Date post: | 02-Jan-2016 |
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Problem
Cases are found on Day of Surgery to have been mis-identified at some point in the process between the point of Scheduling
Request and Registration.Result
Preparatory efforts for Day of Surgery are for the wrong patient, recorded on the
wrong patient, integrated for the wrong patient, creating delays and potential risk in
the delivery of care.
Increasing Deployment of integrated systems for providing Peri-Procedural and Peri-Surgical care
•Scheduling of all resources and the initiation of planning – it all starts here•Clinical documentation - Prior to Arrival efforts, Pre Anesthesiology, Pre Nursing, Intra Anesthesiology, Intra Nursing, Post Anesthesiology , Post Nursing•Hospital Billing, Anesthesiology Billing•Reporting
SLCHBWCCPAP
IVF, GI,
ECT, MRI, CPC, Rad, etc.
North South L&D
OC
195 Cases on a given day
84/195 Seen in CPAP within 30 days101/195 Intubations67/101 Intubations Seen in CPAP38 Inpatient > DOS
63
17
68
26
33
21
31
20
Number ScheduledNumber Seen in CPAP
Opportunity days between planning and occurrence
5 and under
6 to 14
15 to 30
30 or more
The Anesthetic PlanA preanesthetic evaluation allows for the development of an anesthetic
plan, and preparatory testing, that considers all procedural risk and conditions or diseases of the patient that may influence the safe outcome
of the anesthetic.
Case posts in the MetaVision (PreAdmission state which is Inactive) if a MRN is in the Scheduling Message and if not it will post when the MRN
shows up in the Registration Message.
IF Active - Automatically pulls in Past Medical and
Past Surgical History from Previous MetaVision
visit
IF Active - Automatically pulls in
recorded Allergies from Previous visit
IF Active - Automatically imports Last
documented Home Medication, Smoking and Alcohol history,
OSA, Difficult Intubation , Nursing
History.
Labs InterfaceLab message to MetaVision:
Match by MRN. If MRN does not match
delete.
IMPLICATIONSBlood Bank and
Lab results only if MRN
Match. Scheduling errors will
result in failure to post
Manual Import of
PAP if greater than 30
days
Clinician review of Clindesk,
Labs, History, record
findings and plan in
MetaVision.NOTE Just
opening the record in
MetaVision, regardless of
Status, requires
forever save because of
HIPAA
What it takes for Surgical/Procedural Case progression
Documenting
executed care on DOS.
Occurs prior to arrival as preparation or on DOS
ScheduledRegistration in advance of, or on,
DOSDOS
Case Inactive Case Active
End
Resu
lt in
terf
ace
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osp
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illin
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osp
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ata
Ware
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Pri
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Offi
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isit
Pitfalls to Anecdotal Thinking
Failure to ObserveAssuming you know what the problem is without
seeing what isactually happening
Failure to PlanAssuming you know how to fix a problem without first
findingout what is causing it
Failure to ValidateAssuming the action you have taken to fix the
problem hasworked without