ORCHID Downtime for Medicine

What is Downtime?

When ORCHID is not functioning, electronic orders cannot be placed and patient information is limited. When this happens, the need for downtime procedures will be broadcoast. Patient care should continue, including evaluation of patients, admissions, and discharges.

What is Recovery?

When ORCHID has been restored, orders and information must be restored to the electronic health record. Follow the recovery process for downtime care and resume normal procedures for ongoing care.

ORCHID Downtime Procedures

Chart Review & 724 Access

Prepare information ahead of time if downtime is scheduled.

Use a designated 724 Workstation to search & print important recent patient data (results, notes, etc). 724 Access is available in every nursing unit at the nursing station (look for the yellow label on the monitor), and log-in info will be e-mailed. 724 Workstations are shared among healthcare workers, so be judicious about what you need to look up.

Locations: 5A, 5BN, 5BS, 5C, 5D, 4A, 4BN, 4BS, 4D, each ED pod and the Grey Zone physician workroom.

For the scheduled downtime on July 10, 2016, all ORCHID workstations will have special, view-only ORCHID access using your personal log-in.

New Vitals, I/O's, POC Results These data will be recorded on paper by the nurse.
New Lab/Study Results

Results for STAT orders and critical results will be called to the nurse and relayed to you.

Routine results will be printed and may be faxed for you to review.

Medication Administration Find the nurse to review the paper MAR or record medications you administer.
New Orders

Handwrite orders on physician order forms. You must sign, date and time all blocks of orders. All pages must have patient stickers/identifiers. Follow procedures to alert the clerk/nurse of new orders. Written orders are processed by the unit clerk.

Forms are available on the Intranet > Forms > Olive View-UCLA Medical Center > Medical Record forms.

Pre-printed forms should be available in every unit and clinic.

Documentation

Handwrite notes on physician Progress Note forms. You must sign, date, and time all pages of notes. All pages must have patient stickers/identifiers.

Progress Notes forms can be printed from the Intranet > Forms > Olive View-UCLA Medical Center > Medical Record forms > "Progress Notes" PDF.

Pre-printed forms should be available in every unit and clinic.

Admissions Patients will have a hard chart with a face sheet. Place orders and notes in the chart.
Discharges Place orders and notes in the chart, including a copy of the Patient Instructions.
Clinic Visits Place orders and notes in the chart.
Do not discard any written notes or orders. These remain part of the permanent chart.

ORCHID Recovery Procedures

Documentation

For Admissions, Discharges, and Clinic Visits during downtime, you must document the History and Physical, Discharge Summary, and Ambulatory Provider Note in ORCHID.

Orders

Inpatient: Back-enter all ongoing orders, except completed lab orders, completed radiology orders, or any medication order that was previously ordered on paper.

Ambulatory: Back-enter all clinic orders.

Resuscitation Status Order the Resuscitation Status for new admissions, or re-order if it changed during downtime.
Allergies, Medications, Isolation Status, Hold Status

Review and update or notify the appropriate service for changes.

Medications: updated by Pharmacy

Hold status: updated by Psychiatry

Vitals, I/O's, POC Results

For downtime <4 hours, the nurse will back-enter all vitals, I/O's, and POC results.

For downtime >4 hours, the nurse will back-enter most recent vitals and all I/O's.

Complete the recovery process within 24 hours!
Do not discard any written notes or orders. These remain part of the permanent chart.