Change in Sign and Held Status for Pre-Op Orders Placed in the ED
As of September 19, 2023, all orders placed from the ED using pre-op (preprocedure) order sets will change from being signed and held to signed.
Currently, all pre-procedure orders are signed and held regardless of where they are placed (ambulatory, ED or inpatient); this works well except for the ED, where the orders are not visible to the ED nurse and the admission orders are held for release, thereby delaying the admission of the patient. As a consequence, several problematic workarounds have been used to release the orders leading to safety issues.
Any orders that are from a pre-op order set will now be automatically released in the ED, negating the need to do the workaround of changing the phase of care or from signed and held to signed. They will remain as preprocedure phase of care attached to the case selected in the case request portion of the order sets.
A section has been added to the Pre-Op Consult navigator, which is the correct navigator to be using for ED consults that will allow for reconciliation of both home and current (ED) medications. This new section will be at the bottom of the list of activities in the Pre-Op Consult navigator; by clicking on this, you will be given the opportunity to enter home meds and to continue or stop meds active in the ED to avoid ordering duplicate medications. These medications will also be active and not signed and held.
NOTE: These changes will apply only to orders placed when the patient is admitted to the ED, and will not occur with inpatient consults.