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HIT COMPETENCIES DURING HIRING PROCESS

HIT COMPETENCIES DURING HIRING PROCESS. "Oki Si Ksi Kai Ko Wa Na" Hello from the Blackfeet Service Unit. STATS OF BLACKFEET SU ER. 70-80 ER patients in a 24hr period 2100-2400 ER patients per month Located 10 miles e ast GNP Bad weather for helicopters 90-130 miles from Trauma Center

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HIT COMPETENCIES DURING HIRING PROCESS

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  1. HIT COMPETENCIES DURING HIRING PROCESS

  2. "Oki Si Ksi Kai Ko Wa Na" Hello from the Blackfeet Service Unit

  3. STATS OF BLACKFEET SU ER 70-80 ER patients in a 24hr period 2100-2400 ER patients per month Located 10 miles east GNP Bad weather for helicopters 90-130 miles from Trauma Center EHR in ER for 4 1/2 years Large turn over in ER staff (37)

  4. BROWNING, MT. 1.5m acres 8,500 enrolled members

  5. SMILE S TREAMLINE/SIMPLIFY M ONITOR/MANAGE I DENTIFY / IDEAS L ET everyone know their role E DUCATE – Adult orientation

  6. OBJECTIVES: • Identify 5 ways to streamline EHR System, thus streamlining provider orientation to EHR in ER • Design comprehensive ER provider Competency Checklist/Cheat sheet • Identify 5 other helpful tips to aid in limited orientation and competency time spent

  7. 5 WAYS TO STREAMLINE EHR Initial Prep Work • Create a QUIET Vuecentric EHR template • Create ER Diagnosis/POV pick list & super bill • Create ONE STOP SHOPPING ER Order Menu • Design ONE ER provider note template • Setup DEFAULTS: ER patient list, coding, note title, template

  8. CREATE: VUECENTRIC EHR TEMPLATE (KEEP IT SIMPLE/STREAMLINED/SMILE)

  9. DEFAULT: ER Patient List

  10. CREATE & DEFAULT: ER Diagnosis/Purpose of Visit

  11. CREATE & DEFAULT: ER Procedures/Super Bill

  12. CREATE:ONE STOP SHOPPING ER ORDER MENU

  13. ER Provider Template KEEP IT SIMPLE/Streamlined/Smile

  14. EDUCATE the ADULT • Design Competency Checklist/Cheat Sheet • Streamline Orientation process (20-30 min) • ER Provider Signs two copies: a. 1 copy for Competency Book b. 1 copy for ER Provider

  15. EHR ADULT EDUCATION/ORIENTATION TIPS: NOT ALL EHR USERS HAVE ALL THESE ISSUES DO NOT LIKE LOGINS DO NOT HAVE A LARGE ATTENTION SPAN, EASILY DISTRACTED DO NOT LIKE CHEAT SHEETS (1 pg. max) DO NOT LIKE DUPLICATES DO NOT LIKE TO READ DO NOT LIKE TO SEARCH DO NOT LIKE TO “CLICK” (count every click) DO NOT LIKE BRIGHT COLORS DO NOT LIKE MOVING THINGS DO NOT LIKE POP UPS or THINGS THAT JUMP (POP UP FATIGUE) DO NOT LIKE TO SPEND TIME DO NOT LIKE TO SIT LONG DO NOT LIKE DOWN ARROWS OR COMBO BOXES DO NOT LIKE A LOT OF CHOICES DO NOT RESPOND WELL TO CONSTRUCTIVE …… DO NOT LIKE TO DOCUMENT DO NOT LIKE EXTRA INFO 18. NEED A LOT OF POTTY BREAKS DURING ORIENTATION BOTTOM LINE: KEEP IT SHORT, SIMPLE, SMILE

  16. EHR IN ER ORIENTATION/COMPETENCY SHEET EHR NAVIGATION: (3 tool bars) a. Pick a Pt. : click blue box 2ndtool bar b. Postings (allergies, clinical warnings, directives) 2ndtool bar c. Vista Imaging (scanned documents) 1sttool bar 2. GROUPS (left side) a. Information Notifications: unsigned notes, lab results, deficiencies Patient Review: quick look at problem list, labs, meds, vital signs, visits, postings Nurse Review: quick look at nurse chief complaint, vital signs, wellness b. Documentation **Headings are in order of how to document** Allergies: right click on screen to enter Problem/POV/HxDx: enter visit Diagnosis Procedures: enter visit Procedures/E&M Orders: enter ALL ER orders on ER MEDS & ORDERS Notes: click NEW Note → click ER Provider → fill in ALL blanks on template Sign Note c. Results Labs, Radiology Reports, In house Consults 3. TYPE ALL CODES

  17. 5 OTHER HELPFUL TIPS MONITOR: MR/HIM ER Visit Reviewers 1 day hospital orientation (get codes, etc.) WHAT does everyone do? Screen Shot Reference Book (SMILE) EHR Super User makes a shift pass

  18. MEDICAL RECORD ER PROVIDER REVIEW Date of Visit:______________________ Check #1___________________ Record #:_________________________ Check #2___________________ Reviewer: ________________________ Provider:__________________ (Circle NOT done) ______1. TIME of Medical Screening Exam (Physical Exam or Objective) TIME of admission ______ 2. Subjective History of Present Illness (HPI) Review of Systems (ROS) ______ 3. Family History Social History Surgical History Active Problems ______ 4. Medical Screening Exam (PE or Objective) ______5. Purpose of Visit (Assessment) ______6. Plan or Follow up Instructions ______7. Discharge Condition ______8. Injury ______9. Transfer

  19. WHAT DOES EVERYONE DO? • ER PHYSICIAN: Collects S O A P Data & Documents data collected • Exam time, Admit time, discharge condition, • PA/NP during busy times: As above • ER Clerk/CNA: Maintain Emergency Room Log, Time in ER Room, Prints patient PWH, Aid in patient transfer (checks completeness and prints ER transfer documents COBRA form, etc.), Track patient items, label & transfer lab specimens • ER Triage Nurse: Vital Signs, Chief Complaint, ER Assessment, Assigns Level of Triage, Allergy Assessment, Medication Reconciliation, Provides Rights & Responsibilities, Goes over PWH • ER Primary Care Nurse: Acts on Dr. Orders/plans, carries out interventions, discharges patient (time, patient instructions, etc.)

  20. SCREEN SHOT BOOK KEEP IT SIMPLE, STREAMLINE, SMILE Pg 1. HOW TO: ENTER ALLERGIES Pg 2. HOW TO: ENTER FAMILY HISTORY Pg 3. HOW TO: ENTER ADMISSION ORDERS Pg 4. HOW TO: ENTER CLINICAL WARNING/Postings Pg 5. HOW TO: ENTER LATE ER NOTES

  21. HELP! • REMEMBER: CHART IN ORDER (CODING, ORDERS, NOTE) • REMEMBER: SEE PATIENT & FINISH CHARTING IMMEDIATELY • REMEMBER: “SCREEN SHOT” BOOK • REMEMBER: CHEAT SHEET W CODES (DO NOT LET IT OUT OF YOUR SIGHT) • REMEMBER: ASK FOR HELP& I’LL KEEP CHECKING ON YOU

  22. S M I L E

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