CRITICAL EPIC UPDATES – 6/6/22
1. FOR PROVIDERS: ED Course is coming to Epic by June 20th!
Many of you have been asking for this ever since we switched to Epic, and now it’s finally here! For the past 2 years, we’ve been waiting for an Epic upgrade that would enable us to use ED Course at NYP. The moment has finally arrived!
ED Course allows any provider to quickly document ED updates from the ED trackboard, Workup tab, or Storyboard without needing to open a full note.
ED Course updates will automatically flow into the ED Provider Note, even after the note is signed. This ensures that no information is ever lost.
By June 20th, we will switch to a “one-note” system by using ED Course for updates. The initial MDM, subsequent updates, and handoffs will all appear in the ED Provider Note. In general, you should stop using ED Progress Notes to document updates and handoff and use ED Course instead.
For more details, see the attached ED Course presentation and tipsheet (sent to your email).
Stroke Reminders at Columbia
- There has been some confusion regarding activation stroke for TIA (stroke like symptoms that resolved) within 6 hours of onset. These patients need an activation since we still need to report our time metrics for TIAs< 6 hours to New York State. Furthermore, sometimes there are subtle findings on their neuro exam or have stuttering symptoms which would make them a stroke patient rather than TIA. Activate Stroke Code for these patients and neurology is aware of this as it is part of our hospital stroke policy
- Activate Stroke Code for patients who presents with symptoms concerning for SAH or ICH within 6 hours. This is also per our stroke policy and we are required to report out those metrics. It will expedite getting the head ct on time and utilize the appropriate resources to take care of these patients.
- Use ED Adult Stroke Order set for patients that a code stroke is activated for. This order set have key elements that trigger multiple departments to expedite results for stroke patients as all these results are time sensitive. In addition, the [Head CT Acute Stroke Team Activation] order triggers the radiologist to be on standby to read this CT scan and expects someone in the CT scanner to communicate the results to. In addition, the CT scanner is usually placed on standby till the patient arrives. As one can imagine, if it is used for a 6/24 that does not meet criteria for LVO, it can lead to delays in other patients’ care when it is not warranted and may hold up valuable resources such as CT scan room as well as radiologist.
Morning Report
Seniors:
Please remember to email your morning report topic to faculty before your presentation!
Campus Announcements
From Drs. Laurie Malia & David Kessler Wanted: Participants for Intussusception POCUS Study This is an Intussusception POCUS Study evaluating whether an online learning platform can lead to improvement in identifying intussusception on ultrasound.
Compensation: $25 USD/$30 CAD for participation
Click this link to register.
All patients who undergo procedural sedation require a brief pre-sedation evaluation, including an airway assessment, before sedation begins.
To support this workflow, we created a new Pre-SedationAssessment Note to complement the existing ED Procedure Note for procedural sedation.
I. Complete the Pre-SedationAssessment Note Before SedationBegins
- Open the patient’s chart and click on the My Note tab.
- Select the Pre-Sedation Assessment Note.
- Complete the Pre-Sedation Assessment Note template that appears on the right side. This includes information that should be obtained prior to the sedation procedure, including informed consent, an airway assessment, and a focused history and exam including ASA Score and Mallanpati Score.
- Sign the note before sedation begins.
II. Complete the Procedure Note After the Sedation Procedure
- Open the patient’s chart and click on the My Note tab.
- Select the Procedure Note.
- Select the Procedural Sedation template.
- Complete the Procedural Sedation template that appears on the left side. This includes information about what happened during sedation, including findings and complications.
- Sign the note once you are done. Remember to complete a separate Procedure Note for the procedure itself (central line, joint reduction, etc).
CONFERENCE SCHEDULE
8:00 AM | Necrotizing Fasciitis | Dr. Maria Mosley-Colón |
8:30 AM | PEM Rashes | Dr. Julia Gittler |
9:00 AM | Mind the Gap: Disparities in Dermatology Education | Dr. Andrew Alexis |
9:45AM | BREAK | |
10:00 AM | Geriatrics: Atypical Presentations of Diseases | Dr. Surriya Ahmad |
11:00AM | Predicting ED Return Visits | Dr. Peter Steel |
Zoom Link
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Shout out to Mert for rocking first first day as a PGY-3 AND placing a chest tube
Chief On Call
David Chu, M.D.
EM Chiefs’ Cell: 917-410-1056
Please call and do not text/ email so we can address issues promptly.
If you do not hear back within 10 minutes, then call any of the other chiefs
