Wave 3 Launch Support Hot Topics - Day 3

Daily postings on this channel address needs raised in physician huddles, with links to support information. Content is locked in at 16:00, and any additional hot topics after this time will be posted separately. Consider looking back at the previous day's posting(s).

  • ED Prescriber Admitting to a Different Site
    • An emerging Wave 3 workflow involves a prescriber assessing a patient at an ED at one facility (without inpatient beds) and admitting to another facility where the prescriber may continue or handover care. The best way to handle this is being worked out and may involve an addition to the Patient Movement section of the Manual. 
  • ED Prescribers Entering Inpatient Orders
    • Another workflow emerging as Connect Care encompasses more rural sites involves a prescriber working in an ED context admitting a patient to the same facility (possibly as an emergency inpatient) where the ED prescriber is also the inpatient attending. Connect Care orders, navigators and documentation tools tend to be anchored to specific contexts (i.e., inpatient, ED, critical care, outpatient) and so generate alerts if a prescriber logged in to one context tries to take actions for the same patient in a different context. Best practice supports are being enhanced.
  • Controlled Printing of Prescriptions at Discharge
    • Upon signing a patient discharge order, important documents are automatically printed at the relevant patient's hospital location (ward). These include an after visit summary (AVS), medication reconciliation report for community pharmacy and any new physician prescriptions. The printing location is tied to the patient location, under system control.
    • Pandemic and rural workflows may involve responsible physicians off-site at the moment of discharge. Yet the printed prescriptions need to be signed and faxed or otherwise delivered to the preferred pharmacy.
    • Enhancement requests are submitted to improve options for reprinting (under manual control) physician prescriptions, just as it is possible to re-print AVS and pharmacy forms.
    • A workaround for physicians is communicated, hoping that this will decrease temptation to (inappropriately) use signed pharmacy MedRec reports (which can be printed to local devices).
  • Provider Teams
    • Continued progress is made capturing few remaining provider team needs and setting up the associated lists.
    • A summary listing of all Wave 3 provider teams will be linked to the Manual towards the end of the week.
  • Ordering Norms
    • As happens with each Wave launch, prescribers and their supports struggle with situations where it may be difficult for physicians to enter orders directly to Connect Care. 100% CPOE (computerized provider order entry) is the goal, for many reasons, but there are some clearly defined exceptions described.
    • There are many ways (including use of mobile apps) for prescribers to order from a distance without distancing themselves from decision supports.
    • All clinicians are reminded to follow Connect Care Ordering Norms and the heads-up provided in the Wave 3 countdown checklist.
  • Communication Norms
    • Also shared with prior launch Waves is the need for prescribers and healthcare teams to consider appropriate uses of the new secure clinical communication options made possible by Connect Care. Professionalism must guide sensible tool use.
    • All clinicians are reminded to follow Connect Care Communication Norms, especially to devise and adhere to communication pacts among teams. The Norms recognize that different teams may need to use particular tools in different ways. But all must have a clear understanding of which tools to use for different levels of urgency and response timeliness. 

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