Q: Can “not met/admin” be color coded?
A: Not at this time. The only color that can display on a medication quality measure cell is red. You can define a warning period, at the end of the quality measure time window, that will turn the countdown clock red.
Q: Can you click on the “OT Rehab” query and actually see the information?
A: Clicking on any query cell on the status board will create a popup that displays the query response and the performed date and time. Users will have to go into the EMR Care Activity or PCS Intervention History to view the complete assessment documentation.
Q: The Status Board will now display performed date/time. Can users choose between perform date vs document date?
A: No. Only the Performed date/time will be visible. This reflects the timestamp that the user sets when recording their documentation.
Q: Do we have the ability to have multiple LAB EMR ID’s (example: Glucose and Bedside Glucose) linked to a single Status Board cell?
A: Not at this time. For lab results, there is a 1-to-1 relationship with an EMR ID. Any lab test with the corresponding EMR ID can flow to this cell. Distinct EMR IDs must each have their own cell and dictionary entry.
Q: Can you link outcomes to the status board?
A: Not at this time. This item has been suggested to our Development team for inclusion in our 2nd round of quality board development.
Q: Can status board functionality be extended into Pharmacy?
A: Nursing Quality Boards were not designed specifically for pharmacy use, but a pharmacist may find some of the features beneficial. In 5.66, the medication displays and quality indicators could be used to populate a pharmacist status board.
Q: When looking at all orders for 24 hour timeframe, if “new” flag goes away, is there a way to bring back the “ack” flag?
A: Medication orders can be set to requeue for acknowledgement at specific times using the Nursing Customer Defined Parameters - eMAR Acknowledgement Times setting. This will bring back the “Ack” flag. Non-medication orders do not have this feature. We recommend educating nurses that they can click into an empty Orders cell to bring up the Order History panel in an EMR viewer.
Q: Can MAGIC have three rows to display data on a status board like C/S does?
A: Currently, MAGIC is limited to two rows of status board data. This item has been passed on to Development for consideration in our 2nd round of quality board enhancements.
Q: Can medications display after IV on the status board?
A: The display of “IV” on the outer level of the Status Board Medication was deliberately designed due to real estate concerns. IV medication names can become extremely long, based on the number of additives. With one click, users can open the Next Scheduled Medication list and review the full IV medication details, including each component in a dropdown menu.
Q: Where does the information pull from that the met/not met indicators display on? Do nurses populate queries with their assessments and those queries are what display on the quality board for the met/not met indicators?
A: The Met/Not Met flags are based on the last administration date and time from the eMAR. In the Status Board Medication Dictionary, you can link multiple medication EMR IDs to a single quality measure.
Q: For repeatables, are new assessments needed or can the information be added to an existing assessments?
A: Current assessments can be used to populate repeatable data on the status board.
Q: Is drug checking indicators of met/not met based on the administration or ordering of the medication?
A: The met/not met flags are driven off of the administration time of themedication. In the new Status Board Medication Dictionary, you can choose how you want to display medication data. Ordered medications are a display option as well, but this will display the medication name on the status board (instead of the met/not met flag).
Q: The system pulls in the last response to a query. For certain types of Y/N responses that are time sensitive initially entered no, can the system automatically flag or color code a field if query is not updated within a specified timeframe?
A: Not at this time.
Q: Can certain fields be parameterized to change color as an indicator when the elapsed time down is exceeded/passed?
A: It is possible to build a warning time window into the quality measure clock. For example, if a user has 24 hours from admission to administer asprin, we can turn the clock red when there are 2 hours left. This is only possible for medication quality measures at this time.
Q: Can next interventions be documented via queries on the quality board?
A: No. Users must click on the Next Scheduled Interventions cell, or the Intervention Routine, to document interventions.
Q: How would users find information on trending when reviewing lab results?
A: Clicking on a lab result will open a window that trends the results over time.
Q: Where does information for the next scheduled surgery come from? Is it from ORM or other queries within PCS/NUR?
A: Currently, this information can only be pulled from a query. This request has been passed on to Development for consideration in our 2nd round of quality board enhancements.
Q: Can the quality board provide a decision/recommendation on the assessed risk based on the criteria entered?
A: Not at this time. Nurses are responsible for evaluating the patient’s risk level given each of the indicators at their disposal.
Q: Can nurses use a status board to report shift change information on patients?
A: Yes. A shift report quality board could be used to replace a printed Kardex report. The status board can be used to find the most up-to-date data on a patient, and identify the next care items required.
Q: Are recall values used a lot and how can specific users tracked when using recall values?
A: Recall Values is a tool that can be a great time saver on assessments that do not change frequently, like Past Medical History, and inappropriate on others, like vital signs. You can determine at the query level which queries recall and which do not. Also, you can control by access group which users can use recall and which can not. During our session, one participant suggested building two access groups and managing users that are “repeat offenders” versus those that have “earned the privilege” to use recall values.
Q: Is the stroke onset being pulled based on the Admission time?
A: No. The stroke onset date and time information is documented through a different set of queries than the admission date and time pulling from Admissions.
Q: Can the Onset time for stroke be pulled from EDM?
A: Yes, query values documented in EDM can be pulled onto the Status Board.
Note: In CS any query documented outside of the PCS application must be listed in the Shared Queries field in the OE parameters in order to display in PCS.
Q: Is the patient list pulling for all patients or just patients that have a stroke documented? Can chief complaint be used for sorting or creating the list of patients?
A: At this point in time, Quality Boards must be populated manually either by Location or using the Manage List functionality. A proposal has been entered to create a utility that would allow the system to assist in identifying patients that should be monitored for specific conditions. Development is actively reviewing this functionality; however, no final decisions have been made.
Q: Can queries documented in Physician Documentation pull to the Status Board?
A: Yes, query responses documented in Physician Documentation can pulled to the Status Board like any other query.
Q: Are the 5.66 enhancements for the Status Board available on the EDM Tracker?
A: These enhancements are only available on the Status Board in Nursing and PCS at this time.
Q: Who defines the delta range for Lab results?
A: The delta range is defined in the Lab Test Dictionary within the LAB application.
Q: Can physicians use the Quality Boards?
A: Development is currently working a creating the Physician Status Board in PCM. This project will allow the creation of a Status Board aimed directly at physicians that is very customizable. The aim is to complete this project in the 5.66 release, but no final Priority Pack has been determined. In the meantime, physicians can be given access to the Nursing applications in order to use the Quality Boards that are currently available.
Q: Are there different statuses for RAD results that come to the Status Boards?
A: Yes. The Status Board can display the status of RAD results, such as Ordered or Taken. It will also display the status of the report for the procedure in question, such as Draft.
Q: Will results display as Pending, so a nurse knows the test has been ordered?
A: Yes, Pending will display if a test has been ordered, but results have not yet been filed. Additionally, nurses can see what orders have been placed on patients on a particular board by reviewing the Next Order column. Orders that have been placed will flag for acknowledgement on the Status Board, as long as they have been set up to do so in the Order Entry application.
Q: What will display if the patient is on more than one antibiotic and they are set to display on the Status Board?
A: If there are multiple antibiotics set to display, the system determines which medication displays in the cell by reviewing the next scheduled dose and sorting the medications chronologically. However, as noted during the presentation, you should always consult the eMAR to confirm and document the date and time of medication administrations.
Q: How does the system know what type of medication it is and when to put it on the Status Board?
A: The medications for quality measures are pulled to the Status Board by EMR ID. The list of medications that satisfy each quality measure comes from CMS. This list can be found at cms.gov, as they provide the RxNorm codes associated with these medications. From the Medication Display Dictionary, you can perform an RxNorm code look up and the system will pull in all EMR IDs associated to the medications linked to thoseRxNorm codes. Since multiple RxNorm codes may share the same EMR ID, the X Reference report has been created. This report will list all of the RxNorm codes associated with the EMR IDs entered in the Medication Display Dictionary. This should be cross referenced with the CMS approved medication set.
Q: Can the overlap therapy be pulled from POM?
A: Yes. If the Medication Display Dictionary is set to trigger counters based on query responses those query responses can be pulled from a POM CDS. The query responses will appear on the Status Board as long as those query mnemonics are listed in the Shared Queries field in the OE parameters.
Q: Can you show when a result increased or the time of the change?
A: The outer level of the Status Board will display the most recent result that has been filed and the time that the result occurred. If the change from one result to the next is significant enough to trigger a delta change, then the triangle that indicates a delta change will appear; however, there is no way to indicate whether a result is an increase from the previous result on the outer level of the board. To compare a series of results over time, the user must click on the cell and review in the EMR Results window.
Q: Would Surgical Date and Time come from ORM?
A: Currently, the surgery start/complete times captured in OR cannot display on the Status Board. This information needs to be documented via a query either in an assessment that is shared between NUR and ORM or within Nursing itself.
The surgery start/complete times are available options as date/time markers in the Medication Display Dictionary. A proposal has been entered with Development to bring this information forward as a Status Board data field.
Q: Is there anything on the Status Board to indicate that a response comes from a repeatable in CS?
A: There is nothing that displays on the outer level of the Status Board that indicates that a particular query is a repeatable.
Q: Are images only available from ITS or can $T RAD be used as well?
A: Images are available for both ITS and $T RAD, as long as the exam in question has an EMR ID associated to it. The result can then be displayed on the outer level of the Status Board.
Q: Is there any intelligence to how patients get associated?
A: At this time, associating patients to a particular Surveillance Board is a manual process. Providers can review patients on a particular Board by either their specific lists, adding them through the Manage List routine, or by location. A proposal has been entered to enhance the sorting process. The proposed functionality would allow providers to assign patients to a particular board based on a set of inclusion criteria.
Q: How does the system know where to launch a user when clicking on the new cells?
A: The discrete test data, including lab, microbiology and radiology results, that appear on the outer level of the board is EMR ID driven. The EMR ID for the test in question is associated to the data item that appears on the Surveillance Board at the dictionary level in the Nursing or PCS application.
Q: Can anything with an EMR ID be displayed on the Status Board, specifically anything in Mock Lab?
A: Results entered through a Mock Lab can be displayed on the Status Board as long as there is an EMR ID that files to the EMR or Clinical Review.
Q: Is the repeatable displaying the most recent result documented or the first documented?
A: The repeatable that displays on the outer level of the board will be the most recent result documented.
Q: Is this functionality available in EDM on the Tracker or via ORM?
A: The Surveillance Board functionality is only available in the Nursing and PCS applications. In MAGIC, the best way to access this functionality from the EDM or ORM applications is by either adding a button to the Desktop or launching to the Nursing application via the MAGIC Key Menu. The best option available for accessing the Surveillance Board from those applications in Client/Server is to either return to the HUB Menu and launch Nursing or open a second session and launch Nursing from there.
Q: Can the Status Board count Foley days?
A: The Status Board can keep track of the number of days a Foley catheter has been inserted using the Elapsed Time enhancement. This enhancement tracks the amount of time that has elapsed since a particular query has been documented.
Q: How does the system know when the onset of a condition is?
A: The onset of a particular condition can be documented via a query. That query can be added to the Display Criteria in the Status Board Med Display Dictionary.
Q: How does the system determine whether a measure was met or not?
A: The system determines whether or not a Quality Measure has been met or not based on the Display Criteria settings in the Med Display Dictionary. Display Criteria Markers can include query documentation
Q: Is the time displaying in the LAB cell based on the time of draw or the resulted time?
A: The time that displays in the LAB result cell is the time that the specimen was collected.
Q: Do you need Clinical Review in MG or can this be used with PCI?
A: Yes, it is possible to pull LAB, RAD or MIC data to the Status Board if Clinical Review is not set up. The result will appear on the Board as long as the appropriate EMR ID is mapped to the test and in the corresponding Status Board Dictionary.
Q: Is the last administration of a medication restricted to the current visit?
A: Yes, the medication cell is restricted to the current visit.
Q: Are these Status Boards available for physicians?
A: These Status Boards are only available in Nursing. Physicians would have to have access to the Nursing application in order to use these Boards.
Q: Can we use the Status Board for quarterly reports?
A: The Status Board is designed to simplify monitor patient conditions and quality measures in real time by centralizing data captured throughout the system. Information for quarterly reports can be pulled from Clinical Review or the EMR using Report Writer.
Q: Can the Problem List be pulled into the Status Board rather than admitting diagnosis?
A: At this time, it is not possible to pull the Problem List directly to the Status Board. Development continues to review ways to improve the Surveillance Board functionality. They are considering a number of new features including ways to incorporate the Problem List; however, these changes are still early in the design process at this time.
Q: For the new information that can display on the status board, are there standard fields? Can you build unit specific boards?
A: Yes, there are five new status board dictionaries, and several new Item Types in the Status Board Dictionary. Knowledge Base article #46325 contains additional details. Default status boards can be assigned by PCS Access group, so you can build boards for different units.
Q: Will historical test results be available across visits - for example Lab Results?
A: Yes. when viewing discrete LAB, RAD, ITS, MIC, PTH, or BBK results for your patient, the default view is results for the current visit. However, by clicking on the name of the test or report, you can switch to a historical view across all visits.
Q: Is the ETT Insertion a query or is this based on documentation time?
A: The ETT Date is a query that is documented on a PCS Intervention. The amount of time elapsed since this query was documented can display, using the new “Query Elapsed Time” item type on the status board. Alternatively, you may wish to set up a calculation on a result type query on your ETT assessment, which updates each time the assessment is documented. See KB #45124 item #5 for details on this setup.
Q: In the Emergency Department Management module, you are able to launch and update an intervention right from the tracker. Are there any suggested enhancements or proposals out there for the status board?
A: This feature is currently not available in PCS. Note that when viewing repeatable documentation, a footer button does allow the nurse to launch into the intervention worklist.
Q: How does the status board work when the patient is discharged? Will they fall off?
A: If the patient is assigned to “My List”, then following discharge, the patient will remain on the status board up until the Editing Cutoff Date parameter is reached. When viewing patients by location, they will drop off the status board with the midnight run on the night of their discharge.
Q: Is there a way to look at all the stroke patients? Can this be a global list that can be managed manually, as well?
A: This is one of the features being included in the second phase of quality board improvements. The feature is currently in the early design stage.
Q: Will any of this link to the Problem List in the future? For example, if a patient has pneumonia as an existing problem, is there a way to auto populate this onto a status board?
A: Yes. It is presently possible to determine patient populations for medication quality measures by a patient’s problem list. This is defined in the new Status Board Inclusion Criteria Dictionary. In the future, the global condition lists will be able to integrate with patient problems. As noted above, this functionality is currently in the design stages of Development.
Q: Can these be sorted by any location or by hospital? For example, someone who floats.
A: Presently, the status board can display patients only by location or by “My List.” Specialists, such as a stroke coordinator, would need to sort by location and then pull stroke patients onto “my list.“ In the future, the global condition lists will offer the ability to review patients across multiple locations.
Q: The surgery information on the status board is currently query driven. Are there any enhancements in the works for this?
A: Yes, a new item type called “Surgery Times” will enable our system to display the date and time of surgeries on the status board as captured in ORM. This feature is currently being coded and we expect this to be available in our 5.67 release.