requisition.

Hold routine orders (if unable to find patient in the order entry system), on a new admit, until AM/PFM is available and patient is seen in the order entry system.

Transcription

For patients available in SCM, reports will be available in SCM

If a report on a new admit, such a OP note, H&P, etc., is urgently needed, Contact the Transcription Hotline x1122

Results

All results will be available in SCM for all patient’s available in SCM

STAT results on patients admitted during the downtime will be manual.


Patient Scheduling

Central Scheduling will continue to schedule patients in QES. Visit numbers will not be immediately returned but will be created once AM/PFM is available.

Surgery will continue to schedule patients in the surgery system.

Group 2: Ancillary Patient Care Areas (Outpatient testing, Outpatient Rehab and Urgent Care Centers) ‐ excluding North Port Emergency Care Center Admissions

No non‐essential admissions will be done during an AM/PFM downtime. o

Orders

Follow your departments downtime order entry procedure

Group 3: Clinical and Business Systems (AM/PFM) System Analysts: Contact AllScripts 1‐888‐GET‐HELP

Contact the Manager On Call (MOC)

Contact the Clinical Support Analyst if during on‐site hours; or Senior Clinical Analyst On Call if Clinical Support Analyst is not available.

Notify the Call Center x6107 of an AM/PFM Level 1 Downtime.

Contact DBA and Server Tech on call to aid in problem solving, if needed.

On Call Clinical and Business Systems (AM/PFM) Analyst will handle the technical system problem, working with DBA and Allscripts

On Call Analyst should request other Clinical and Business Team members (if available), request assistance from the MOC, to facilitate communication between SMH ECC, North Port ECC and Patient Placement, Nursing Administration, Labor and Delivery, and areas. If help with communication is needed, the Clinical and Business Systems (AM/PFM) Analyst should request assistance from the Manager On Call (MOC).

Provide a copy of the ‘Downtime Activity Log’ to Pharmacy SA, Andrea Blanken (Radiology) and Senior Clinical Systems Analyst.


Recovery

When the downtime is over open the MRN processing option (if needed) and the Visit Number processing option (if needed).

DB/HDR/REG

PA/HC/UC/PROC/PM – F11 to the 3rd Screen


Users will need to select User and then enter the downtime number when registering the patients. They must use the downtime number – this it the number that is already in the downstream systems

Also verify:

AM/PFM Interfaces and communications are running ‐ INTF/MM/MON

eLink interfaces are running

All Schedule classes are ACTIVE and none are in a PROBLEM status

When the users have completed entering downtime numbers close Visit Number processing option and MRN processing option (if needed).



Close the MRN processing option – DB/HDR/REG


When this has been completed, AM/PFM can be released back to all users.

Notify Call Center to send the All Clear bank shot

Review Scheduled Jobs – verify all schedule classes are active and processing

Distribute Downtime Event Summary via email and enter downtime ticket into Footprints.

Review Completed Jobs Report and Problem Jobs Report

Provide a copy of the ‘Downtime Activity Log’ to Pharmacy SA, Manager of Radiology and Senior Clinical Systems Analyst.


Level 2 AM/PFM Downtime Procedure – Command Center Active At 45 minutes

Prepare to open Command Center o Contact Pharmacy SA (On-Call)

Pharmacy will determine at that time based on time of day and location (if Pharmacy Staff is off-site and have to drive in, at 45 min may want to put the house on override before leaving home to come in for command center) or wait until 60 if resources are on-site.

o Contact Senior Analyst (On-Call) Request MOC to call Command Center Participants

o MOC will be responsible for calling in Command Center Participants.

MOC to Notify Nursing Administration (NAD) Supervisor. At 60 minutes

Open Command Center o Senior Clinical Systems Analyst o Pharmacy SA o Clinical System User Support –report to ECC if Staff levels permit. o AM/PFM Analyst - one in Command Center. Staff levels permitting, second AM/PFM Analyst report to ECC o Analyst(s) familiar with Teletracking, Cardiology, and Radiology systems. o Patient Placement – participation via phone

Nursing Administration (NAD) SupervisorMOC to notify Nursing Administration and other key Administrators Call Center sends bank shot to the house regarding command center. Publish Command Center Phone number (typically

x3800 unless an alternate number is being utilized). Contact ECC (x6846 or Voalte), Patient Placement (x1440), North Port (257-2801), and Scheduling (x4225) Update Urgent Care Centers (8am – 8pm)

DT Numbers: \\smhfile01\infosys\Ad_team\DT_Procedures\Downtime numbers & MRN's OneNote Downtime OneNote Downtime Log to track patients during downtime: Reference

Group 1: Patient Care Areas – Hospital Main Campus and North Port Emergency Care Center The guideline is, if you have a pharmacy Pyxis station or are a Walk In Clinic you are in Group 1.

Emergency Room and Walk In Clinic admissions (Same as Level 1)

Use accessANYware to check if the patient has an existing medical record number. Contact the Command Center if the patient does not have an MRN and a number will be assigned.

Use downtime packets that include downtime numbers and downtime registration form.

Once the downtime number has been assigned, contact the Command Center. This information will be logged by a Clinical and Business Systems (AM/PFM) Analyst. Be prepared to provide the following information: Admission, Discharge or Transfer, Patient MRN, Patient Downtime Visit Number, Patient Date of Birth, Patient SSN, Visit Type, Date/Time, Physician, Location, Service Area, Room/Bed.


Once all clear has been called, enter the visits into AM/PFM with the Downtime Visit Number o See Recovery Procedures

Direct Admissions

Call the Command Center to get the patient medical record number and a Downtime Visit Number

The Clinical and Business Systems (AM/PFM) Analyst will enter the patient data on the Downtime Activity Log

Continue to use the Patient Tracking (Patient Transport) system for patient pick‐ups. . If the patient is unavailable in the system, contact the Command Center.


Outpatient Lab and Radiology will handle outpatient admissions according to their department downtime

procedures.

Discharges

Continue to use the Teletracking (Patient Transport) system for discharge pickups. If the patient is unavailable in the system, contact the Command Center.

Immediately notify the Command Center of the patient discharge and the Clinical and Business Systems (AM/PFM) Analyst will enter the discharge information on the Downtime Activity Log.

Transfers

Limit intra‐unit moves or non‐essential transfers. ECC and Nursing Adminisitration should consult to determine when it is essential to transfer patients from ECC.

For essential transfers call Patient Placement at x 1440 for a bed assignment.

Note, if the AM/PFM system is down and the patient is not in Teletracking and an urgent transfer or admission is required, then ECC Administration, Nursing Administration, and Patient Placement will work to move the patient if deemed urgent/critical.Continue to use the Teletracking (Patient Transport) system for transfer pickups. If the patient is unavailable in the system contact the Command Center

When the patient is transferred the sending unit will immediately notify the Command Center and the Clinical and Business Systems (AM/PFM) Analyst will enter the transfer information on the Downtime Activity Log.

Census Reconciliation

Continue doing Census Reconciliation. An Inpatient Patient list is available on the downtime pc. This list is updated every hour on the hour.

Patient Identification


Orders

Continue order entry on all patients available on the order entry system.

For STAT orders on a new admit (unable to find patient in the order entry system), use a manual requisition.

In addition to entering a STAT order into SCM, notify the ancillary department by phone.

Transcription

For patients available in SCM, reports will be available in SCM

If a report on a new admit, such a OP note, H&P, etc., is urgently needed, Contact Transcription Hotline x1122

Results

All results will be available in SCM for all patient’s available in SCM

All Results on patients admitted during the downtime will be manually sent to the unit.

Radiology, Cath Lab, and Echo Results will file in the patients EMR.

Patient Scheduling

Central Scheduling will continue to schedule patients in QES. Visit numbers will not be immediately returned but will be created once AM/PFM is available. Surgery will continue to schedule patients in the surgery system.

Physicians List

Physicians will continue to get their list from SCM or from the Physician Kiosk


Operators/Triage ER/Information Desk Patient list

An updated patient list will be printed from SCM and be distributed every hour. Environmental Services

If the patient is not in a bed in TeleTracking, call radio 2954

CELL PHONE/PAGER NUMBERS ARE AVAILABLE ON PULSE Group 2: Ancillary Patient Care Areas excluding the North Port Emergency Care Center and Walk In Clinics Admissions

Use the Downtime Activity Log to admit patients assigned downtime visit numbers.

Orders

Follow your department downtime order entry procedure.

Group 3: AM/PFM System Analysts:

Contact AllScripts 1‐888‐GET‐HELP

Contact the Manager on Call

Manager on Call to Assemble On call staff to man the Command Center.

Contact the Clinical Support Analyst if during on‐site hours; or Senior Clinical Analyst On Call if Clinical Support Analyst is not available.

The Clinical and Business Systems (AM/PFM) Analyst to send bank shot to Call Center for distribution notifying all SMH Users of the AM/PFM Downtime

Notify the Call Center x6107 of the AM/PFM Level 2 Downtime.

Contact DBA and Server Tech on call to aid in problem solving, if needed.

On Call AM/PFM Analyst will handle the technical system problem, working with DBA and Allscripts

On Call Analyst should request other Team support to handle communication between SMH ECC, North Port ECC and Patient Placement, Nursing Administration, other system analysts and users. If assistance with communication is needed, the Clinical and Business Systems (AM/PFM) Analyst should request assistance from the Manager On Call (MOC).

The Clinical and Business Systems (AM/PFM) Analyst will disable Web Services to prevent user access with Allscripts assistance.

Provide a copy of the Downtime Log to Pharmacy Systems Analysts, Manager of Radiology and the Senior Analyst On‐Call.


Group 4: Patient Placement and Clinical Business Systems (includes SCM, Pharmacy, RAD, LAB, Surgery, STRM)

A member of the Clinical and Business Systems (AM/PFM) Team will be assigned to coordinate the downtime and ensure the patient information has been entered in the Downtime Activity Log(OneNote).

Patient care areas will call the Command Center with all transfer, discharge and admit information gathered by patient care personnel.

The Clinical and Business Systems (AM/PFM) Analyst will ensure patient transfer and discharge data has been entered on the Downtime Activity Log(OneNote). This log will be used for Clinical Business Systems input and AM/PFM recovery.

The Clinical and Business Systems (AM/PFM) Analyst will ensure basic patient admit data has been entered on the Downtime Activity Log. This log will be used for Clinical Business Systems input and AM/PFM recovery.

SMH ECC and North Port ECC will use accessANYware to check if the patient has an existing medical record number. Contact Command Center if the patient does not have an MRN and a number will be assigned. Patient Placement will contact the Command Center to check for an existing medical record number. A MRN will be assigned by the Command Center if the patient does not have an existing MRN in addition to a Downtime Visit Number.


Recovery

When the downtime is over open the MRN processing option (if needed) and the Visit number processing option (if needed).

DB/HDR/REG



Users will need to select User and then enter the downtime number when registering the patients. They must use the downtime number – this it the number that is already in the downstream systems

Also verify

AM/PFM Interfaces and communications are running ‐ INTF/MM/MON

eLink interfaces are running

All Schedule classes are ACTIVE and none are in a PROBLEM status


When the users have completed entering downtime numbers close Visit Number processing option and MRN processing option (if needed).


Close the MRN processing option – DB/HDR/REG


When this has been completed, the AM/PFM system can be released back to all users.

Notify Call Center to send the All Clear bank shot

Review Scheduled Jobs – verify all schedule classes are active and processing Distribute Downtime Event Summary via email and enter downtime ticket into Footprints.

Review Completed Jobs Report and Problem Jobs Report

Provide a copy of the Downtime Log to Pharmacy Systems Analysts, Manager of Radiology, and the Senior Analyst On‐Call.

COMMAND CENTER SEATING FOR DOWNSTREAM SYSTEMS

COMMAND CENTER ROOM

MANAGER ON‐CALL (MOC) For additional reference for Communication, Contact Numbers, and time guidelines, please see the below reference available on Pulse, Downtime Procedures & Resources site: \\smhfile01\dept\ClinicalSystems\Financial Business Systems\Downtime\AMPFM downtime ‐Quick‐and‐Dirty‐DRAFT.docx


REVIEWING AUTHOR (S):

Jeff Sergi, Director of Clinical and Business Systems

APPROVALS: _________________________________ Dated: 12/29/17 Jeff Sergi, Director, Clinical & Business Systems __________________________________ Dated: 01/04/18 Pam Ramhofer, VP/CIO

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