Epic Update: Triage/CC/POCUS/MDM section/emesis

Epic Updates of the Week 🚑:

Please scroll for 6 tips/updates re: Provider in Triage, critical care billing, POCUS, *new* divisional MDM pathway smartphrases (courtesy of your SMEs – thank you), new Hyperemesis Panel to mimic our pathway, and new Gastroenteritis Discharge Smartset

1. Seeing patients in Triage/Triage MD

1. • For patients you can ‘treat and street’ from triage, they need to be formally ‘roomed’ in Epic before they can be discharged/transferred. The RN can room them in a triage room by doing the following: 1) right click patient status and ‘room’… 2) ‘Bed’ in TR 01-05

1. • Documentation: If you are starting their work-up in Triage/want to document your assessment/management without taking over their entire care, there is a quick

1. • • ‘Triage Notes’ option under the My Notes Activity. Can also access from ‘Provider in Triage’ in the Triage tab. 

1. • • Within the note there will be an automatically generated drop-down (smartlist) to quickly document your assessment/plan!

2. Critical Care &  – coming real soon! If you file a critical care procedure note, your critical care billing will automatically drop… if you attempt to also file a LOS/Level of Service, you will now receive this pop-up message letting you know it is not necessary. You also will no longer receive a LOS deficiency in your In Basket.

3. POCUS documentation  – please utilize the macros created by Cindy to document all the required elements of your POCUS. From the procedure note section can select the play button  or from within the note, can find them at the top of the procedure note. 

4. MDM Smartphrases: Our pathway SMEs have helped create divisional smartphrases for your MDM section  that can be utilized by trainees/APP/fellow/attendings and accessible to all without needing to search and share. As with all our divisional phrases, type “.ED”, then MDM… and you’ll now have these available that mimic the recommendations of our pathways. More to come later as we work through.

5. New Hyperemesis/Cyclic Vomiting Panel 🤮– thanks to Fish, Toce, Megan Trexler & Joel, new updated panel to mimic guideline/ provide recommendations based on QTc and filter based on age.

6. (more on emesis theme…) New Discharge Smartset: Gastroenteritis 🤢  … please encourage trainees as well to utilize as incorporates appropriate dosages for prescriptions 

Quick Identifier Column quiz, hotshot 🚍 💣 (scroll for answers)–

Bronze: 

Silver:  

Gold:  

Flonkerton champ: 

Answers:

Bronze:   = V3 appropriate

Silver:    = Sepsis screen positive (need to huddle) + social work need/consult

Gold:  = FYI flag which may include EIF, behavior plan, important info! Boomerang = return to BCH within 72 hours/bounce

Flonkerton champ:  = time sensitive patient (fever + neutropenia/sickle cell, asthma…), home meds due within 4 hours, needs an observer, on a section 12, with an expect!)

Thanks for reading! Keep suggestions coming to @EDclinicalapps-dl or any break-fixes/safety concerns with tickets (and SERS)

Your ASAP Team

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