2019 Epic Upgrade & Instance Alignment

1. 2019 Epic Upgrade & Instance Alignment ED Impact

2. Today’s Purpose

3. 2019 Unified Epic Optimization & Upgrade High Level Timelines

4. BETA Testing • Unified Epic and Upgrade Build will be completed and available for User Acceptance Testing: • Providence: Feb 13-March 1 • Swedish: May 16 – June 1 • Kadlec: TBD

5. Epic Learning Resources: March 18th Education Materials Release

6. Learning Home Dashboards

7. Role Specific Landing Page • One location for end user facing learning content organized into three categories • Epic Updates • Epic User Guide • New Learners • 144 roles across all Epicapplications

8. Epic Updates Page • Instance Alignment/Upgrade & Optimization change summaries, new content highlights or other recent updates • Instance Alignment/Upgrade change summaries • Role-based most impactful changes • Summary of change with links to more details where appropriate • Organization specific • PHS, Swedish and Kadlec

9. High Impact Changes ASAP Only

10. ASAP Specific Items • Finish-Up Fast • ED Admit Bed Request • Restraints SmartSet • Track Board Customization • Dashboard Metrics • Reorder of Triage Activities • Optimized Narrator for Nurses

11. Finish-Up Fast Project Summary • The Finish-up Fast Track Board view makes it easy to find patients you are no longer caring for with incomplete charts. A new report showing the remaining tasks appears in the side-by-side Track Board Workspace. Clinicians can complete simple tasks directly from the report.

12. ED Admit Request Project Summary • The Bed Request workflow has been optimized to eliminate the need for staff to manually place a Bed Request. • The Bed Request will now automatically be placed when the ED Admit Request (formerly the ED Admit – ADT99 order) order is signed in the Disposition activity. • This new order will contain patient specific information visible to Bed Planners.

13. Restraints SmartSet Project Summary • A new Restraints SmartSet has been created to provide a more efficient method of completing the required Face to Face evaluation documentation. • The SmartSetwill create an ED Note, containing the required documentation text.

15. Restraints SmartSet • When the SmartSet is added for a patient with an existing Clinical Impression, you will receive a prompt to associate a diagnosis. • Options: • Click Accept to bypass the association • Associate the diagnosis if appropriate

16. Optimized Narrator for Nurses • Project Summary • Staff can now optimize their Narrators to more closely match their typical workflow. Different preferences can be set for each Narrator type.

17. ED Turnaround Times (New Dashboard) • Now displays all current Radiology, Lab and Consult Orders • Hyperlinks give quick access to the ED Control Center dashboard for additional detail • Easily identify orders that could be “stuck” in certain stages slowing throughput • Drill down to the provider level detail ED Turnaround Times: Dashboard

18. ED Turnaround Times: Track Board • Project Summary: Provides a direct visual of patient throughput and order turnaround times from the Track Board. • No need to go to the ED Control Center. • Patient Throughput: Initially, the Warning Time is 75% of Goal Time. These Metrics were pulled from the Emergency Department Benchmarking Alliance. • Radiology and Lab Turnaround times: The Warning time is 50% of Goal. • These metrics are unique to each department and were derived from one years' worth of data in 2017. For departments that did not come on board prior to 2018 our analysts worked w/ED leadership at each site.

19. ED Control Center Updates • Outstanding Orders • Updated andhyperlinked to ED Turnaround Times Dashboard • Rad & Lab components • Removed and added to ED Turnaround Times Dashboard • New ED Running Census Component • NEDOCS stand-alone component w/link to formula reference guide • New patient statuses added to Dispo to Depart column

20. Reorder of Triage Activities Project Summary • In alignment with the Isolation Orders Project, the sequence of Triage activities has been modified. • *Allow earlier screening for Infection & Isolation requirement in the triage process* • Triage activities have been divided into the following sections: Initial Triage, Infection & Isolation, and Continued Triage.

21. Track Board Customization • You can now personalize your Track Board view buttons and set preferred defaults • Views that are less commonly used can be placed in a drop-down menu

22. High Impact Changes Shared

23. Shared Items • Risk for Violence • SOGI • Multilingual AVS

24. Risk for Violence Project Summary • There is a new FYI Flag Alert titled Risk for Violence. Documenting this FYI Flag generates an alert to clinicians via: • Patient Header • Track Board • Reports (Overview, etc.) • PAF Columns w/Icons • Banners on Landing Pages • Note: Use will be defined by each ministry and governed by local policy

25. Who Can Activate This FYI Alert? • Access to place the FYI Risk For Violence Alert: • Nurse Managers (should include House Supervisors) • Nurse Executives • Clinic Managers • Security • Social Services • Case Managers

26. SOGI (Sexual Orientation Gender Identity) Project Summary • SOGI Phase 3 focuses on improving the patient experience and patient-centered care. System wide updates display a patient’s gender identity, legal, and birth sex. • Changes include, but not limited to: • Age & Legal Sex now appear in one column • Name appears as: Last, Legal First, “Preferred” • Track Boards, Side-by-Side, ED Maps, InBasket, Reports, Patient Headers • Header highlights in orange when there is an incongruence between gender identity (legal sex and sex at birth) • Updated Smartlinks

27. Updated SOGI Smartlinks • Now, Smartlinks respect incongruence and preferred pronouns • Personalized Smartphrases that contain these links will be automatically updated to reflect these changes

28. Multilingual AVS • Translation finalized and approved into: • Russian • Vietnamese • Simplified Chinese • Spanish • Arabic • Applies to dischargeinstructions in languages other than English • Includes rule-based verbiage for: immunizations, sleep apnea, smoking cessation, Warfarin, Aprepitant, Sugammadex, methotrexate, designated care providers, antibiotics, and call 911 verbiage • Epic cannot translate certain pieces of information: procedure names, medications, free text notes

29. Additional Items to Consider • Including, But Not Limited To: • Bloodborne Pathogen Post Exposure Prophylaxis OS • ED Alleged Sexual Assault OS • Care Plan Updates • Outside Info Reconciliation Update • Isolation Orders • Code Status Updates

30. Any Questions?