Anesthesia CRNA/SRNA VPIMS Overview VPIMS Application Suite eOR Board A dashboard glance and tracking of patients in the Perioperative phase of care from Admitting and Arrival to Postop discharge. eOR board displays a color coded view of surgical case flow by site location. Specific case information can be viewed by hovering over case label with mouse cursor. OR Whiteboard A display of patient information on a large monitor in operating rooms utilized by all members of the surgical, nursing and anesthesia teams to verify and agree during the time out to confirm critical patient information in accordance with policy to proceed. DOS Preop A documentation module used by anesthesia providers to complete an adult preop evaluation for day of surgery cases for patients that did not have a VPEC clinic appointment. Types of Preop tools available: VPIMS, Paper, Star Panel (Pediatric Anesthesia Preoperative Evaluation) Gas Chart A documentation module used by the anesthesia provider in the operating room. Features a case template option, quick comments, auto-collect VS, marker option in Vitals grid, Break Tracker, quick paging option, VPIMSweb, Star Panel and ACGME Case log links. Vigilance An electronic monitoring system that allows roaming clinicians immediate access to vital signs, lab data and streaming video of the patient’s point of care in critical care locations (OR, PACU, ICU). VPIMSweb This secured internet website contains links used by anesthesia, nursing, physicians and schedulers to access various sites for clinical, general and other useful information. In this tool, a user can view the OR schedule, reports, anesthesia call schedules, protocols and departmental policies. 0B 1 Anesthesia CRNA/SRNA VPIMS Overview 10.04.2010 v1. gomeza eOR Board A dashboard glance and tracking of patients in the Perioperative phase of care from Admitting and Arrival to Postop discharge. o Select View from the toolbar to change the default settings and preferences. The default display mode is set to HIPPA protected info initially. When the screen is set in a non-HIPAA mode, more information will display about the patient such as full name, admission status, surgeon and scheduled procedure. o The key Legend feature can be found under View and displays a list of the meanings of different color schemes and icons within the application. o The patient’s admission status can be seen directly to the right of the patient’s name. You will see one of four letters in brackets. [S] - SAS, or Short Anesthesia Stay, [I] – Inpatient [A] AM Admit, [O] - Observation (23 hours) Alert Flags & Other Indicators o Direct To OR designates that a patient will be transported directly to the OR. It is denoted by the “D”. o Isolation precautions are designated by the letter “I” and a description of what type of precautions can be viewed when user scrolls mouse over the patient’s case. o Level Case (Trauma) will display a number level to signify the status. o Scrolling text feature will display an important message pertinent to surgery location site such as duplicate patient name alert, blood shortage or charge staff for the day. This is primarily set by the Charge OR board runners. 2 Anesthesia CRNA/SRNA VPIMS Overview 10.04.2010 v1. gomeza OR Whiteboard A display of patient information on a large monitor in operating rooms utilized by all members of the surgical, nursing and anesthesia teams to verify and agree during the time out to confirm critical patient information in accordance with policy to proceed. The OR Whiteboard is subject to change as it evolves to meet Universal protocols for patient safety. o OR Whiteboard information flows from the various VPIMS documentation modules such as PT Nursing, Gas Chart and DOS Preop or Preop Clinic. o The OR Whiteboard will only launch in the Operating rooms and is not visible on workstations outside the OR’s. o Whiteboard patient data will fully display once the final confirmation questions are addressed by all providers present in the room. As the circulator clicks through the questions the information will release the Whiteboard patient information. View of White Board prior to Time-out. The checklist will initially appear when displayed in the OR. View of White Board as Time-out questions are being addressed. Check box changes to green. 3 Anesthesia CRNA/SRNA VPIMS Overview 10.04.2010 v1. gomeza List of Final Confirmation Time-Out questions to be addressed before start of the procedure. Final View of White Board in the OR with info flow hints. 4 Anesthesia CRNA/SRNA VPIMS Overview 10.04.2010 v1. gomeza DOS Preop A documentation module used by anesthesia providers to complete a Preop evaluation for day of surgery cases on adult patients that did not have a VPEC clinic appointment. Patient Selection Screen Advanced List: Allows user to search for a patient by name or MRN to create a new record. Open Case: Select a patient on the screen to highlight in yellow then click Open Case. Reports: Select a patient to highlight and click on Reports to populate a view of the report in PDF format. o The application will import previous information from a recent record upon opening a new case. Verify and change the information appropriately. o See Quicksteps for DOS Preop below: Star Panel: Pediatric Anesthesia Preoperative Evaluation (PATCH) o Vanderbilt Children’s Hospital uses a Star Note form specific to children. o The Patch Clinic completes preop evaluations on complex cases with an ASA 3 or 4 primarily. They will see a child the day before or up to 3 weeks in advance if necessary. o Day of Surgery: First case start Preops are completed by the Anesthesia providers in Star. Any subsequent Preops not completed by the PATCH team are the responsibility of the Anesthesia provider. o Set up a short cut in Star Panel to save your user preferences. Use the Pediatric Anesthesia Preoperative H&P and or a short form of the same document to complete the preop assessment. 5 Anesthesia CRNA/SRNA VPIMS Overview 10.04.2010 v1. gomeza Gas Chart A documentation module used by the anesthesia provider in the operating room. Patient Selection Screen Past Due ACR: A late notice reminder will appear if case documentation is unfinished on day of service. Open Case: The case selected will highlight in yellow, click this button to begin. Open Read-Only: To view a case in-use or locked, highlight a case and click this button to view the record. Reports: Highlight a case and click this button to view a pop up of various reports specific to the case. All are visible in preview mode and some are printable. Late ACR Screen Attending Notes: This button is reserved for Attendings to document case notes, Postop orders and TEE Notes. My Profile: Open this tool to update your signature, email and contact info such as pager and office phone. Postop Rounds: This feature allows the easy creation of a postop note. It is primarily used for all in-patients especially with Periop concerns or events that require a follow up (difficult airway, pain issues, etc…) Features in the Menu Bar o Scheduling: Case Scheduling Wizard is an integrated tool that allows the clinician to directly schedule cases in VPIMS. This can be done either manually or by importing cases that have already been scheduled in ORMIS (our OR Scheduling system). o Case Info: Allows user to view case info and problem list or patient demographics. o Template: A case template may be created and used to start the documentation of a new case. o Tools: User can access a variety of calculator options (ABL, Drip Rate, and Conversion) and an Infusion guide. o Break Tracker: Found under “Tools.” This feature allows break reliever to track the rooms that need lunch or a quick break. Search Tool: o Gas Chart search tool allows user to search by Date, Site/Room and Patient’s Name. o The Case Status Filter and Legend displays a list of the meanings of different color schemes and icons within the case selection screen. 6 Anesthesia CRNA/SRNA VPIMS Overview 10.04.2010 v1. gomeza Templates: o Allows the user to select a chart template. User can create a personal template or copy templates from another provider to edit as their own. o Global: This feature will give you existing global system templates all ready created. Choose from the options provided. User cannot create a global template. Creating a Global template is reserved for clinical leadership at this time. o Personal: Allows user to select a template from another provider that can be edited to fit your needs. Once the user creates user specific templates, they will be available in the Personal list. Creating a New Template: o From the tool bar, select Template, then New to choose either “Blank Template” or “Template Based on Selected Case. You will name your template to proceed. o Next the screen will populate the tabs that you can pre-fill with information for later use. Click through each tab and document desired information. o o o Copy allows the user to copy a template from another user and to rename and edit to their preferences. Edit allows the user to select from the list of created personal templates and change accordingly. Delete allows the user to remove template from the list. Quick Comments: o A quick comment allows the user to create a comment that can be used for subsequent cases as desired. o Users can only edit comments that they have written and are specific to each tab. o System comments are available in various options such as Event marker and Attending notes. o User can insert current date and time, create and edit saved quick comments. 7 Anesthesia CRNA/SRNA VPIMS Overview 10.04.2010 v1. gomeza Event Marker – Vitals grid o Allows the user to bookmark a time that is significant and document a quick comment during the course of their anesthesia care in the OR. o Right click on the grid to add the marker. It will populate a quick comment box to pick from add a note or select a system comment available. Scheduling Case Wizard o Allows user to schedule a case directly in VPIMS to bypass the ORMIS scheduling system. This is to be used only for down time per administration and specific sites that use VPIMS only to schedule cases such as Labor and Delivery (LEP cases) and C-section cases. Quick Steps: Select Scheduling from tool bar, click on Schedule Case. Click on type of case you wish to schedule. Example: Labor and Delivery Case and click ‘Next.’ Click on ‘Schedule Case Manually’ to open next screen where you will type in the patient’s MRN. Answer the question; Is this a reoperation for the patient during the past 24 hours? Click ‘Next.’ Verify the patient’s name, date of birth and sex are correct. Change if necessary. Fill in the appropriate information for the case. Start/Stop time, Site, Room, Procedure and Anesthesia required. Verify Case type. Click ‘Finish.’ 8 Anesthesia CRNA/SRNA VPIMS Overview 10.04.2010 v1. gomeza VPIMSweb This secured internet website contains links used by anesthesia, nursing, physicians and schedulers to access various sites for clinical, general and other useful information. In this tool, a user can view the OR schedule, reports, anesthesia call schedules, protocols and departmental policies. Anesthesiology o Contains links and tools pertinent to the Anesthesiology department such as clinical, call/vacation schedules, evaluations and miscellaneous links. It also populates the current surgery schedule that can be filtered by site. VORS o VPIMS On-line Report System. This is a tool that allows access to various web reports. It is used by clinicians, administration, non-clinicians and Perioperative services. 1B 2B 3B PIC-Status Board o This link allows the user to look at a schedule pre-view of a surgical patient’s current status in the operating room. Anesthesia Pagers o This is a useful tool where the user can access the quick link to the VPIMS Anesthesiology phone and pager listing. 5B Remote Desktop o A user can use remote access to their PIC workstation. 7B Anesthesia Break Tracker o o This feature allows break reliever to track the rooms that need lunch or a quick break. It is also accessible in Gas Chart. It currently is used by the following sites: VOR3, VUH1, VUH4, MCE3, MCE6, and FEL4. Open Tempo o This tool is a workforce scheduling application used by anesthesia providers to look for future work schedules, room assignments and vacation requests. 7B 9 Anesthesia CRNA/SRNA VPIMS Overview 10.04.2010 v1. gomeza