OH NO! THERE’S A DOWNTIME!

1. OH NO! THERE’S A DOWNTIME!

2. How Everything Works • First of all let’s make sure everyone really understands how things work when everything is working normally. • Doctor’s orders are entered via P.O.M. system. • An Order Session Print generates. • Requisitions print to departments as ordered and lab labels print. • Medication orders cross over to pharmacy, they review and validate them and they cross over to the M.A.K . system. • Now let’s look at each system having a downtime to when they are all down and what you, the Unit Secretary, need to do.

3. POM IS DOWN • Doctor’s orders are handwritten on “Downtime Doctor’s Orders "forms. You will need to have the forms available at your desk. • You will need a “Downtime Orders Tracker”form. This is important to have for a smooth downtime recovery. You will also need “Downtime Dept Requisitions” and “Downtime Lab Requisitions” • All downtime forms are available to print on the “Patient Services” website. You should also have a stock in your Downtime folder in the A-Z file. Orders cannot be entered.

4. POM IS DOWN • As the doctor’s orders are written you will fax order forms to pharmacy that include medication orders. Write “FAXED” on the order sheet. Pharmacy will enter the orders into the Pharmacy system and they will cross over to MAK. Therefore, the R.N. can still continue to administer medications. • Send now or stat labs to the lab with a “Lab Downtime Requisition” and a stamped 1x3 sticky label on the specimen. • Order stat and now Radiology and other department tests by faxing the “Downtime Dept. Requisition”. • Write “DT” under the “Action Taken” in the Downtime column to the right of the order and initial the “By Whom” column. Place the “Downtime Doctor’s Orders” form in the patient’s kardex/profile in the “Orders”section. • Write the patient’s name on the “Downtime Orders Tracker” form. What do I do with the doctor’s orders?

5. POM IS UP • Using the “Downtime Orders Tracker” form, locate the “Downtime Orders” form(s) for each patient on the tracker. • Enter all orders into the computer by using “(32) Enter POM Orders" with the exception of • medication and IV orders • any labs that were performed during the downtime. Those will be entered by the laboratory department. • any radiology or other department tests that were performed during the downtime. They will be entered by the department. If a test has not been performed yet, then you will need to order the test in POM even if you had faxed down a “Downtime Dept. Requisition” form. What do I do now?

6. POM IS UP (CON’T) • “T” each line in the “Action Taken” column under “Computer Entry " as you enter the orders. • Initial each line in the “By Whom” column as you transcribe. • When you have completed the orders, each line should have either “DT” and initials in the “Downtime” column or “T” and initials in the “Computer Entry” column.

7. MAK AND PHARMACY ARE DOWN • Print the “Downtime MARs” • You can still print “Downtime MARs “even after MAK has gone down. • You will need to hand-transcribe to the “Downtime MARs” any medications ordered during the downtime. • The R.N. will document medications given during the downtime on the Downtime MARs. Orders can still be entered in POM but what about medication orders?

8. MAK AND PHARMACY ARE UP • Pharmacy orders will cross over to MAK. • The R.N. will need to do a med recovery which includes documenting in MAK any medications administered during the downtime. • The “Downtime MARs” need to be filed in the patient’s record at the end of the “Dr’s Orders-Section 2”. What do I need to do now?

9. POM, MAK, AND PHARMACY ARE DOWN • Follow the downtime plan for each of the systems. • Don’t forget, you may not be the person doing the recovery process when the system comes back up. Therefore you want to be sure you follow all the guidelines for addressing the downtime. This will make the recovery process a success as opposed to creating a disaster!

10. ADT FUNCTIONS ARE DOWN • Transfer, discharge, admission status downtime forms are available on the Patient Services Website. • Complete the appropriate downtime form for the ADT function and fax to the number on the form. • Keep up the Patient Flow Worksheet accurately with times of arrival, discharge, etc. You may need this information when the downtime is over. You are not able to perform any transfer and discharge functions.

11. SOME TIPS • If a downtime is planned you will have advanced notice so that you can be sure you have all the forms you need. • An unplanned downtime can happen at any time. Of course, chances are it will be one of those “anything that could go wrong will” days! • Be prepared. Keep your “A-Z” file stocked with a good supply of all the downtime forms. They are all available to print on the “Patient Services” website. • Also remember, if for any reason all computer systems go down, including the internet/intranet, you will not be able to get to the website to print the forms. • Detailed information regarding the different types of downtimes can be found on the Patient Services Website. Always be prepared!