$TXT Created by NABER,DAVID A at DEVCUR.FO-SLC.MED.VA.GOV (KIDS) on Tuesday, 09/09/03 at 13:43 ============================================================================= Run Date: SEP 26, 2003 Designation: OR*3*186 Package : OR - ORDER ENTRY/RESULTS REPORTING Priority: Mandatory Version : 3 SEQ #179 Status: Released Compliance Date: OCT 27, 2003 ============================================================================= Associated patches: (v)OR*3*177 <<= must be installed BEFORE `OR*3*186' Subject: Event delayed orders issues, display issues Category: - Routine Description: ============ This patch will fix a problem with pharmacy orders being reinstated when a patient is readmitted following a discharge from observation. Prior to this patch, it was possible for pharmacy orders to be reinstated when a patient was readmitted following a discharge from observation and no active discharge auto-dc rule were in place. Now, if there is no active discharge auto-dc rule and pharmacy auto-dcs orders upon discharge from an observation admission, the temporary space that holds these orders for possible reinstatement is cleared. This patch will also fix a problem with orders appearing on the active orders list with more than one status. If a pharmacy order were placed and finished and then updated multiple times in such a way as to not create a new order, it was possible for the AC cross reference in file 100 to have more than one entry. The AC cross reference indicates active orders and their corresponding action. When multiple AC cross references are in place an order will appear more than once with the appropriate status based on the action. A change was made so that the AC cross reference gets updated correctly. In addition, a change was made so that when orders are displayed the AC cross reference is reviewed to be sure that only the latest, and correct, entry is in place. Additionally, this patch fixes two problems related to delayed surgery events. It's possible for delayed orders to be released more than once if the TIME PAT OUT OR field is entered and then immediately edited to a new value. In addition, it's possible for orders to be rejected by a package if the OPERATING ROOM field for a procedure is not identified. A change has been made to ensure that a surgery event is only processed one time. A change has also been made so that the patient's current ward location is used if an operating room has not been entered for the procedure. A change was made to the detailed display for an order so that the person who marked the order as signed on chart is now shown. In addition, the date/time the order was marked as signed on chart will show as well. A problem was identified with NHCU patients who were ASIH to an observation type ward that needed to be followed up for continued care. When the patient went ASIH to observation and then was discharged and then was sent back to ASIH non-observation, the pharmacy orders did not reinstate as expected. Transfers back TO ASIH following an observational ASIH visit in which the user indicated that the patient would be immediately readmitted will now reinstate pharmacy orders as expected. It's important to note that when a patient is ASIH on a non-observation ward that the receiving site's treating specialty auto-dc rule may be invoked if it's active. All TO ASIH and FROM ASIH movements include a treating specialty change. As a result, even a FROM ASIH movement may invoke the treating specialty rule if it's active as treating specialty changes always over-ride. When the patient is ASIH on an observation ward, then the receiving site's FROM ASIH auto-dc rule will take precedence. You will want to review your FROM ASIH set-up to be sure that the correct orders are auto-dcd in this case. NOIS ==== BAY-0103-30614 DC/EDIT ORDERS REMAIN ON ACTIVE ORDERS SHEET WPB-0902-31431 LIST DUP IN CPRS MOU-0302-32622 Orders displaying in two statuses The AC cross reference should only have one entry per order. It was discovered that multiple AC cross reference entries could exist under unusual circumstances. The AC cross reference is now set correctly under the identified scenario. UNY-0403-11545 AUTODISCONTINUE Not working always For observation patients who have active pharmacy orders and there is no active discharge auto-dc rule, it is possible to have pharmacy orders reinstate upon readmission, which is incorrect. A check is now made to see if there is an active discharge auto-dc rule. If there is not then the temporary space holding the pharmacy orders to be reinstated is deleted. HWH-0503-40688 Duplicate orders from order set If the TIME PAT OUR OR field is entered and then immediately changed, it's possible for two processes to be running that will release and/or auto-dc orders. A flag is now set so that once processing of a surgery event begins, no other process can attempt to work with the same surgery event. BHH-0403-40376 Delayed orders for O.R. causes radiology orders to cancel When the TIME PAT OUR OR field is filled in and an active surgery event is processed, the OPERATING ROOM field is used to determine the location to print the orders to (if defined) and is used as the ordering location for the order. Depending on the package and the setup of the OPERATING ROOM field it's possible for orders to be rejected. In addition, if the OPERATING ROOM field is undefined, it's possible that an order could end up with no ordering location, which can also cause orders to be rejected. A change has been made so that the OPERATING ROOM will be used to determine where to print orders to. If no OPERATING ROOM is defined then the patient's current ward location will be used to determine where the orders print. In either case, the patient's current ward location will be used as the ordering location. MAC-0403-60380 Unsigned orders released as signed on chart When an order is signed as "signed on chart" the user who released the order with this signature status is not show in the order's detailed display. For this type of order, the "released by" line now indicates who released it and when. LEX-0503-40797 Meds didn't auto dc after specialty transfer When a patient is returning to the NHCU after being ASIH to an observation ward, the FROM ASIH auto-dc rule at the receiving site will be invoked. In this case, the site did not have an active FROM ASIH rule and therefore orders were not auto-dcing as expected. In addition, pharmacy orders were not being reinstated upon readmission to ASIH on a non-observation ward. ROUTINE SUMMARY: ================ The following is a list of the routines included in this patch. The second line of each of these routines will look like: ;;3.0;ORDER ENTRY/RESULTS REPORTING;**[patch list]**;Dec 17, 1997 CHECK^XTSUMBLD results Routine name Before Patch After Patch Patch List ============ ============ =========== ========== ORMEVNT 18914687 21880680 24,45,70,79,141, 165,177,186 ORMEVNT1 17761469 18971009 141,165,177,186 ORMEVNT2 7599981 9143536 177,186 ORMPS2 10179181 10307777 94,116,129,134,186 ORQ11 20286165 20427366 7,27,48,72,78,99, 94,148,141,177,186 ORQ20 21256519 22591707 12,27,92,94,116, 141,177,186 INSTALLATION INSTRUCTIONS: ========================= This patch should be loaded during non-peak hours to minimize disruption to users. Users may be on the system during installation. Installation will take less than 1 minute. *NOTE: Sites should review the setup of their FROM ASIH auto-dc rule. When a patient is ASIH on an observation ward and is subsequently discharged, the receiving site's FROM ASIH rule will be invoked. When a patient is ASIH to a non-observation ward then the receiving site's TREATING SPECIALTY auto-dc rule is invoked (if it's active); otherwise, the FROM ASIH auto-dc rule will be used. It's important to review the FROM ASIH and TREATING SPECIALTY auto-dc rules to be sure they were working as you expect them to. 1. Use the INSTALL/CHECK MESSAGE option on the PackMan menu. 2. From the Kernel Installation and Distribution System Menu, select the Installation menu. 3. From this menu, you may elect to use the following options (when prompted for INSTALL NAME, enter OR*3.0*186): a. Backup a Transport Global b. Compare Transport Global to Current System c. Verify Checksums in Transport Global 4. Use the Install Package(s) options and select the package OR*3.0*186. 5. When prompted 'Want KIDS to INHIBIT LOGONS during install? YES//', respond "NO". 6. When prompted 'Want to DISABLE Scheduled Options, Menu Options and Protocols? YES//', respond NO. Routine Information: ==================== Routine Name: - ORMEVNT Routine Checksum: Routine Name: - ORMPS2 Routine Checksum: Routine Name: - ORQ11 Routine Checksum: Routine Name: - ORMEVNT1 Routine Checksum: Routine Name: - ORQ20 Routine Checksum: Routine Name: - ORMEVNT2 Routine Checksum: ============================================================================= User Information: Entered By : NABER,DAVID A Date Entered : APR 29, 2003 Completed By: MERRILL,DAVID P Date Completed: SEP 19, 2003 Released By : KREUZ,SHERI B Date Released : SEP 26, 2003 ============================================================================= Packman Mail Message: ===================== $END TXT