Physician Updates - MEDITECH Expanse

This page is to provide physicians with updates in regard to MEDITECH Expanse.

CHANGE SUMMARY

Change	Change Date	Change Summary	Benefits	Review/ Approval
Breast Density Reporting to Patients	January 2024	Starting January 2024, breast density will be directly reported to patients. The patient’s breast density category, along with related information, will be included in the results letter that patients receive from the Yukon Mammography Program following routine screening mammography.	Improves communication to patients	Medical Imaging
VFSS Reflex Order	Jan 24, 2024	Both an order for Video Fluroscopy Swallowing Study (VFSS) and SLP Referral are required for the study to be booked. With this change, the SLP referral order will automatically reflex from the VFSS order if the patient doesn’t have an active SLP referral.	Prevents delay in care	Medical Imaging, Med Rehab, PLC
Patient Age on Reports	Jan 24, 2024	The patient age in the report header will be changed to display the patient’s age at the time of the report creation, instead of the patient’s age on admission.	Improves accuracy on reports	Health Records, PLC
Image Release Order	Jan 24, 2024	The order will be updated with the question “Is the Image Release for Patient Transfer Network?” If the response is "Yes”, contact info is not required.	Streamlines order	PLC, Imaging
Requiring Lab and Imaging Order Start Time	Jan 24, 2024	Start Time will now be required on all Lab and Imaging orders. All lab and Imaging orders have default start times, except for labs ordered as “Timed”. To enter a start time on Timed lab orders, expand the order or click on the order date.	Ensures orders are properly transmitted, reduces delays in care	PLC, MELT
Contact Plus Isolation Precaution	Jan 29, 2024	A new option for “Contact Plus” will be available for Isolation Precaution orders and assessments. Contact Plus is applied when patient has diarrhea and/or vomiting AND gastroenteritis is suspected (e.g. Norovirus, C-diff). How is it different from Contact Precautions? Wash your hands with soap and water (preferred) Twice daily cleaning of high-touch surfaces Spore killing disinfectant required for C-diff – which includes hydrogen peroxide (please use to clean surfaces, and patient equipment if C-diff suspected) – these are labeled on the units in storage.	Allows for proper ordering and documentation of Contact Plus isolation precautions, improves patient and front-line staff safety	IPAC, MELT, PLC
Public Health Special Indicator	Jan 30, 2024	A new Special Indicator called Public Health will be available. The purpose of this special indicator is to improve communication between Yukon Communicable Disease Centre (YCDC) and YHC Emergency Departments. The special indicator will be managed by the nurses at YCDC. Viewing Special Indicator Tip Sheet	Improves communication between YCDC and YHC	YCDC, ED, CHCAC, PLC, MELT
Lab Bundle Changes	Jan 30-31, 2024	The orders for Basic Metabolic Panel (BMP), Comprehensive Metabolic Panel (CMP), Liver Panel, and Extended Lytes Panel will now reflex each individual LAB order part of that panel. If one of these orders is in a personalized order set and you pre-selected it, they will be replaced with the new orders and the pre-selection will need to be made again. Please see the tip sheet on updates to personalized sets: Managing Updates to Personalized Order Sets Tip Sheet	Improves trending ability and visual in Plexia, improves patient safety and reflex testing	Lab, PLC
POCi Daily Frequency for Community Hospitals	Feb 5, 2024	A new ordering option for Daily POCi orders will be available for the Community Hospitals. To change the default number of days, change the day count then hit ‘Enter’ (ignore the list of frequencies in the drop down list).	Streamlines ordering	CHCAC, MELT, PLC
Report Clean Up	Ongoing	Duplicate headers and square brackets [] will be removed from reports.	Simplifies reports	PLC

FOR INFORMATION

Item	Summary	Review/Approval
Physician Support Email	PhysicianSupport@yukonhospitals.ca
Physician Education Material	https://1healthyukon.ca/general-physician-education
Cancelled Medical Imaging Orders	Medical Imaging was previously following up on every cancellation/stop request. Moving forward, MI will not be following up on imaging orders that are stopped or cancelled.	Medical Imaging, PLC
Gestational Diabetes Intr/Ps Order Set	Order Set reminders will be updated from “diet controlled or on insulin” to “diet controlled or on medication”.	PLC
Urgent/Emergent OR Booking Form Order	Procedure field will be updated to allow more text.	PLC
ED MedDir Suspected Stroke Order Set	A medical directive for suspected stroke will be available for ED. It replicates the paper medical directive on SharePoint and does not include medications outside of fluids.	PLC, MELT

If you encounter any issues or have any questions about these changes, please contact the
Meditech Expanse support line at ext 8601 (internal) or (867) 393-8601 (external) or through JIRA

Physician Communication - December 2023

CHANGE SUMMARY

Change	Change Date	Change Summary	Benefits	Review/ Approval
Diabetes Education and Dietitian Outpatient Reports	December 13, 2023	The Diabetes Education and Outpatient Dietitian reports will be updated so that they can be distributed to the referring physician. Reports will flow to Plexia instead of being faxed. These reports will now display in the Provider Notes tab instead of the Nurse/Allied Health tab.	Reduces printing and manual faxing	PLC
Blood Bank Order Changes	December 14, 2023	Changes to multiple blood product orders are being made to improve ordering accuracy and communication to nursing for administration. Blood product ordering tip sheet is located here.	Clearer blood product orders	PLC, MELT, LAB
Exclude Admitting Provider from Imaging Reports	December 14, 2023	This change will remove the Admitting Provider as a recipient from imaging reports. An ED Physician admitting a patient and ordering imaging would receive the report as the Ordering Provider.	Reduces reports for Admitting Providers	PLC, Medical Imaging
PIH Bloodwork order set changes	December 15, 2023 (TBC)	Updates to PIH Basic Bloodwork and PIH Extended Bloodwork order sets to reflect most recent best practices	Reflects best practices	PLC, MELT, LAB, Mat/Newborn
New “Report Edit Request” order	December 15, 2023	A new order called “Report Edit Request” is being created to allow physicians to request a report to be reverted to draft status, deleted, or to have the report type changed. This order will print to the health records department and can be used on discharged accounts. Please note that reports changed to draft status and re-signed will resend to Plexia.	Easier communication with Health Records dept	PLC, Health Records
ED STEMI - Fibrinolytic checklist and contraindications	December 18, 2023	The Fibrinolytic Checklist and Contraindications have been added as Reminders in ED STEMI Order Set.	Clinical Decision Support	PLC, ED SME

FOR INFORMATION

Item	Summary	Review/Approval
Physician Support Email	Yukon-Hospitals-Meditech_Educators@yukonhospitals.ca
Ambulatory Orders for WCB forms	When documenting on the ED WCB forms, the usual discharge section will not be available. If the patient requires ambulatory orders, please use the “Discharge” button.	ED SME
Same Day Physiotherapy Referrals	If a patient needs to be seen on the same day, a pop up will now display from the order screen with the phone number to call for same day service.	Inpatient SME
Eat, Sleep, Console Assessment	As of December 13, this nursing assessment tool will now be available for Maternity.	Mat/Newborn, Pediatrics
Locked Up Home Medications	In November, changes were made to the nursing admission assessment and discharge checklist to improve the tracking of home medications.	MELT
MPR Patient Tracker	A public tracker has been set up for MPR and Cast Clinic	Surgical Services

Physician Communication - August 24, 2023

CHANGE SUMMARY

Change	Change Date	Change Summary	Benefits	Review/Approval
Bowel Management Order Set	26 July 2023	Visual changes done to collapse reminders and bowel management medications.	Cleaner view.	PLC
Changes to Transfer Discharge Letter	27 July 2023	- Change name of report to Transfer Discharge Summary - Remove Labs from formatted data - Move all formatted data to bottom of report - Renamed section from "Results" to "Additional Patient Information" - Addition of a new section for current active medications. - Removed “Barriers and Goals” section		PLC
Image Release From – Order	02 August 2023	-Image Release Form (Push to Grid) is now available as an Order in Web Acute -Output will print out in Medical Imaging for MI Dept to fulfil request. ** NOTE Between 11 PM and 7 AM, you must call on-call imaging tech for urgent and STAT image push.	Workflow can move from paper to Meditech.	PLC/MI Dept.
New “Radiologist Order Set”	August 23^rd 2023	This new order set is meant to be used ONLY by radiologists to place post-op orders when performing an interventional radiology procedure.		PLC
New “Outpatient referral to Preop Clinic – Anesthesia Consult Review” order	22-August-2023	This new order is to communicate to booking clerk that the patient needs to return to the pre-op clinic for a second assessment before the surgery.		PLC
New “Outpatient Follow-Up to Surgical Clinic Order”	23-August-2023	This new order is to be used ONLY by surgeons that practice in the outpatient surgical clinic. It’s purpose is to notify the clinics staff that the patient requires a post-op follow-up appointment.
Changes to “Outpatient Dietitian Services” Referral	23-August-2023	This is an optimization of the Outpatient Dietitian Referral. The title of referral was Changed to “Outpatient dietitian/ Diabetes Education Services” , and Improved list of “Reason for referral”		PLC

FOR INFORMATION

Item	Summary	Review/Approval
Physician Support Email	Yukon-Hospitals-Meditech_Educators@yukonhospitals.ca
Question Correction on Discharge Summary	Comment questions for Barriers to Discharge is being updated to fix a background issue. This will affect the Discharge Summary Document. As of August 30^th, you will see 2 comment questions for each category of Discharge Barriers (Nursing, Rehab, Social)--one question for comments entered before August 30^th and one for comments entered after August 30^th. Approximately 1 week later, this will be corrected, and you will only see one comment question for each discharge barrier category.

If you encounter any issues or have any questions about these changes, please contact the
1Health support line at ext 8601 (internal) or (867) 393-8601 (external) or through JIRA http://yhsdkb:8080/servicedesk/customer/portal/1/create/6

Physician Communication - June 29, 2023

CHANGE SUMMARY

Change	Change Date	Change Summary	Benefits	Review/Approval
Aliases for Xrays	May 30th, 2023	All X-rays now have an alias of XRAY. Typing in XRAY will return all x-rays available in the results.		Approved at PLC March 27
Add Problem functionality issues in documentation		Since the last Meditech upgrade, users documenting a plan in the “Assessment and Plan” section of many documents were required to add a problem. Users will now be able to document an overall plan for the patient and/or a problem-specific plan (with the use of the “Add Problem” button). Please refer to the attached tip sheet for details about the workaround solution. Additionally, only in the Admission Note, the “Add Problem” button has been removed and cannot be removed from other reports.
Personalized Order Sets	May 1, 2023	All reminders for personalized order sets will be removed in separate comms to all phys.		Approved at PLC March 27
DKA Order sets Community Hospital		A DKA order set has been built for Community Physican to accurately represent the lab tests available in community. In Step 2 the ongoing investigations reflect the POCi lab work available and the Beta-Hydroxybutyrate has been removed. When the patient arrives to WGH the receiving Physican will need to order the ongoing investigations to reflect what is available at WGH.	Order Sets accurately represent what is available in communities	Dr. Von Wiegen
Anes Post C-Section Epimorph order set	June 7 2023	Addition of a reminder to help inform where physicians can access documentation on the status of spinals for maternity patients. Documentation process is still paper, so information not available in the EMR.
Resuscitation pre-click for Mat/Child order sets	June 13 2023	The resuscitation status order has been added to the following sets: - OBS Admit Antepartum - OBS Preterm Labour - OBS Labour at Term The resus status has been defaulted to "CPR - Resuscitative Care".		Mat/ NB committee, Approved at PLC on June 12^th 2023
ED Pain meds and ED Pain Meds (No NSAID) order sets	June 13 2023	The route of administration on the medications have been updated to the following: 1. SUBCUT meds changed to IM 2. IV/IM meds changed to IV		Approved at PLC on June 12^th 2023
Alcohol Withdrawal (CIWA) Order set	June 13 2023	Default activity level “Activity as Tolerated” instead of “Bed Rest w/Bathroom privileges” Adding a comment of “assess patient sedation and CIWA prior to mobilize“ to activity order Added “consult dietitian if patient has no intake for 24 hours” to nurse to manage diet instructions and removed individual order.		Approved at PLC on June 12^th 2023
Gyne Major Surgery Post Op order set	June 13 2023	- Pre-click Activity as Tolerated - Add nursing communication order - Expand all sections by default, except two medication sections - Change wound management order direction from “protocol” to “As directed”		Approved at PLC on June 12^th 2023
Gyne Post Op Day Surgery order set	June 13 2023	Reordering the meds from PO to IV to ensure consistency		Approved at PLC on June 12^th 2023
Readmit newborn order set	June 29^th 2023	- Uncheck the sucrose 24% order - Remove Antimicrobial reminders - remove vitamin k - remove hep B immune globulin reminders and order - remove cord blood gas, CRP, baby ABO/Rh, urine drug screen, herpes culture, blood culture, HSV type Specific - remove PT,OT and SLP, RD, Pharmacy (only include first nations health and SW) - add daily weights, add vitals Q4, Capillary Blood Glucose POC - Neonatal (same as newborn order set) - add Nurse to manage diet

FOR INFORMATION

Item	Summary	Review/Approval
Physician Support Email	Yukon-Hospitals-Meditech_Educators@yukonhospitals.ca
Enter a Meditech Support Ticket	The Meditech support form (Jira ticket) is now a direct link on all physician desktops.	PLC
Co-Sign Date/time and Name on physician reports	Upon request from Health Records, Co-Signer's to appear on reports in the signature line. It's not always clear that a co-signer has signed the report as it doesn't show anywhere.	PLC
New Note Templates for SSOP	The nursing note template “Surgical Services Outpatient” will be replaced by “SSOP/Cast Clinic”, “SSOP/Colposcopy” and “SSOP/MPR”. Historical notes will continue to be listed as “Surgical Services Outpatient”	OR Manager

Physician Communication - May 19, 2023

CHANGE SUMMARY

Change	Change Date	Change Summary	Benefits	Review/Approval
Priority Pack	April 25	The MEDITECH System was successfully upgraded on April 25th. This update is called a Priority Pack and contained several corrections to resolve software deficiencies, as well as several enhancements for workflow improvements. The Priority Pack posed some issues to Physician Documentation in particular, that are actively being actioned by 1Health support staff.	System performance improvements Additional functionality
Personalized Order Sets	May 1, 2023	As medications are updated on order set, reminders are sent to physicians reflecting their personalized order sets. All reminders for personalized order sets will be removed for physicians, by the 1Health team, starting May 1 This tip sheet provides guidance on how to remove reminders Tip Sheet	Assistance in the cleanup of residual notifications on personalized order sets, caused by updates to Order Sets	PLC March 27
Physician Favorites	June 2, 2023	The 1Health team will set up specialty specific scope of order, order set and document favorites at training and upon physician onboarding	Build a baseline of favourites for physicians to improve on efficiency and reduce searches	PLC March 27
Aliases for X-rays	June 9, 2023	An alias of XRAY will be added to all XR orders to improve search functionality of ordering Xray orders	Improve efficiency in ordering and makes ordering easier to find	PLC March 27

FOR INFORMATION

Item	Summary	Review/Approval
Physician Support Email	Yukon-Hospitals-Meditech_Educators@yukonhospitals.ca	PLC
Co-Sign Date/time and Name on physician reports	Upon request from Health Records, Co-Signers and contributors date, time and name will appear on the bottom of all physician reports, in the signature line.	Health Records, PLC

1Health Physician Communication - April 27, 2023

Change	Personal Order Sets
Change Date	May 1, 2023
Review/Approval	PLC

Change Summary

Physicians using personalized order sets will have noticed that a pop-up displays when the order set has been updated. The 1Health Team will be clearing all personalized order set pop-up reminders on May 1, 2023.

Moving forward, please ensure that updates to personalized order sets are reviewed. Follow the steps below to clear the reminders from personalized order sets after they are reviewed.

Go to Menu > Manage Personal Sets
Select the personal order set and select Do Not Show Again when the pop-up displays.

Benefits

Maintaining personal order set reminders ensures that physicians are notified of new changes to personalized order sets.

1Health Physician Communication March 31, 2023

CHANGE SUMMARY

Change	Change Date	Change Summary	Benefits	Review/Approval
Priority Pack	April 25	The MEDITECH System will be upgraded on April 25th. This update is called a Priority Pack and contains several corrections to resolve software deficiencies, as well as several enhancements for workflow improvements. Lunch and Learn Sessions will be held the week of April 17^th and at the elbow support will be available for providers after the go live. The Priority Pack will include changes to Physician Documentation and HIM Deficiencies, as well as other areas. More information will be communicated in April.	System performance improvements Additional functionality	PLC
Medical Directive: Pre-op Pediatric Analgesia	April 5	Medical Directive for Surgical Services – Pre-Op Pediatric Analgesia Hold queue can be used to order Medical Directive for pre op visit, this includes: Acetaminophen dosing Ibuprofen dosing The directive will flow to the nursing worklist for the nurse to enter the medication orders once the patient is weighed. The medication order will auto calculate the proper dose if the patient is weighed, and the weight is documented in the system.	When patient is weighed on return for OR nursing will give appropriate doses of pre op medications Acetaminophen and Ibuprofen dosing will be calculated based on the patient's most current weight	PLC, NAHLC, Surgical Services, CNE’s, MAC
DKA/HSS Order Set Changes	April 12	The DKA/HHS order set will be divided into four separate order sets guided by the Protocol Steps established at YHC: DKA/HHS Step 1 DKA/HHS Step 2 DKA/HHS Step 3 and 4 DKA/HHS Step 5 Additional changes have been made to improve the workflow: Additional orders have been pre-selected, including nursing protocols for each step Anion Gap will be auto calculated and documented hourly Insulin infusion will default to 0.1 units/kg/hr if a weight has been documented for the patient ½ NS has been removed Dextrose is now a nursing worklist order and will not flow to the MAR without nursing placing an order The Adult Diabetic Ketoacidosis flowsheet will be updated to include Anion Gap	Reduces clicks and streamlines ordering Streamlines the MAR and clarifies nursing protocols	PLC (March 27, 2023) Lab Pharmacy NAHLC

FOR INFORMATION

Item	Summary	Review/Approval
Physician Support Email	The following email can be used to request MEDITECH training or support: Yukon-Hospitals-Meditech_Educators@yukonhospitals.ca	1Health Team
Hyperkalemia Order Set	A Hyperkalemia order set is now available to improve patient care.	PLC
Gestational Diabetes Order Set	The insulin sliding scale has been pre-selected as it is a required element of the protocol that is pre-selected.	Maternity
Ortho Order Sets	The following order sets have been updated with the changes requested by the orthopedic surgeons. Ortho Nausea Vomiting Ortho Fracture Pain Meds Ortho Post Op Inpatient Ortho THA Post Op Ortho Hip Fracture Pre Op Ortho Hip Fracture Post Op Ortho TKR Post Op Ortho Pain Meds Day Surgery	Orthopedic Surgery
Caesarean Section Recovery Policy	On March 13, A Caesarean Section Recovery Policy was added to the Anes Post C-Section Epimorph order set and is pre-selected. The policy will flow to the nursing worklist.	Mat Newborn Committee
ED Face Sheet	Triage Interventions have been added to the ED Face Sheet. The contact section has also been updated to display the first two contacts. If applicable, any additional contacts can be accessed within the Chart.	ED Committee
Closing Old Session and Starting New	Starting a new session can fix some general issues with your MEDITECH session Tip Sheet	General Help Tip
Ability to open 2 MEDITECH sessions	Physicians have the ability to open 2 concurrent sessions of MEDITECH Tip Sheet	General Help Tip
Clearing the Cache	Clearing the cache by itself or in combination with starting a new session can also fix some general issues Tip Sheet	General Help Tip

1Health Physician Communication - February 23, 2023

CHANGE SUMMARY

Change	Change Date	Change Summary	Benefits	Review/Approval
Diet Order Changes	Feb 14	Diet order screens have been adjusted so that Easy Chew is no longer an option for texture. General Adult Diet order will now default in a Regular texture Clear Fluid and Full Fluid orders will default a texture of “Not Applicable”	Reduces clicks, ensures the diet transfers properly to the kitchen	PLC (Jan 16, 2023)
WGH Respiratory Panel and COVID orders	Feb 21	The required fields for the following orders have been removed: Respiratory Panel – WGH COVID-19 n-Coronavirus NAT-WGH	Reduces clicks and non-mandatory field removed	Lab, PLC (Feb 13, 2023)
ED Pre-click Order Sets	Feb 23	The following pre-clicked order sets are now available: ED Chest Pain (Not Diagnosed) PRECLICK ED Abdominal Pain PRECLICK ED Asthma/COPD PRECLICK ED Headache PRECLICK	Reduces clicks, streamlines ordering	PLC Members (Jan 2023) and Pharmacy (Jan 2023)
ED Convenience Order Set	Feb 23	A new order set, called ED Orders, has been created with frequently used ED orders. The order set includes labs, imaging, microbiology and therapeutics.	Streamlines ordering	PLC Members (Jan 2023) and Pharmacy (Jan 2023)
OB Order Set Changes	Feb 27	OB Vaginal Delivery Postpartum: Naproxen changed from BIDCC PRN to Q12H PRN New section added called In Event of 3^rd or 4^th degree tear OBS Cesarean/Forceps Post Op New section added called In Event of 3^rd or 4^th degree tear	Improves ordering	Mat/Newborn Committee (Feb 14, 2023)
ED Discharge	March 7	A new Meds to Go order will be available for patients in the ED. Tip sheets will be posted here prior to go live.	Improves meds to go process	PLC (Jan 16, 2023)

FOR INFORMATION

Item	Summary	Review/Approval
Infant Formula Diet Order	The Infant Formula Diet order will now flow to the nursing worklist.	PLC, Nursing Allied Health Leadership Committee
PCA Assessments and Pain Management Flowsheet	As of March 6, the nursing PCA assessment will now be documented in the worklist. This is more intuitive for nursing and will improve charting. A Pain Management Flowsheet will also be available.	Nursing Allied Health Leadership Committee
Discharging Scheduled Surgical Admits when OR Cancelled	New Discharge Dispositions have been added for surgical services: IN-OR Home (Surg Deferred) IN-OR LTC (Surg Deferred)	Health Records and Surgical Services
Resuscitation Status History and Advance Directives	Resuscitation Status history can be accessed from the patient header under “Hx Avail” If an Advance Directive exists, it will be located under the Legal tab on the Resuscitation Status history screen	PLC

1Health Physician Communication - Jan 26th, 2023

CHANGE SUMMARY

Change	Change Date	Change Summary	Benefits	Review/Approval
FN Indicator	Jan 10	A First Nation indicator will now display on the Acute Status Board and ED Tacker.	Reduces clicks	PLC (Jan 3, 2023)
Preferred Name on Status Board and Tracker	Jan 10	If applicable, the patient preferred first name will now display in brackets on the Acute Status Board and ED Trackers.	Reduces clicks	PLC (Nov 7, 2022)
POC at Community Hospital	Jan 17	i-Stat and Piccolo tests (Chem8, CG4, INR, TROP, LFTs) are interfaced as of Jan.17^th. The orders are placed as interventions, once the testing is performed on the instrument, results will upload to the patient's EMR. Physicians can find this under Diagnostics. The results will have appropriate associated comments, including critical result comments, will have the date and time associated to testing and will be trend able, like any other lab result.	Access to results in the EMR from all YHC locations.	PLC (Jan 16, 2023) Lab
Admit ICU and Admit Med Surg PRECLICK Order Sets	Jan 17	The following pre-clicked order sets are now available. Within these new order sets, orders such as MRP Handover, Resuscitation Status, Isolation/Precaution, Diet and Activity are pre-selected to reduce clicks. Admit ICU CPR/ISO Admit ICU CPR/noISO Admit MedSurg CPR/noDVT/ISO Admit MedSurg CPR/noDVT/noISO Admit MedSurg DNR/noDVT/ISO Admit MedSurg DNR/noDVT/noISO	Reduces clicks and streamlines admission ordering	PLC Members (Dec 2022 and Jan 2023)
IV Solution Ordering	Jan 31	Effective Jan 31, all standalone IV fluid order strings (Normal saline, KCL large volume bags, D5W, etc.) will be housed within an order set for streamlined ordering. The order set can be accessed by searching the fluid name (ie: D5W) or by searching “IV FLUIDS”. All existing order sets will remain formatted as they are at present. If physicians have favorited IV Fluid standalone order strings, these will no longer be available after Jan 31^st and all favorites should be saved from within the new order set	Simplifies IV Fluid ordering	PLC (Jan 16, 2023) P&T (Jan 9, 2023)
Colonoscopy and Gastroscopy Prep	Jan 31	Order sets for Colonoscopy Prep and Gastroscopy Prep will now be available. The order sets can be used prior to the procedure being booked. Tip Sheet is posted here prior to go live	Improves ordering process for physicians	PLC (Nov 21, 2022) P&T (Nov 17, 2022)
ED Discharge	Early February	A new Meds to Go order will be available for patients in the ED. Tip sheets will be posted here prior to go live.	Improves meds to go process	PLC (Jan 16, 2023)
Gen Surg Order Set Changes	Jan 27	With this change, new order sets were created providing additional pre-clicked options	Streamlines ordering and reduces clicks	PLC Members (Jan 2023)

FOR INFORMATION

Item

Summary

Review/Approval

OBS Stillborn Order Set

As of January 18^th, most of the lab orders on the OBS Stillborn order set are now pre-selected. This ensures that the orders cross to lab with a consistent start time. Please note that any labs not required can be unchecked.

Lab, Maternity

Frostbite Order Set

As of December 23^rd, the Frostbite Order Set was streamlined so that once the grade is selected only applicable orders display.

Lab, Pharmacy, Physicians

New Mono Test

The lab has moved to a new methodology for their Mono test.

There is no change to the ordering name
There is no change to the EMR ID or report distribution
Improved turnaround times will be noticed as the test will no longer be batched but processed as priority ordered.

Lab

Critical Result Comment

There is a new critical result comment that was recommended by the Medical Director to ensure the urgency of the result is verbally communicated and visually represented on the report.

BBK has also done a review/revision of the critical result comment associated to positive Antibody Screens in Transfusion Medicine to be more appropriately worded to the testing.

Lab

Reference Range Review/Update

As part of the preparation of the POC interface Go-Live, reference ranges of the POC tests and tests processed on the main Lab analyzers took place. Some of the reference ranges were updated as recommendations of the Medical Biochemist and Hematopathologist.

Reference Ranges updates were done on the following analytes and will continue as we review/update the remaining tests at WGH:

Sodium (Na) Potassium (K)	Chloride (Cl) Carbon Dioxide (CO2)
Creatinine (Crea) Urea (BUN)	Glucose POC Glucose (Glucometer) Whole Blood Glucose (Blood Gas)

Lab, Maternity

1Health Physician Communication - Dec 15th

CHANGE SUMMARY

Change	Change Date	Change Summary	Benefits	Review/Approval
WGH to Community Hospital	Dec 12	Discharge Transfer functionality in Discharge Plan can be used for inpatients transferring from WGH to a community hospital. Overview of Transfer from WGH to Community Hospital ( Tip Sheet) Completing Discharge from WGH to Community Hospital (Video) Accepting Discharge Transfer Orders at Community Hospital (Video)	Streamlines ordering for receiving physician Improves BPMH process on future admissions	PLC (November 7, 2022)
Pediatric DKA Protocol	Dec 12	The Pediatric DKA Protocol order on the Pediatric DKA order set is now pre-selected.	Reduces clicks	PLC (Dec 5, 2022)
Orthopedic Flowsheet	Dec 14	A new Orthopedic Flowsheet is now available. The flowsheet includes the following patient information: Vital Signs, Labs, Imaging, Microbiology, Pathology, Provider Notes, Nursing Notes, PT Notes, OT Notes, Med Rehab Notes, Medication Administrations	Provides one central location for viewing specific patient information	PLC (Dec 5, 2022)
Orthopedic Minor Procedure Note	Dec 14	A new physician documentation template has been created for the Orthopedic Surgeons. The report will flow to the Chart as a “Minor Procedure Report”.	Streamlines documentation	PLC (Dec 5, 2022)
Cast Clinic Order Prompt	Dec 14	A new prompt has been created that will auto-launch the cast clinic referral order once the report is signed. It has been added to the following physician documentation templates: Orthopedic Minor Procedure Note Cast Clinic New Consult Cast Clinic Follow Up	Reduces clicks	PLC (Dec 5, 2022)
Drain Management Order	Dec 15	The Drain Management order can now be used for NG Tubes. If NG Tube is selected as the drain type, “Reason for tube” and “Tube suction” fields will display. Previously, only Insert or Discontinue orders were available for NG Tubes.	Improves ordering	PLC (Dec 5, 2022)
GI Tube Insertion	Dec 15	“Tube suction” responses will be optimized.	Reduces scrolling and clicks	PLC (Dec 5, 2022)
OBS Order Set Changes	Dec 16	OBS Dinoprostone: change to the monitoring for the first hour post Cervidil to reflect current nursing practice. OBS Preterm Labour, OBS Labour at Term, Admit Antepartum: formatting changes OBS Post Delivery Newborn, OBS MedDir Newborn: simplified lab ordering	Reduces clicks Streamlines ordering	Mat/Newborn (Dec 13, 2022)
Tumour Marker Orders	Dec 21	Tumour marker orders will be update so the only mandatory response is Sample Type, which will default as “Serum”. The fields will also be collapsed to reduce scrolling.	Reduces scrolling and clicks Streamlines ordering	PLC (Dec 5, 2022)
Tumour Marker Convenience Order Set	Dec 21	A Tumour Marker Convenience order set will now be available. Please ensure that when ordering using the Tumor Marker Convenience order set to be mindful of the choosing wisely recommendations.	Reduces clicks	PLC (Dec 5, 2022)
Hospitalist Provider Teams	January	A new column will be added to the Acute Status Board for Provider Teams. The provider team will be used by the Hospitalist group to manage patient lists and evening coverage. Tip sheets will be posted on the Physician Education website in January.	Improves Hospitalist patient list management	PLC (Dec 5, 2022)

FOR INFORMATION

Item	Summary	Review/Approval
Exiting out of transfer orders	Please ensure that the Transfer order screen is not left open within a patient’s chart. If the Transfer order screen is left open, nursing is not able to administer medications in the MAR.	1Health Team
Inpatient Communication	Inpatient communication, including Hey Doc functionality, is currently being reviewed. Tip sheets and more information will come in January.	1Health Team, PLC, NAHLC
Respiratory Virus Testing	The following orders are available for respiratory virus testing: Respiratory Panel-WGH includes Covid-19, Influenza A, Influenza B and RSV orderable at all 3 YHC facilities as a panel tested at WGH on the GeneXpert limited to symptomatic, admitted patients of YHC (including inpatients and those to be admitted from the ED). Respiratory Viruses includes Covid-19, Influenza A, Influenza B and RSV completed at BCCDC Covid-19 n-Coronavirus NAT-WGH still available as a single test completed at WGH Covid-19 Virus (2019nCoV) NAT still available as a single test completed at BCCDC	Lab
Liquid Base Cytology Pap Test	BCCA is changing to the liquid-based cytology method for Pap testing. Communication has been sent out to all providers. Supplies are a direct order from BCCA, but all specimens and requisitions will be forwarded to WGH Laboratory for transport to BCCA. There is no change to report distribution of pap testing from BCCA.	Lab
Wound Vac Order – Alternate dressing	As of Dec 9th, “Alternative dressing (If unable to maintain VAC 22 hr/day)” was added to the Wound Vac order and is required. This reflects what was previously on the paper order. Additional information for this field is available on the order using the expand order tab.	CNE’s
First Nations Health Program (FNHP) Note Category	Under the “Nurse/Allied Health” notes tab of the chart, there is now a “First Nations Health Program” note category. This category allows providers to easily locate the First Nations Health Program Notes.	First Nations Health Program

If you encounter any issues or have any questions about these changes, please contact the
1Health support line at ext 8601 (internal) or (867) 393-8601 (external) or electronically at http://yhsdkb:8080/servicedesk/customer/portal/1/create/6

Page last updated: 15 Apr 2024, 10:37 AM

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