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CPOE Monthly Newsletter: 1st Edition September, 2005 POM – Past, Present and Future In 2001, the Leapfrog Group, an organization that works to reduce preventable medical mistakes and improve the quality and affordability of health care, recommended utilizing a CPOE system – Computerized Physician Order Entry, to reduce medication errors. Improving safety around patient medication was and is one of Mount Auburn Hospital’s top initiatives. The institution committed to installing MEDITECH’s POM module – Provider Order Management. After 2 years of planning and building, and several iterations of software, the Labor and Delivery unit piloted the product on May 13th, 2003. The successful 2 week pilot, including the ordering of Medications and Order sets, expanded. The floors stayed LIVE with ordering online and soon began ordering all diagnostic procedures. The next step was to roll out POM on Wyman 2, the Geriatric Psych unit. With longer patient stays and constantly changing doses, there were several new challenges that were faced with online ordering on Wyman 2. As Mount Auburn hospital has expanded its usage of POM, so have other MEDITECH hospitals. The most recent software upgrade, the 5.4 version, offered many improvements over the original POM system we went LIVE with. Most recently, the first Med/Surg floor, Needham 8, went LIVE. This go LIVE encompassed the largest number of Ordering users to date and has been very successful. Plans are underway to continue rolling out Provider Order Management. The current plan is to bring the Needham 7 and South 4 units LIVE at the end of October. Building, planning and infrastructure upgrades are underway. Training will begin at the end of September. Software improvements are continually being made in an effort to streamline and facilitate ordering practices among users, as well as to improve communication to Nursing and support staff, and ancillary departments. Training and Review Sessions We will be holding training and review sessions for POM twice a month. These will be held in the Clark basement training room on: Second Wednesday of every month at 8:00 – 9:00am Fourth Wednesday of every month at 12:00 – 1:00pm There are only 6 spots available per class. To sign up go to www.mountauburnhospital.org Click on Calendar of Events on the left-hand side of the page Calendar view will default to Month, click Submit Look for the POM User Training on the calendar and click on it Click Register for this event Fill in the appropriate information. If you need to cancel a registration you can either MOX or call Sarah Freeman at 5610. POM Tips and Tricks Keystrokes and Shortcut Bar: The MEDITECH System has standard keystrokes. In the POM module, most of these can either be performed using the keyboard, or by clicking on one of the icons on the toolbar, which is located on the right hand side of the screen. The following is a list of typically used functions: File/OK (Used to save and file work being done) F12 or Green Check Mark Exit (Used to leave a screen without saving) F11 or Red X Online Help (Can be used to access info about a prompt) Shift, F8 or Question Mark Lookup (Used to look up into a list of choices for prompts) F9 or Binoculars Navigation Keys – in PCI, use arrow keys to navigate through Table of Contents And other menus. Arrow keys on the toolbar have the same functionality. See below for some helpful keystroke tips that can be used in the MEDITECH POM system. Example: Admission Screen Any field denoted with an asterisk requires a response before filing. There are lookups available at many fields. Access the lookup by using the F9 key. Admit To: This provides a lookup to all Inpatient Locations. To see the list, press F9, or click on the binoculars on the toolbar on the Right Hand side of the screen. Telemetry: Type Y or N. INP/OBS: This also has a lookup associated that can be accessed by pressing F9 or clicking on the binoculars. Diagnosis: Allows a free text entry. Condition: Allows a free text entry. Attending Physician: This is a lookup into the full Provider Listing. This is a long list. Suggested: Type in the first three letters of the Attending Physicians last name (Must be in CAPS), then hit the lookup (F9) key. This will bring you directly to the area of the list where you can pick the attending Physician from. Either select the corresponding number with the Physician on the list, or click with your mouse. Pager: Allows for the 4 digit pager to be entered. House Officer/PA: Free text entry. Fill in whichever is appropriate for this patient. Pager: Fill in the 4 digit pager id associated with the House officer or PA. What do I do if I can’t find the medication or IV fluid that I am looking for? The MEDITECH system allows the use of free text medications and IV fluids. This can be used if the user cannot find the medication or IV fluid in the regular lookup. The free text functionality is also used when a patient is on a medication that is not in the hospital’s formulary and the patient will be given the medication from his or her own supply. To use this free text functionality, follow the steps below. Click on the Medications/IVs button to bring yourself into the medication lookup screen. Here you will see a button called Non-Formulary. This will allow you to free text in a medication or IV fluid. Once you click on this button you will be asked whether you would like to enter a medication or an IV. Select the appropriate response. You will need to answer the questions that follow (reason for use, expected duration of time, number to be obtained, can patient use their own supply). Once all the questions are answered you will be brought to one of the following screens Non-Formulary Medication Non-Formulary IV Free text in the medication/IV fluid name and fill out the appropriate dose, route, direction, start time, and stop time. Click OK when done. You will need to Submit and enter your pin and password as usual. Printing off Physician List of Orders There is a new report that will allow you to print off a list of your orders. You can find this on your MIS menu, #68 – POM Orders by Provider. Defaults to ALL, can be changed to put in one patient. Defaults to T-1, can be made any date Defaults to 0000, can be made any time Defaults to T-1 can be made any date Defaults to 2359, can be made any time Defaults to you, can be changed to put in whomever Editors: Jeannette Currie and Sarah Freeman, Information Systems CPOE Executive Team To contribute ideas and future topics please email Sarah Freeman [email protected]