Quick Order Setup

Learning Objectives• Become familiar with the steps used to create

and modify Quick Orders• Identify the various namespaces used to identify

service category orders (e.g., RA-radiology, PSO-Outpatient meds, etc)

• Examine options to be completed when creating a Quick Order

• Review various menu models and design on paper the menu type that will be used for your facility

• Using your design, perform the steps for creating a Menu for orderable items

Managing Quick Orders

Order Menus

Creating a Menu• Select ORDER MENU: ORZM OUTPT QUICK ORDERS// ORZM

NEW MENU Are you adding 'ORZM NEW MENU' as a new ORDER

DIALOG? No// Y (Yes)• Do you wish to copy an existing menu? YES// NO• DISPLAY TEXT: New Menu• DESCRIPTION: No existing text Edit? NO// y YES Test Menu• COLUMN WIDTH: 40 • MNEMONIC WIDTH: 2• PATH SWITCH:Y • ENTRY ACTION: <<<<<< not used• EXIT ACTION: <<<<<< not used

Adding an Item• Using the Add option, any quick order created

can be placed on the menu.• Type the row and column to place the quick

order on the menu. Add: menu Menu Items ITEM: PSOZ AMOXICILLIN 250MG TID ROW: 5 COLUMN: 1 DISPLAY TEXT: MNEMONIC

Naming Convention for Quick Orders

Namespace Department

RA Radiology

LR Lab

PSO Outpatient meds

PSJ Inpatient (Unit dose) meds

PSIV IV meds

PSOXZ Outpatient Meds for ePrescribing

GMRC Consults

OR CPRS (Nursing Orders)

Name Spacing

BE CONSISTENT

Menu

Generic OrderLab Order

Outpatient Pharmacy Order

IV Order

Inpatient

Pharmacy Order

Radiol

ogy O

rder

Laboratory Quick OrdersSelect QUICK ORDER NAME: LRZ CALCIUM TODAY

Are you adding 'LRZ CALCIUM TODAY' as a new ORDER DIALOG? No// Y (Yes)

TYPE OF QUICK ORDER: LAB LABORATORY

TYPE OF QUICK ORDER: ?Choose from: ACTIVITY ALLERGIES CONDITION CONSULTS DIAGNOSIS DIET ADDITIONAL ORDERS DIET ORDERS EARLY/LATE TRAYS GENERAL RADIOLOGY IMAGING INPATIENT MEDICATIONS IV MEDICATIONS LABORATORY NURSING OUTPATIENT MEDICATIONS PRECAUTIONS PROCEDURES SUPPLIES/DEVICES TUBEFEEDINGS UNIT DOSE MEDICATIONS VITALS/MEASUREMENTS

Laboratory Quick OrdersSelect QUICK ORDER NAME: LRZ CALCIUM TODAY Are you adding 'LRZ CALCIUM TODAY' as a new ORDER DIALOG?

No// Y (Yes)TYPE OF QUICK ORDER: LAB LABORATORY NAME: LRZ CALCIUM TODAY//DISPLAY TEXT: Calcium TodayVERIFY ORDER: y YESDESCRIPTION: Calcium level done for outpatients for todayENTRY ACTION: Lab Test: CALCIUM

Collected By: SP Send patient to lab SP Send patient to lab WC Ward collect & deliver LC Lab blood team

Collection Sample: BLOOD//Collection Date/Time: TODAY (MAR 23, 2004)How often: ONCE ONCE

Review Order-------------------------------------------------------------

Lab Test: CALCIUMCollected By: Send patient to labCollection Sample: BLOODSpecimen: BLOODCollection Date/Time: TODAYHow often: ONCE

------------------------------------------------------------- (P)lace, (E)dit, or (C)ancel this quick order? PLACE//Auto-accept this order? NO//

Auto-accept this order? NO//

Auto-accept should not be used for quick orders. Orders that are auto-accepted do not display to the provider for final review and are a potential source of error.

Lab Schedule

• ONCE must be setup as a laboratory administration schedule.

• Lab menu option is LRZM LAB TESTS

Select ADMINISTRATION SCHEDULE: ONCE ONE-TIMENAME: ONCE//TYPE OF SCHEDULE: ONE-TIME//

Quick Orders - RadiologySelect QUICK ORDER NAME: RAZ ELBOW XRAY Are you adding 'RAZ ELBOW XRAY' as a new ORDER DIALOG? No//

Y (Yes)TYPE OF QUICK ORDER: IMAGINGNAME: RAZ ELBOW XRAY//DISPLAY TEXT: Elbow XrayVERIFY ORDER: YDESCRIPTION: No existing text Edit? NO//Select one of the following imaging types: ANGIO/NEURO/INTERVENTIONAL GENERAL RADIOLOGY ULTRASOUNDSelect IMAGING TYPE: general RADIOLOGY

Quick Orders - RadiologyRadiology Procedure: 14 ELBOW 2 VIEWSProcedure Modifier:History and Reason for Exam: No existing text Edit? No// Category: Is this patient scheduled for pre-op? NO//Date Desired: TODAY//Mode of Transport: Is patient on isolation procedures?Urgency: ROUTINE//

Review Order----------------------------------------------------------

Radiology Procedure: ELBOW 2 VIEWSDate Desired: TODAYUrgency: ROUTINESubmit request to: X-RAY

----------------------------------------------------------

(P)lace, (E)dit, or (C)ancel this quick order? PLACE// Auto-accept this order? NO//

Quick Order – Outpt MedsNAME: PSOZ AMOXICILLIN 500MG BID 7D ReplaceDISPLAY TEXT: Amoxicillin 500mg bid 7 days ReplaceVERIFY ORDER: YES//DESCRIPTION: No existing text Edit? NO// Y Amoxicillin 500mg BID outpatient for 7 daysENTRY ACTION: Medication: AMOXICILLIN CAP,ORAL //Complex dose? NO//Dose: 500MG// The dose should have been set up by pharmacyRoute: ORAL// Setup by pharmacy

Quick Order – Outpt Meds• Days Supply: 7//• Quantity (CAP): 14//• Refills (0-11): 0// • Schedule: BID// • Pick Up: WINDOW// • Priority: ROUTINE// • Comments:• No existing text• Edit? No// (No)

• Select ADMINISTRATION SCHEDULE:

Review Order----------------------------------------------------------

Medication: AMOXICILLIN CAP,ORAL 500MGInstructions: 500MG ORAL BIDDays Supply: 7Quantity (CAP): 14Refills (0-11): 0Pick Up: WINDOWPriority: ROUTINE

---------------------------------------------------------- (P)lace, (E)dit, or (C)ancel this quick order? PLACE// P Place to save quick order

Special Med Quick Orders

• Clinic Meds (In-House Meds)– Pick up is ADMINISTERED IN CLINIC– Status is ASAP or STAT, not DONE

• CII Prescriptions– Entered as usual. Hardcopy printed for signature

• Prescriptions for outside pharmacies– Make orders just like meds on formulary.

• It is printed as an RX• It is ePrescribed

• Prescriptions received from outside providers– Must be entered into RPMS/EHR. User may have to

edit Drug File

Review the Order

---------------------------------------------------- Medication: CEFTRIAXONE INJ,SOLN 1GM/VIAL

Instructions: 1 GRAM 1GM/VIAL INTRAMUSCULAR Q12H Days Supply: 1

Quantity (VL): 1

Pick Up: ADMINISTERED IN CLINIC

Priority: STAT

----------------------------------------------------

(P)lace, (E)dit, or (C)ancel this quick order? PLACE//

Quick Order – Inpatient MedsSelect QUICK ORDER NAME: PSJZ LISINOPRIL 20MG QDNAME: PSJZ LISINOPRIL 20MG QD ReplaceDISPLAY TEXT: Lisinopril 20mg QD//VERIFY ORDER: YES//DESCRIPTION: No existing text Edit? NO//ENTRY ACTION:Medication: LISINOPRIL TAB //Complex dose? NO//Dose: 20MG//Route: ORAL//Schedule: QD//Give First Dose NOW? NO// Priority: ROUTINE//Comments: No existing text Edit? No//

Review the Order----------------------------------------------------------

Medication: LISINOPRIL TABInstructions: 20MG ORAL QDPriority: ROUTINE

---------------------------------------------------------- (P)lace, (E)dit, or (C)ancel this quick order? PLACE//Auto-accept this order? NO// Meds should NEVER be auto-accepted

Quick Orders – IV Meds• Select QUICK ORDER NAME: PSIVZ D5W WITH 30KCL• NAME: PSIVZ D5W WITH 30KCL Replace• DISPLAY TEXT: D5W 1000CC with 30KCL Replace• VERIFY ORDER: YES//• DESCRIPTION: No existing text Edit? NO//• ENTRY ACTION:

Quick Orders – IV Meds• Solution: DEXTROSE INJ,SOLN // • Additives: 1: POTASSIUM CHLORIDE INJ,SOLN 30 MEQ 2: <enter more>

Can add multiples

Select (1-2) or <return> to continue:• Infusion Rate: 75• Schedule:• Priority: ROUTINE//• Provider Comments: No existing text Edit? No//

Review the Order---------------------------------------------------------- Solutions: DEXTROSE INJ,SOLN 1000 ml Additives: POTASSIUM CHLORIDE INJ,SOLN 30 MEQ Infusion Rate: 75 ml/hr Priority: ROUTINE---------------------------------------------------------- (P)lace, (E)dit, or (C)ancel this quick order? PLACE//Auto-accept this order? NO//

Nursing/Generic Quick OrdersNursing Quick Orders rely on “Orderable Items”

Manage Orderable Items

Select Order Menu Management Option: OI Manage orderable items

OI Enter/edit orderable items QO Enter/edit QO restriction SR Search/replace orderables

Select Manage orderable items Option: OI Enter/edit orderable itemsType of Orderable: NURSING Select ORDERABLE ITEMS: CATHETER Are you adding CATHETER' as a new ORDERABLE ITEMS (the 3499TH)? No// Y (Yes)NAME: CATHETER//

Create a Nursing Quick Order TYPE OF QUICK ORDER: NURSINGNAME: ORZ FOLEY CATHETER//DISPLAY TEXT: Foley Catheter to DrainageVERIFY ORDER:DESCRIPTION: No existing text Edit? NO//ENTRY ACTION: Patient Care: CATHETER Instructions: Empty Foley Catheter to drainage bag q shift Start Date/Time: NOW// Stop Date/Time: T+7 (FEB 24, 2007)

Review the Order-----------------------------------------------------------------

Patient Care: FOLEY CATHETERInstructions: Empty Foley Catheter to drainage bag q shift Start Date/Time: NOWStop Date/Time: 7 DAYS FROM TODAY

----------------------------------------------------------------- (P)lace, (E)dit, or (C)ancel this quick order? PLACE//

Generic OrdersSelect ORDER DIALOG NAME: ORGXZ RESTRAINTSNAME: ORGXZ RESTRAINTS//DISPLAY TEXT: RESTRAINTS//SIGNATURE REQUIRED: ORES//VERIFY ORDER: YES//ASK FOR ANOTHER ORDER:DESCRIPTION: No existing text Edit? NO//ENTRY ACTION:EXIT ACTION:VALIDATION:ADDITIONAL TEXT:DISPLAY GROUP: NURSING//Select PROMPT: ? Answer with ITEMS, or SEQUENCE Choose from: 1 OR GTX ORDERABLE ITEM Orderable Item, e.g. RESTRAINTS 2 OR GTX WORD PROCESSING Can use TIU Template Fields 3 OR GTX START DATE/TIME 4 OR GTX STOP DATE/TIME You may enter a new ITEMS, if you wish Type a Number between .1 and 999.9, 1 Decimal Digit Select PROMPT:Auto-accept this order? NO//

Quick Orders - ConsultsSelect QUICK ORDER NAME: GMRCZ PHYSICAL THERAPYNAME: GMRCZ PHYSICAL THERAPY DISPLAY TEXT: Physical Therapy Consult VERIFY ORDER: YES//DESCRIPTION: Quick order for physical therapy consult Edit? NO//ENTRY ACTION:Consult to Service/Specialty: PHYSICAL THERAPY//Consult Type:Reason for Request: No existing text Edit? No// N (No) Category: OUTPATIENT//Urgency: ROUTINE// Place of Consultation: Consultant's Choice// Attention: Provisional Diagnosis:

Review Order

------------------------------------------------------------Consult to Service/Specialty: PHYSICAL THERAPYCategory: OUTPATIENTUrgency: ROUTINEPlace of Consultation: Consultant's Choice

------------------------------------------------------------ (P)lace, (E)dit, or (C)ancel this quick order? PLACE//

Order SetsSelect ORDER SET NAME: LRZ DIABETIC TESTS ORDER SETNAME: LRZ DIABETIC TESTS ORDER SET ReplaceDISPLAY TEXT: Diabetic Yearly tests ReplaceDESCRIPTION: No existing text Edit? NO//ENTRY ACTION:EXIT ACTION:ORDER SET COMPONENTS: 1 LRZ HGBA1C OUTPT 2 LRZ LIPID PANEL 3 LRZ TSH OUTPTSelect COMPONENT SEQUENCE#:

Quick Order Restrictions

Quick Order Wizard

• Wizard can be most useful when creating large number of similar Quick Orders (e.g. many dose variations of a medication)

• Quick Order Wizard requires a “special” EHR VueCentric Template for the CAC since it should not be on the regular template

• CAC still has to use roll-and-scroll RPMS to place Quick Orders on menu

Lab using Quick Order Wizard

Lab and Quick Order Wizard

• Name of quick order• Name the User sees• Click to have user verify• Enter description

Lab and Quick Order Wizard

• Enter Lab Test• Specimen and

sample may default

• Urgency• Collection Type

– Date/time– How often– How long

Select QUICK ORDER NAME: LRZ MAGNESIUM

NAME: LRZ MAGNESIUM//

DISPLAY TEXT: Magnesium//

VERIFY ORDER: YES//

DESCRIPTION:

Test Quick Order Wizard Magnesium

Edit? NO//

Lab Test: MAGNESIUM//

Collected By: Send patient to lab//

Collection Sample: BLOOD//

Collection Date/Time: TODAY//

Urgency: ROUTINE//

How often: ONCE//

Indication://

Indication ICD9://

-------------------------------------------------------

Lab Test: MAGNESIUM

Collected By: Send patient to lab

Collection Sample: BLOOD

Specimen: BLOOD

Collection Date/Time: TODAY

Urgency: ROUTINE

How often: ONCE

Indication:

---------------------------------------------------------

Problem: Ordering a Medto be given in Clinic

• If only a Pharmacy Order is used, how is Nursing notified to give?

• If only Nursing Order is used, Medication is not processed in Pharmacy package

Pharmacy Order(“real” Medication)

Priority: ASAP, or STATPickup: Clinic

Med Tab: YesHealth Summary: Yes

Allergy Check: YesDrug interaction: Yes

Nursing Order(text only)

Allergy Check: NoDrug interaction: No

Med Tab: NoHealth Summary: No

Generic Order(text only)

Free text entry of order

Allergy Check: NoDrug interaction: No

Med Tab: NoHealth Summary: No

Comparison of Order Types used to order a Medication

Order checking: No Verification: No

Solution: Order Set containingboth Pharmacy and Nursing Orders

NURSING QUICK ORDER: ORZ ALBUTEROL NEB RXGive an Albuterol Neb Treatment in Room #. Use 0.25ml/3ml Saline

PHARMACY QUICK ORDER: PSOZ ALBUTEROLNEB RX

TWO TYPE ORDERS IN ONE SET:Nursing orders: one and Pharmacy Orders: one

Med Tab: YesHealth Summary: Yes

Allergy Check: YesDrug interaction: Yes

Meds administered in clinic are generallybilled using J-Codes, not through POS.

Questions and Discussion