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ASAP ED Provider Dispo Activity

ASAP ED Provider Dispo Activity

This tip sheet demonstrates the use of the Dispo Activity print groups (sections) for ED Providers.

Workflow

The Dispo activity contains access to all documentation and orders necessary to discharge/admit/transfer patients from the ED.

LEFT COLUMN:

  1. SmartSets : SmartSets pull in suggested Clinical Impressions, Discharge Instructions, and automatically set the disposition to Discharge. These are not used extensively, however, Covid is an example of a SmartSet that will help increase efficiency with quickly discharging patients.
  2. Clinical Impression : Based on the documented Chief Complaint , a list of suggested impressions may appear. Use the Add a new impression search field to search for an appropriate Clinical Impression or click one of the suggestions to add.
  3. Bed Request : When admitting a patient, use the ED Admit Decision (ADT 9) order in the Bed Request section. NOTE: This is sent to Bed Planning for awareness; no bed will be assigned until the IP provider signs the Place Patient in Bed (ADT1) order.
  4. ED Transfer to L&D should be used for pregnant patients who have been medically screened and need to go to L&D. Place Patient in ED Psych order is used for a patient being moved to the BHED (Behavioral Health area).
  1. PDMP Report : Link to the PDMP.
  2. ED/Orders/Rx/Amb Ref : Place, both, ED orders to be acted upon before the patient leaves, including consult orders, AND/OR discharge orders for prescriptions and referrals.
  3. a. Click to open the orders sidebar. When searching, the default orders returned will be ambulatory orders. To place an inpatient order (to be carried out in the ED), click to expand the section. Inpatient Orders

NOTE: From your Preference List, toggle between Inpatient and Ambulatory orders at the top of the window.

  • b. Prescribe medications administered during the ED visit by clicking Prescribe .
  • c. Pause, Modify or Discontinue Home Medications using the respective quick buttons.
  • d. Use the hyperlink Mark Unselected Medications No Change or Mark Current Unselected Medications No Change / Mark Expired Unselected Medications Stop Taking as appropriate to efficiently manage medications.
  • Follow up Nurse : Send an In Basket message to the resource nurse for follow-up with a patient.
  • RDC Referral : For specific referrals to an RDC (Respiratory Diagnostic Center) -COVID-19 specific.
  • BestPractice Advisories : Address BPAs.

RIGHT COLUMN:

  1. Discharge Inst : Provide discharge instructions via Suggested Attachments, search using the Add attachments search field, or by clicking the hyperlink to Clinical References. Patient instructions can be free-text and/or SmartPhrases/SmartTexts.
  2. Follow Up : Provides information for the patient and any providers listed for follow-up. Messages will be automatically routed via In Basket to individual providers listed as follow-up providers on the ED discharge. Follow-up providers and departments can be manually entered from the Follow-Up section. Entering a department only will not generate/route an In Basket message. This information will appear in the patient's AVS.
  3. a. Providers specified in referral orders will automatically populate in Follow-Up section.
  • b. If the department only is specified in the referral order, the department will default in the FollowUp section, the department will not receive any In Basket messages.
  • c. Follow-Ups can also be entered as free-text from the navigator section if a specific provider/department isn't appropriate .
  • Disposition : Select the disposition unless automatically set by placing the Bed Request order. Each disposition will populate an appropriate SmartText in the comment box. There are three dispositions that will populate other sections for documentation. The AMA disposition will populate the AMA form, Transfer to Another Facility will provide access to the EMTALA navigator, and Expired will populate the Preliminary COD documentation.
  1. Work/School Excuse : Excuses can be provided for patients or caregivers. Click the appropriate link to complete the excuse. Click the printer icon. If a discharged patient or caregiver requests an excuse, after leaving the facility, complete the excuse then click the print icon to print a copy and send one electronically to the patient's MyChart.
  2. Chart Status: Yellow warnings appear to indicate items may require attention. Use the double chevron in the upper right corner to expand and review the warnings before proceeding with printing the After Visit Summary (AVS) . If the patient declines an AVS, place a check in the box. Click Preview AVS (which opens the print screen). From the print screen, choose the ED or IP After Visit Summary. Note Excuses and Rx Savings are also available here.