$TXT Created by DAYON,RUFINO at DEV.DEV.FO-HINES.MED.VA.GOV (KIDS) on Thursday, 10/12/06 at 11:07 ============================================================================= Run Date: DEC 19, 2006 Designation: FH*5.5*4 Package : FH - DIETETICS Priority: Mandatory Version : 5.5 SEQ #6 Status: Released Compliance Date: JAN 19, 2007 ============================================================================= Subject: Tickler File Modifications/Pharm APIs/Lab APIs Category: - Routine - Data Dictionary - Print Template - Other - Enhancement (Mandatory) Description: ============ This patch contains the following items: 1. This patch updates the tickler file options as described below. The DIETITIAN TICKLER FILE (#119) allows the user to receive notifications that act as reminders for you to take some action. In the current manual process a tickler file entry can be made two ways: 1) when entering a Nutrition Location, the parameters contain a field that holds the number of days for the notification concerning the review of supplemental feedings or review notes based on patient nutrition status level; and (2) the file can also be accessed via the Tickler File [FHCTF] menu option. Through the enhancement, the file would be automated to provide alert notification to the user if they desire. Performance monitors that are needed to improve patient safety and monitoring while adhering to guidelines provided by quality management are updated. Monitor values for BMI have been changed from <21 to <18.5. Monitor values for Albumin have been changed from <3.2 gm/dl from <2.8 gm/dl. Also, elimination of the duplicate tickler file entries for each patient and allowing the current entries to follow the patient when they are transferred to another unit, will eliminate the extra work currently being performed to duplicate that tickler file entry for each area. The following bullets summarize each area of change: Functionality ============= a) Provide ability for use of alerts as the notification method for monitors. The Enter/Edit Nutrition Locations [FHPRO2] option may be used to set up alerts for the different monitor types, by setting the alert fields to YES. The clinician entered for that location will receive the alerts. Additionally, other individuals who may need to receive the alerts may be added in the "Also Send Alerts to" multiple field. Example: Select OPTION NAME: Enter/Edit Nutrition Locations [FHPRO2] Select WARD or OUTPATIENT Location: Ward Location Select NUTRITION LOCATION NAME: 4AS NAME: 4AS// CLINICIAN: DOCTOR,TEST// <--- Alerts will go to the clinician Select ROOM-BED: Select ASSOCIATED MAS WARD: 4AS-1// TRAY SERVICE POINT: REMOTE CAFETERIA// TRAY FORECAST %: 25// CAFETERIA SERVICE POINT: DINING ROOM TRAY SERVICE?: YES// DINING ROOM FORECAST %: 25// COMMUNICATION OFFICE: WASH COMM OFFICE// SUPP. FDG. SITE: SUPPLEMENTAL FEEDINGS// PRINT ORDER: 5// DEFAULT ADMISSION DIET: REGULAR// 'NO ORDER' DIET ON ADMISSION: NO// Select BULK NOURISHMENTS: CAPPUCINO// BULK NOURISHMENTS: CAPPUCINO// QUANTITY: 5// Select BULK NOURISHMENTS: # DAYS TO REVIEW NPO: 3// # DAYS TO REVIEW TF: 7// # DAYS TO REVIEW SF: 14// # DAYS FOR STATUS AFTER ADMIT: 3// # DAYS TO REVIEW STATUS I: # DAYS TO REVIEW STATUS II: # DAYS TO REVIEW STATUS III: # DAYS TO REVIEW STATUS IV: CAFETERIA ON TRAY TICKET: INACTIVE?: ALERT BMI: YES// ? Do you want to be alerted for BMI value for this location? Choose from: Y YES N NO ALERT TUBEFEEDING: YES// ? Do you want to be alerted for Tubefeeding value for this location? Choose from: Y YES N NO ALERT HYPERALS: YES// ? Do you want to be alerted for Hyperals value for this location? Choose from: Y YES N NO ALERT ALBUMIN: YES// ? Do you want to be alerted for Albumin value for this location? Choose from: Y YES N NO ALERT NPO+CLRLIQ: YES// ? Do you want to be alerted for NPO+CLRLIQ value for this location? Choose from: Y YES N NO Select ALSO SEND ALERTS TO: NURSE,TEST <--- Add others who will receive alerts Are you adding 'NURSE,TEST' as a new ALSO SEND ALERTS TO (the 1ST for this NUTRITION LOCATION)? No// Y (Yes) Select ALSO SEND ALERTS TO: b) The routine FHCTF5 has been modified to change the monitor value of BMI from the previous value of <21 to <18.5 with the timeframe to include the present admission or with in 7 days back for creating a new monitor, and 30 days later for a subsequent monitor. This change will be reflected in the selection of the patients that meet this criteria via a tasked job, INPATIENT MONITOR SCAN [FHCTF5]. c) The routine FHCTF5 has been modified to change the monitor value of Albumin from the previous value of <3.2 to <2.8 gm/dl with the timeframe to include the present admission or with in 7 days prior to the admission for new monitors. This change will be reflected in the selection of the patients that meet this criteria via a tasked job, INPATIENT MONITOR SCAN [FHCTF5]. d) Sites may access the Taskman Management [XUTM MGR] menu and use the option Schedule/Unschedule Options [XUTM SCHEDULE] (please see your IRM Support Person) or manually modify the Inpatient Monitor Scan [FHCTF5] option to run twice daily to update criteria more than once a day. To accomplish this, sites should use VA Fileman [DIUSER] to change the RESCHEDULING FREQUENCY (#19.2,6) field in the OPTION SCHEDULING (#119.2) file to "12H" (every 12 hours) for the Inpatient Monitor Scan [FHCTF5] option. Below is an example: Select OPTION: 1 ENTER OR EDIT FILE ENTRIES [DIEDIT] INPUT TO WHAT FILE: OPTION SCHEDULING (#19.2)// EDIT WHICH FIELD: ALL// RESCHEDULING FREQUENCY (#19.2,6) THEN EDIT FIELD: Select OPTION SCHEDULING NAME: INPATIENT MONITOR SCAN [FHCTF5] RESCHEDULING FREQUENCY: 12H e) The routine FHWTRN has been modified to better utilize the DIETITIAN TICKLER FILE (#119) so that the Tickler file entry for that admission is used when the patient is transferred to another unit. Previously, a new tickler was created when a patient was transferred to another unit, resulting in multiple entries. f) The option, Display Tickler File [FHCTF1], has been modified so that there is only one tickler for the same patient in the display list and it displays in alphabetical order by clinician and patient, and by date. Previously, each tickler file entry resulted in repeated displays of the patient name. g) Personalized Ticklers could previously be entered but were not being displayed to the user in a useful format or being cleared in a timely manner. This has been changed so that Personalized Ticklers are now displayed using the option Display Tickler File [FHCTF1], and outdated personalized ticklers will be cleared automatically. h) The option, Clear Tickler File Entries [FHCTF2], has been modified so ticklers can be cleared individually, through a series of numbers or all at once. Previously a user could only clear one tickler at a time. i) The report option, Nutrition Monitor Statistics Report [FHMNREP], has been modified internally to reflect the change in BMI and Albumin monitor values. The header summary for each location has been generalized because historical data on previous monitors will not be converted and old as well as new values can be viewed. j) The report option, List Ward Assignments [FHORC6], has been modified to add a column "ALSO SEND ALERTS TO" and the corresponding users for each Nutrition Location. 2. This patch replaces all direct global reads of Pharmacy Files and replaces them with Pharmacy API's provided by the Pharmacy Re-engineering team. The options affected by these changes are the Inpatient Monitor Scan and the Nutritional Assessment options. These changes are all transparent to the user and will allow these options to look and work exactly as they did prior to this patch. 3. This patch fixes a problem in which M-code was incorrectly displaying under the Lab Data section of the Nutritional Assessments [FHASM1] option. Direct global reads of lab files resulted in incorrect reference ranges, so they have been replaced by calls to Lab API's. 4. This patch allows the ability to enter/edit the ROOM-BED (#2) and SUPP. FDG. SITE (#7) fields of the Nutrition Location (#119.6) file for Outpatient Locations using the Enter/Edit Nutrition Locations [FHPRO2] option. These changes will be necessary for a future patch. Options ======== Clear Tickler File Entries [FHCTF2] Display Tickler File [FHCTF1] Inpatient Monitor Scan [FHCTF5] Enter/Edit Nutrition Locations [FHPRO2] Nutrition Monitor Statistics Report [FHMNREP] List Ward AssignmentS [FHORC6] Remedy Tickets: =============== # 67529 - Request to allow the tickler to only give notifications for a set number of days, regardless how many times the labs are drawn. # 67985 - Per Dietitician, the Ticker File doesn't alert her for ward. # 68240 - No tickler when a patient is moved or assigned to another ward. # 106645 - Personal Entries-should disappear automatically. # 112685 - Entries are not being deleted according to date. # 141554 - Tickler sporadically not generating with low albumin. # 143123 - Last four numbers of patient ssn not matching on Display Tickler File option. Data Dictionary Changes: ======================== File: NUTRITION LOCATION (#119.6) Field: ALERT BMI (#119.6,107) Field: ALERT TUBEFEEDING (#119.6,108) Field: ALERT HYPERALS (#119.6,109) Field: ALERT ALBUMIN (#119.6,110) Field: ALERT NPO+CLRLIQ (119.6,111) Field: ALSO SEND ALERTS TO (#119.6,12) Subfield: ALSO SEND ALERTS TO (#119.66,.01) Documentation Retrieval ======================= The N&FS User Manual and Adpac Guide have been updated and are available on the ANONYMOUS.SOFTWARE directory at one of the following Office of Information (OI) Field Offices. This documentation can be retrieved in one of the following ways: (1) The preferred method is to FTP the files from download.vista.med.va.gov, which will transmit the files from the first available FTP server. (2) Sites may also elect to retrieve documentation directly from a specific server as follows: Albany ftp.fo-albany.med.va.gov Hines ftp.fo-hines.med.va.gov Salt Lake City ftp.fo-slc.med.va.gov The documentation distribution includes: FILE NAME DESCRIPTION RETRIEVAL FH5_5P4UM.PDF User Manual - Outpatient Binary Meals Update V.5.5 FH5_5P4AG.PDF Adpac Guide - Outpatient Binary Meals Update V.5.5 (3) Documentation can also be retrieved from VISTA Documentation Library (VDL) on the Internet at the following address: http://www.va.gov/vdl/Clinical.asp?appID=67 Installation instructions: ========================== This Patch is created with Kernel V8 KIDS. Follow these instructions: 1) Use Packman option 'INSTALL/CHECK MESSAGE' to load the KIDS build onto your system. 2) On the KIDS menu, under the 'Installation' menu, use the option 'Verify Checksum in Transport Global' and verify that all routines have the correct checksums. 3) From the 'Installation' Menu of KIDS, use the option 'Install Package(s)'. Select the package 'FH*5.5*4' and proceed with install. 4) Users may remain on the system. Install should take less than two minutes. The routines included in this patch should be installed in the production UCI. 5) The DIETETICS options do not need to be disabled during the installation of this patch. Your customer support representative will answer any questions regarding this patch. 6) Recommended responses to the following installation questions: Want KIDS to INHIBIT LOGONs during the install? YES// NO Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//NO Routine Summary: ================ The following routines are included in this patch. The second line of these routines should look like: ;;5.5;DIETETICS;**[patch list]**;Jan 28, 2005 CHECK1^XTSUMBLD results: (NEW CHECKSUM VALUES) Routine Pre Patch 4 Post Patch 4 Patch List ========== =========== ============ =========== FHASM4 12052466 13994312 4 FHCTF1 9148269 13661672 4 FHCTF3 24411252 55764978 4 FHCTF5 12923038 26427742 4 FHMMNPRT 34894053 34957812 4 FHMNPRT 16366448 16395628 4 FHORC5 2667793 2760179 4 FHPRO 10200393 10948850 4 FHWTRN 4252356 35702761 4 Test Sites ========== Baltimore/Perry Point Central-Texas Cleveland Phoenix Installation instructions: ========================== This Patch is created with Kernel V8 KIDS. Follow these instructions: 1) Use Packman option 'INSTALL/CHECK MESSAGE' to load the KIDS build onto your system. 2) On the KIDS menu, under the 'Installation' menu, use the option 'Verify Checksum in Transport Global' and verify that all routines have the correct checksums. 3) From the 'Installation' Menu of KIDS, use the option option 'Install Package(s)'. Select the package 'FH*5.5*4' and proceed with install. 4) Users may remain on the system. Install should take less than two minutes. The routines included in this patch should be installed in the production UCI. 5) The NUTRITION AND FOOD SERVICE options do not need to be disabled during the installation of this patch. Your customer support representative will answer any questions regarding this patch. 6) Recommended responses to the following installation questions: Want KIDS to INHIBIT LOGONs during the install? YES// NO Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES// NO Routine Information: ==================== The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: FHASM4 Before: B12052466 After: B13994312 **4** Routine Name: FHCTF1 Before: B9148269 After: B13661672 **4** Routine Name: FHCTF3 Before: B24411252 After: B55764978 **4** Routine Name: FHCTF5 Before: B12923038 After: B26427742 **4** Routine Name: FHMMNPRT Before: B34894053 After: B34957812 **4** Routine Name: FHMNPRT Before: B16366448 After: B16395628 **4** Routine Name: FHORC5 Before: B2667793 After: B2760179 **4** Routine Name: FHPRO Before: B10200393 After: B10948850 **4,5** Routine Name: FHWTRN Before: B4252356 After: B35702761 **4** ============================================================================= User Information: Entered By : KNOEPFLE,RICH Date Entered : DEC 05, 2005 Completed By: PATRICK,PAT Date Completed: DEC 06, 2006 Released By : KREUZ,SHERI B Date Released : DEC 19, 2006 ============================================================================= Packman Mail Message: ===================== $END TXT