SPECIAL EDITION
volume 3
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** Epic Wave 3 **
RWJBH-Rutgers Medical Group/ RWJ University Hospitals – New Brunswick, Hamilton, and Rahway / Bristol-Myers Squibb Children’s Hospital / CINJ Infusion Center / CINJ Physician Practice
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Top 10 Inpatient Provider Change Readiness Topics
As we transition to Epic, ten topics require inpatient provider awareness at Go-Live.
These Special Edition newsletters, covering 1-3 points each, further outline the information for easy reference.
Previously Released Topics:
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Topic 5: Sign & Held Orders in the ED
Situation: Since orders entered through the Admission Navigator default to be held until the patient arrives on the receiving unit, most Admission Navigator orders will not be activated while the patient is in the ED unless specific action is taken.
Background:
In Heritage Systems, orders default as active on the unit where the patient is located. In Epic, orders placed through the Admission Navigator default to "sign and held." Therefore, these orders will not be released and activated until the patient arrives at the receiving unit. One exception is the admission order, which is always defaulted to active even in the Admission Navigator.
Assessment:
If orders placed through the Admission Navigator need to be activated immediately, the provider has two choices:
- Manually release each order through the “Release Orders” window on the Admission Navigator.
- Place orders outside of the Admission Navigator. When using the default “Orders” tab in Epic, orders default as active on the unit the patient is located in - including the ED.
Recommendation:
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As a safety net, if patients are still located in the ED four hours after the admission order was placed, the ED Track Board will display, and the nurse will receive an alert to release and activate all sign and held orders.
- However, providers need to actively manage sign and held orders in the Admission navigator so that orders are carried out in the ED or the receiving unit as intended.
For further information, please review the Sign and Held tip sheet on the Learning Home Dashboard.
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Topic 6: Patient Status Orders
(from the ED to Inpatient)
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Patient Status Orders are orders to admit, update status (e.g., Observation to Inpatient or Inpatient to Observation), transfer a patient to a different unit, or discharge the patient.
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Admitting Provider – The provider who decides and has privileges to admit a patient at their site.
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Attending Provider – The provider who has the primary responsibility for a patient's medical care during admission or encounter.
In a typical hospital admission, after discussing the case with the inpatient attending, the ED Provider selects themselves as the “Admitting provider” and the inpatient attending as the “Attending Provider.”
- This establishes the order for admission and immediate transfer of care from the ED to the inpatient provider who accepted the patient.
In the case of a direct admit, the admitting and attending providers may be the same person.
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Epic Together's Guiding Principles:
Patient Safety & Quality, Patient Engagement; Clinician & Staff Satisfaction;
Frequent and Transparent Communication; Research & Education;
Project Approach – Configuration not customization; Optimize Financial Systems
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RWJBH-Rutgers Medical Leadership Team
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Dr. Joshua Bershad
EVP, Physician Services;
Clinical Assistant Professor of Medicine Rutgers Robert Wood Johnson Medical School
Cell: 973-202-0900
Dr. Frank Sonnenberg
Chief Medical Informatics Officer, RWJBarnabas-Rutgers Medical Group; Professor of Medicine, Rutgers Robert Wood Johnson Medical School
Cell: 908-313-6563
Dr. Carol Ash, DO, MHCDS, MBA, FACHE, CPHQ, CHCQM-PHYADV
Chief Medical Officer
Robert Wood Johnson University Hospital Rahway
Phone: 732-499-6134
Cell: 732-857-6535
Dr. Seth D. Rosenbaum, MD, MMM
SVP, Chief Medical Officer Robert Wood Johnson University Hospital Hamilton;
Clinical Assistant Professor, Department of Medicine, Rutgers-Robert Wood Johnson Medical School
Phone: 609-584-2865
Cell: 609-508-7951
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Dr. Sal Moffa
Phone: 908-685-2816
Cell: 609-238-5248
Dr. Stephen O’Mahony
SVP & Chief Health Information Officer, RWJBarnabas Health;
Clinical Associate Professor of Medicine, Rutgers New Jersey Medical School
Phone: 973-322-4231
Cell: 203-820-6519
Sheraz Siddiqui, MD
Chief of Hospital Medicine
Robert Wood Johnson University Hospital
Associate Professor, Department of Family Medicine and Community Health
Rutgers-Robert Wood Johnson Medical School
Cell: 732-986-3577
Dr. Deborah L. Toppmeyer
Professor of Medicine, Robert Wood Johnson Medical School; Chief Medical Officer, Chief, Division of Medical Oncology, Director, The Stacy Goldstein Breast Center
Rutgers Cancer Institute of New Jersey
Rutgers, The State University of New Jersey
Phone: 732-235-9692
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