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					                                                      PATIENT CARE CLINICAL GUIDELINES




SUBJECT: Computer Downtime

POLICY STATEMENT:
All members of the health care team and support services will follow a standard practice during
computer down time.

The downtime procedure will be initiated when the patient care system for computer entry is unavailable
for 60 minutes or longer. STAT and now orders will be initiated immediately.

The SLHS Universal Downtime Requisition (MD.02) will be utilized to facilitate taking off and
processing orders when computerized data entry is not available. Future orders to departments will not
exceed 24 hours, unless noted in Department Downtime Guidelines.

When downtime exceeds 22 hours all ordering departments must complete a review of all future
recurring orders and complete a Universal Downtime Requisition for any future order that would
have normally printed a collection requisition during downtime.

All nursing units and clinical departments that enter charges via the computer are responsible for
maintaining a current manual charge requisition which accurately reflects all unit specific patient
charges. The unit/department specific manual charge sheet/requisition will be utilized to record all
patient charges during the downtime. When the system is up, charges will be entered by the
unit/department from the manual charge sheet/requisitions into computerized order entry system from
the furthest date to the current date using the correct service date.

In case of a power outage, ALL information below that indicates communication by “fax” will need to
be communicated via phone or be hand carried to the receiving department.

In case of internal phone system outage, ALL information below that indicates communication by
“phone” will need to be hand carried to the receiving department.

In case of a power outage, NO labels will be available from the Admitting Department. The Admitting
Department will complete the initial Universal Downtime Requisition for each patient with the
handwritten downtime patient label information. Subsequent Downtime Requisitions will be labeled by
hand by the unit/department with the patient label information.

If the computerized order entry system is down label print from computerized order entry system will
also be down. If power is available, Admitting will have capability of printing downtime labels for new
admits and on request for current patients.

ISSUED BY:                               Lynn Vaughn, Donna Findley, Shirlee Miller
EFFECTIVE DATE:                          12/05
SUPERSEDES EFFECTIVE DATE:               4/19/99, 11/19/99, 4/02, 12/03, 10/04, 03/05
APPROVED BY:                             Plan for Care Committee, PFIS “Super Group”
PAGE:                                    Page 1 of 15
                                                        PATIENT CARE CLINICAL GUIDELINES




SUBJECT: Computer Downtime

All nursing units and clinical departments will be responsible for maintaining a daily unit census that
includes patient name, admission time, transfer time and discharge time.

PURPOSE STATEMENT:

To provide a standardized process to follow during computer system downtime.

SCOPE:
All members of health care team and support services.

Department Downtime Guidelines
Admitting
**** In case of power outage, all admission/registration paperwork will be handwritten to be entered
in the computerized order entry system when power restored. No labels will be available for new
admits so all labeling etc., will need to be completed by hand.

Preparation For Planned Downtime:
   1. Print a hospital census. If downtime expected to continue during physician rounding
      periods AND Browser will be down, an adequate number of hospital census reports will be
      printed and made available in the physician lounge.
   2. Validate the Downtime Labels Database is loaded locally on the desktop.
   3. If network will also be down, confirm local printer is installed and operational.

   Requirements for print of downtime labels include:
   1. The database must be copied directly to the local C:drive of any PC that will need to
      be able to use the database when the network is down.
   2. MS Access must be loaded locally on the PC.
   3. If the network will be down, a local printer must be set up for the PC.
   4. The downtime label template is located on the N drive under
      N:\SLH\Admitting\PtLabelsA97.mdb

System Down:
REGISTRATION OF PATIENT (EXCEPT NEWBORNS)
1. Prior to downtime whenever possible, CPI numbers are obtained for patients expected to come in
    during downtime for admission.
ISSUED BY:                                Lynn Vaughn, Donna Findley, Shirlee Miller
EFFECTIVE DATE:                           12/05
SUPERSEDES EFFECTIVE DATE:                4/19/99, 11/19/99, 4/02, 12/03, 10/04, 03/05
APPROVED BY:                              Plan for Care Committee, PFIS “Super Group”
PAGE:                                     Page 2 of 15
                                                      PATIENT CARE CLINICAL GUIDELINES




SUBJECT: Computer Downtime
2. Patient presents for treatment.
3. After full name, date of birth, and social security number have been collected, Admitting calls Health
    Information Management to obtain an existing CPI (corporate) number or have a new one assigned.
    HIM also assigns an account (visit) number.
4. The Admitting Rep creates facesheet utilizing the Word Downtime Form.
5. When appropriate, a more in depth interview occurs The rest of the Downtime Form is completed
    and the consent form (B131) is signed. The timing of this interview is dependent upon where the
    patient presents for treatment.
6. The patient is logged on the Downtime Activity Log to insure accurate entry into the system when it
    comes up.
7. One copy of the completed Downtime Form is attached to the Downtime Activity Log. The original
    is attached to the B131 and is provided to the clinical area to computerized order entry system the
    medical record.
8. Patient labels are printed using the Downtime Labels Database.
9. Two armbands are created and placed on the patient (or sent to the unit if the patient is not present).
    The balance of the labels printed are sent with the facesheet and B131 to the clinical area.
10. The Downtime forms that are attached to the logs are used to enter information when the system
     comes up and then they are distributed to the Reimbursement Coordinators for Insurance
     Verification activities.

System Down:
REGISTRATION OF NEWBORNS
1. Admitting is notified that newborn needs a number.
2. Admitting Rep records in blue newborn downtime book: date, mother’s name, baby’s sex, time of
    delivery, type of delivery (V or C) and pediatrician.
3. Admitting Rep relays corresponding corporate number to labor and delivery staff.
4. Labor and delivery staff confirms number with admitting.
5. Admitting Rep initials newborn downtime book in the appropriate field.
6. Admitting calls Health Information Management to obtain account (visit) number.
7. Minimal data is completed on the Word Downtime form and three pages are printed.
8. Information is logged on the Downtime Activity Log with a copy of the Downtime Form attached.
9. Patient labels are printed using the Downtime Labels Database.
10. Two copies of demographic information are sent to the floor with the patient labels, two armbands
    and any necessary additional paperwork.
11. The Downtime forms that are attached to the logs are used to enter information when the system
    comes up and then they are distributed to the Reimbursement Coordinators for Insurance
    Verification activities.

ISSUED BY:                               Lynn Vaughn, Donna Findley, Shirlee Miller
EFFECTIVE DATE:                          12/05
SUPERSEDES EFFECTIVE DATE:               4/19/99, 11/19/99, 4/02, 12/03, 10/04, 03/05
APPROVED BY:                             Plan for Care Committee, PFIS “Super Group”
PAGE:                                    Page 3 of 15
                                                      PATIENT CARE CLINICAL GUIDELINES




SUBJECT: Computer Downtime



System Down:
BED ASSIGNMENT
1. Admitting maintains manual bed log, updating as beds are assigned, patients transfer, and patients
    are discharged. Since the computer is down, this communication is to be via Universal Downtime
    Requisition faxed to main admitting (23884) 6am-11pm and ER admitting (28179) 11pm-6am.
2. Admitting is notified that a patient needs a bed assignment in one of the following ways:
    ER calls to Admitting
    Recovery (or other outpatient department) calls Admitting.
    Inpatient unit requests transfer via the fax machine.
    Physician’s office calls a reservation for same day.
    Patient presents for admission.
3. Admitting determines most appropriate unit based upon information given and current bed status.
4. Admitting calls unit to receive room assignment.
5. If bed assignment was for patient in ER or other outpatient department, that unit is called with room
    assignment. Otherwise, assignment is noted on reservation log and used when patient arrives.

NURSING REQUEST TO TRANSFER PATIENT
System Down:
   1. Nursing completes Universal Downtime Requisition indicating patient’s need to transfer and
      requirements and faxes to Admitting at 23884.
   2. Admitting follows procedure for assigning bed if bed has not already been noted on requisition.
   3. Room assignment is called to requesting unit.
   4. Requisition is placed in appropriate stack until system comes up.

System Up:
1. Transfer is processed in the system by the Nursing unit.

NURSING NOTIFICATION OF PATIENT TRANSFER
System Down:
1. Nursing completes Universal Downtime Requisition indicating patient has transferred and faxes to
   Admitting so bed list may be updated.
2. Downtime Requisition is placed in appropriate stack until system comes up.

System Up:

ISSUED BY:                               Lynn Vaughn, Donna Findley, Shirlee Miller
EFFECTIVE DATE:                          12/05
SUPERSEDES EFFECTIVE DATE:               4/19/99, 11/19/99, 4/02, 12/03, 10/04, 03/05
APPROVED BY:                             Plan for Care Committee, PFIS “Super Group”
PAGE:                                    Page 4 of 15
                                                      PATIENT CARE CLINICAL GUIDELINES




SUBJECT: Computer Downtime
1. Once the system comes up, it will be the Nursing Unit’s responsibility to process the discharge.



NURSING PATIENT DISCHARGE
System Down:
1. Nursing completes Universal Downtime Requisition, indicating patients discharge information:
    Date
    Time
    Disposition
2. Nursing faxes requisition to Admitting so bed list may be updated.

System Up:
1. Once the system comes up, it will be the Nursing Unit’s responsibility to process the discharge in the
   system.

ADMISSIONS, DISCHARGES AND TRANSFERS
System Up:
Admitting
1. Downtime Activity form is recreated in the computer, utilizing the Downtime Log for accurate
   functionality and times. Patient accounting paperwork serves as a tool to enter collected information
   into the system for registrations.
2. All activity will be prioritized chronologically and by acuity, and entered in one at a time.
3. All admissions will be entered in the computerized order entry system using the CPI number and
   account (visit) number assigned by HIM during downtime.
4. If papers were not sent to the unit, computer generated forms will be sent.
Nursing
   1. When patients admitted during downtime are registered in the computerized order entry system
       the Unit will print labels and affix to all chart forms and re-band patients. NOTE: the downtime
       admission DOES NOT include the patient’s medical record number so this is an essential step in
       accurate patient identification.
   2. NOTE: the Unit should validate the computerized order entry system registration against the
       downtime registration information PRIOR to affixing labels on chart forms and patient wrist
       bands.

Central Supply
System Down: Bring manual request form to CSR on Universal Downtime Requisition. Indicate item
ISSUED BY:                               Lynn Vaughn, Donna Findley, Shirlee Miller
EFFECTIVE DATE:                          12/05
SUPERSEDES EFFECTIVE DATE:               4/19/99, 11/19/99, 4/02, 12/03, 10/04, 03/05
APPROVED BY:                             Plan for Care Committee, PFIS “Super Group”
PAGE:                                    Page 5 of 15
                                                      PATIENT CARE CLINICAL GUIDELINES




SUBJECT: Computer Downtime
being requested, item stock number if known, quantity, unit account number, or patient label.

System Up: Orders placed during the downtime process will not need to be entered into the
computerized order entry system.

Communication Disorders
System Down: Speech Therapy and Audiology orders will be communicated to the Communication
Disorders Department by calling the department at extension 23262. If the audix is reached, please give
the patient’s name, room number and the type of service needed.

System Up: Orders placed during the down time process will not need to be entered into the
computerized order entry system.

Digestive Disease Center (GI Lab)
System Down: Orders are to be called to 22040 for the same day orders. Next day orders can be faxed to
25985, called to 22040 or be sent on Downtime Requisition. Any order needs to specify the physician to
perform the procedure, not the ordering attending or resident.

System Down: Charges – Digestive Disease Center staff will maintain manual charge sheet for each
patient.

System Up: Routine orders will be entered into the system by the GI Lab Department. Prompts will
elicit information needed.

System Up: Charges – Digestive Disease Center staff will enter charges into the computerized order
entry ssystem when system becomes available.

ECHO
System Down: Orders for Echos, Holter, and Signal Average ECGs will need to be telephoned to the
respective department by calling Echo at 22588 and ECG Computer Services at 23306.

System Up: The ordering department personnel need to place orders in the system which occurred
during the downtime process. Please note in comments section, the word “DOWNTIME” to distinguish
this as the paperwork for the downtime orders and not as a new order.

EEG
System Down: Orders are to be called to 22086 for same day orders. Next day orders may be called to
ISSUED BY:                             Lynn Vaughn, Donna Findley, Shirlee Miller
EFFECTIVE DATE:                        12/05
SUPERSEDES EFFECTIVE DATE: 4/19/99, 11/19/99, 4/02, 12/03, 10/04, 03/05
APPROVED BY:                           Plan for Care Committee, PFIS “Super Group”
PAGE:                                  Page 6 of 15
                                                      PATIENT CARE CLINICAL GUIDELINES




SUBJECT: Computer Downtime
22086 or sent on Downtime Requisition.

System Up: Routine orders will be entered into the system by the EEG Department.


EICU/ICU
System Down:
Responsibilities:
    1. The ICU is responsible to notify the eICU Center of any interruption in monitoring equipment or
       either the hospital or clinical information systems at the hospital/unit level.
    2. The eICU is responsible to notify each ICU of any interruption in any component of the eVantage
       system that impacts patient care.
    3. The eICU physician is responsible to stay in the COR in case any calls come in requesting help
       (although limited, the eICU physician will have access to some data).
    4. In the event of expected long term failure of the eVantage system, the eICU is responsible to
       deploy nurses and physicians to the ICUs to help maintain the current level of care.

System Down:
Guidelines for Failure of the Hospital System:
    1. On failure of any hospital system, the eICU Center is notified of expected length of downtime of
       the hospital or clinical information systems or bedside monitoring.
    2. If the hospital or clinical information system is down, the ICU staff will fax results to the eICU
       on a regular basis as needed.
    3. If the bedside monitoring system is down, the ICU staff will note all manual vital signs on the
       white board for the eICU staff to review and document in the eCare Manager.

System Down:
Guidelines for Failure of the eVantage System:
    1. On failure of any component of the eVantage system that is expected to have a long downtime,
       the eICU staff will notify the ICUs of loss and will use the following procedures:
           a. Notify physicians with unstable patients in the affected ICUs.
           b. Manually track all verbal orders for entry after the system comes back up. If written
              documentation is necessary, use fax machines.
           c. All on-site documentation by physicians (PAs, NPs) should be deferred and entered later
              in the day if reasonable or should be done manually and faxed to the eICU for entry into
              eCareManager when system functionality has been restored.
           d. The Information Associate (or RN if no IA) will manually track the census and update

ISSUED BY:                               Lynn Vaughn, Donna Findley, Shirlee Miller
EFFECTIVE DATE:                          12/05
SUPERSEDES EFFECTIVE DATE:               4/19/99, 11/19/99, 4/02, 12/03, 10/04, 03/05
APPROVED BY:                             Plan for Care Committee, PFIS “Super Group”
PAGE:                                    Page 7 of 15
                                                      PATIENT CARE CLINICAL GUIDELINES




SUBJECT: Computer Downtime
             after system functionality is restored.
          e. Verbally communicate any outstanding clinical issues between patient’s physicians and
             eICU physician if electronic sign-off is not possible.
          f. When the eVantage system fails, use the regular phone system and fax documents and
             results.
          g. If the regular phone system failes, use hot phones or cellular phones.
          h. If the eICU must be evacuated, the eICU team is to go to a designated ICU and operate
             from there until the system comes back up. Back-up physicians will be called in if
             clinically indicated.
Reference:
VISICU eICU/ICU Downtime Policy

Emergency Department
System Down:
   1. If possible, ED staff will leave discharged patients on the tracking board in the Downtime
      Waiting Room at the bottom of the screen until it is indicated the patients are registered in the
      computerized order entry system.
System Up:
   1. Once the flag “flips”, the patients can be discharged from the tracking board.
   2. NOTE: if patients are removed from the tracking board PRIOR to computerized order entry
      system registration, the records have to be merged by Admitting.
   3. NOTE: The Emergency Department must coordinate discharge of patients with Radiology.
      Patients cannot be discharged until the Radiology exams are completed in the computerized order
      entry system.


Health Information Management
System Down:
1. Admitting and Emergency Department place a call to HIM (ext 22860) with the correct spelling of
   the patient name and the patients date of birth.
2. HIM staff will review the microfiche Master Patient Index to determine if the patient has an existing
   CPI number or if the patient is new.
3. The existing CPI number is communicated to the admitting staff. The new CPI number is
   communicated to the admitting staff and written in the manual log in HIM.
4. An account (visit) number is assigned and communicated to the Admitting staff.

System Up: Admitting will enter the admission into the system using the CPI number and account
ISSUED BY:                               Lynn Vaughn, Donna Findley, Shirlee Miller
EFFECTIVE DATE:                          12/05
SUPERSEDES EFFECTIVE DATE:               4/19/99, 11/19/99, 4/02, 12/03, 10/04, 03/05
APPROVED BY:                             Plan for Care Committee, PFIS “Super Group”
PAGE:                                    Page 8 of 15
                                                      PATIENT CARE CLINICAL GUIDELINES




SUBJECT: Computer Downtime
number assigned by HIM during downtime.

Image Manager
System Down:
Request/retrieval of PIM original paper record:
   1. Unit/Department must call Prep Technician at ext 22860 and request copy of original patient
      record.
   2. Prep Technician will determine discharge date of last patient admission.
          a. If computerized order entry system is available, computerized order entry system will be
              used to obtain discharge date information.
          b. If computerized order entry system is unavailable, the Tech will obtain closest discharge
              date of last admission from the requesting Unit/Department then locate patient on the
              Census/Encounter Sheets by discharge date.
          c. The Tech will determine status and area of the original record (eg., prepping, scanning,
              indexing, storage, or to be shredded box).
          d. NOTE: Records that have not been placed on the PIM system will be retrived per HIM
              policy, utilizing CRIS when necessary.
   3. Retrieve available original record from status location if possible.
   4. Prep Technicial will make a colored copy of the requested record documents and deliver to the
      requester and refile original record back to designated area.

Information Services
System Down:
   1. Information Services (IS) will notify affected hospitals of scheduled downtimes at least two
      weeks before the downtime. Exceptions are possible and may include (but are not limited to)
      problems that do not immediately stop the system, but need a more immediate resolution.
   2. The Help Desk will notify the Hospital page operator to announce overhead that the clinical
      system will be unavailable at approximately xx:xx. The Help Desk also notifies all other
      impacted facilities of the downtime.
   3. NOTE: For unexpected downtimes or for delay in system up, IS will notify the Hospital page
      operation to announce status reports overhead.

System Up:
1. The Help Desk notifies the Hospital page operator to announce that the clinical system is available.

Laboratory
(including ABGs)
ISSUED BY:                               Lynn Vaughn, Donna Findley, Shirlee Miller
EFFECTIVE DATE:                          12/05
SUPERSEDES EFFECTIVE DATE:               4/19/99, 11/19/99, 4/02, 12/03, 10/04, 03/05
APPROVED BY:                             Plan for Care Committee, PFIS “Super Group”
PAGE:                                    Page 9 of 15
                                                     PATIENT CARE CLINICAL GUIDELINES




SUBJECT: Computer Downtime
The Laboratory will prepare and distribute downtime specific instructions prior to each planned
downtime expected to last greater than four (4) hours.

NURSING UNIT
System Down:
1. The unit IA will process all physician orders and transcribe physician order information onto the
   Universal Downtime Requisition.
2. The unit IA will notify the appropriate unit PCT, RN, or RCT of the pending order.
3. NOTE: if specimen is to be run on “specimen in lab” the SIL portion of the downtime requisition
   must be completed as instructed.
4. After collection, the Universal Downtime requisition and the labeled specimen will be delivered to
   the Laboratory.
5. Laboratory personnel will enter this information into the Cerner system or process via Laboratory
   backup system.

NURSING UNIT
System Up:
1. Nursing unit will not need to enter in computerized order entry system any order that has been
   completed (i.e. specimen drawn and Universal Downtime Requisition delivered to Lab with
   specimen).
2. The unit IA will enter future orders collected during downtime on the Universal Downtime
   Requisition into computerized order entry system.
3. Follow unit procedure for notification of unit PCT, RN, or RCT for collection of specimen.

LABORATORY
System Down:
1. The PCTs, RNs, or RCPs responsible for laboratory collections can pick up labels for the early AM
   draws in the Drawing Center if available. When Cerner is up, cerner labels will continue to print on
   units with label printers.
2. Any orders not having a Cerner label must be labeled with a patient label (or hand written patient
   information to include first and last name and identification numbers such as date-of-birth, CPI,
   Account number, or SSN), date and time of draw, tests needed, patient location, and user’s A
   number. These collections must be accompanied by a completed Universal Downtime Requisition
   when delivered to the Laboratory Support Center.
3. Laboratory Support Center staff will not be able to generate the Nursing Collection Checklist for
   PCT’s during downtime and they will not be able to follow-up with units that have pending
   outstanding collections. PCT’s are responsible for being aware of new orders that require collecting

ISSUED BY:                              Lynn Vaughn, Donna Findley, Shirlee Miller
EFFECTIVE DATE:                         12/05
SUPERSEDES EFFECTIVE DATE:              4/19/99, 11/19/99, 4/02, 12/03, 10/04, 03/05
APPROVED BY:                            Plan for Care Committee, PFIS “Super Group”
PAGE:                                   Page 10 of 15
                                                      PATIENT CARE CLINICAL GUIDELINES




SUBJECT: Computer Downtime
   and delivery to the laboratory.
4. ALL RESULTS WILL BE CALLED or FAXED DURING THE DOWNTIME.
5. NOTE: “Lab-only” patients, ACT orders, Specimen in Lab orders, and main pre-operative orders
   will be called to the Laboratory Support Center at 22423.




LABORATORY
System Up:
When hospital clinical system is available and the patients admitted during downtime are entered into
the system, laboratory backup orders will be placed by laboratory staff. All orders received in the
laboratory during downtime on Universal Downtime Requisitions will be entered into the laboratory
system by laboratory staff.

Neuro Diagnostics Department
System Down: Charges – Department staff will maintain manual charge sheet for each patient.

System Up: Charges – Department staff will enter charges in computerized order entry system when
system is available.

Nursing
Preparation for System Down:
   1. Print adequate number of sheets of labels for each current patient and place in chart.
   2. Assure adequate number of downtime requisitions are available for use during downtime.
   3. Place all future orders for next day prior to 2100 the night before expected downtime.
   4. Inform staff working during downtime of the downtime procedures to be followed.
   5. Print commonly used physican order sets from Browser.
   6. Print Unit census for each staff person working during downtime. Maintain a master paper unit
      census report during downtime for validation after system up.
   7. NOTE: A master copy of each order set on Browser is available in the Nursing Staffing Office
      for re-print as needed. Contact the Nursing Staffing Office to fax order set.
Nutrition Services
System Down: Orders will be communicated to Nutrition Services by means of a Downtime
Requisition. Requisitions are sent to Nutrition Services by means of the transportation service. Diet
orders sent after the following cut-off times must be communicated by phone (ext. 22117), in addition to
ISSUED BY:                               Lynn Vaughn, Donna Findley, Shirlee Miller
EFFECTIVE DATE:                          12/05
SUPERSEDES EFFECTIVE DATE:               4/19/99, 11/19/99, 4/02, 12/03, 10/04, 03/05
APPROVED BY:                             Plan for Care Committee, PFIS “Super Group”
PAGE:                                    Page 11 of 15
                                                     PATIENT CARE CLINICAL GUIDELINES




SUBJECT: Computer Downtime
the Downtime Requisition, in order to ensure a tray for the upcoming meal: 0500, 1000, and 1530.

System Up: Nutrition orders must be entered into computerized order entry system by the nursing staff.

Pharmacy/Pyxis
The Pharmacy will prepare and distribute specific downtime instructions prior to planned
downtime expected to be greater than two (2) hours.

System Down: Orders
1. Pharmacy operations may be centralized. Pharmacy personnel will round hourly to pick up routine
   physician orders. Nursing should contact the pharmacy for STAT and NOW orders per routine
   uptime procedures. Allergies, height, weight and pertinent patient conditions must be noted by
   nursing on physician orders.
2. Medications not available from Pyxis will be delivered by pharmacy personnel. Medication labels
   will be manually generated and should be read carefully.
3. MARs will be manually maintained by nursing. A computerized set of MARs will be generated on
   the next scheduled MAR run once all orders are input.

System Down: Charges
1. Charges – Medication orders will be maintained in Pharmacy Department with amount of medication
   sent noted. Pyxis billing information will be stored in Pyxis system.
2. During a downtime in which the Pyxis machines experience a loss of power, the Nursing Station
   should:
   a) Call Pharmacy and report a loss of power
   b) Check to see if a red outlet can be used to power the pyxis machine during the power outage.
       Extension cords may be required to maintain Pyxis operation.

System Up: Orders
1. All orders will be entered in chronological order, as systems become live.
2. Due to communications load there may be a significant delay in the time it takes orders to become
   available on Pyxis.

System Up: Charges Billing information stored in Pyxis will pass through interface to computerized
order entry system.

Radiology
(including Nuclear Medicine)
ISSUED BY:                              Lynn Vaughn, Donna Findley, Shirlee Miller
EFFECTIVE DATE:                         12/05
SUPERSEDES EFFECTIVE DATE:              4/19/99, 11/19/99, 4/02, 12/03, 10/04, 03/05
APPROVED BY:                            Plan for Care Committee, PFIS “Super Group”
PAGE:                                   Page 12 of 15
                                                     PATIENT CARE CLINICAL GUIDELINES




SUBJECT: Computer Downtime
System Down: Orders
1. Orders for Radiology exams including Nuclear Medicine, Ultrasound, MRI, CT, Special Procedures
   and Diagnostic Procedures will be sent to the Radiology Department (by Fax #22698 or hand
   delivery) utilizing the Universal Downtime Requisition. Ordering Physician and reason for exam
   MUST be included on the request by the individual placing the order, i.e., nursing staff.
   Radiology staff will be responsible for documenting all pertinent information for EDE on the
   downtime request.
2. ALL STAT ORDERS WILL BE CALLED to the Radiology Department at extension 22550 in
   addition to sending the Universal requisition.

System Down: Charges – Radiology Department staff will make copy of Universal Downtime
Requisition and retain.

System Up: Orders - Radiology will log the Downtime Requisitions in a designated area and be
responsible for entering those orders into computerized order entry system.

System Up: Charges – Radiology Department will enter charges in computerized order entry system
when system becomes available.

Rehabilitation Services
System Down: Orders - Use Universal Downtime Requisition and fax orders to extension 26211.

System Down: Charges – Rehabilitation Services department therapists will record charge information
on audit sheet for each patient.

System Up: Orders - Orders placed during the down time process will not need to be entered into
computerized order entry system.

System Up: Charges – Rehabilitation Department secretaries will entry charge information from
patient audit sheet in computerized order entry system.

Respiratory Care Service (RCS)
(including EKG)
System Down: Orders
1. Contact the Respiratory Care Practitioner in your area directly for all STAT, Urgent or Timed orders
   (including ABGs, EKGs and phlebotomy in designated areas), or for questions regarding Respiratory
   Care.
ISSUED BY:                              Lynn Vaughn, Donna Findley, Shirlee Miller
EFFECTIVE DATE:                         12/05
SUPERSEDES EFFECTIVE DATE:              4/19/99, 11/19/99, 4/02, 12/03, 10/04, 03/05
APPROVED BY:                            Plan for Care Committee, PFIS “Super Group”
PAGE:                                   Page 13 of 15
                                                        PATIENT CARE CLINICAL GUIDELINES




SUBJECT: Computer Downtime
    The correct pager number may be obtained from the hospital operator daily.
    If more help is needed, the shift coordinator may be reached on pager 440-2432.
    The clinical manager may be reached through the shift coordinator.
2. Contact the Respiratory Care Services Department (ext. 22289) during regular business hours to
   schedule:
    Pulmonary Rehabilitation
    Pulmonary Function Studies (PFT)
    Sleep Study
    Bronchoscopy
    Hyperbaric Oxygen Therapy (HBO)
    Metabolic Testing
    MVO2
    any other diagnostic test. Please contact your RCP for order interpretation.
3. Complete a Universal Downtime Requisition for the ordered procedure and keep it with the patient’s
   medical record.
4. The RCP will pick up the requisition when the patient is seen.


System Down: Charges – The manual Pulmonary Lab Requisition will be completed on each patient by
department staff.

System Up: Orders
The RCP will enter the physician order into computerized order entry system (as needed) when it
becomes available.

System Up: Charges – RCS department will enter charges into computerized order entry system when
system becomes available.

Social Work Services
(including Home Health)
System Down: Orders and consults will be communicated by phone call to extension 22169. Please
include: patient’s name, room number, reason for consult, who is requesting consult (e.g. physician,
nurse, data base, etc.), priority required, and name of admitting physician. Even if Unit personnel may
not think an order is urgent, early notification is necessary to prioritize and ensure the Social Worker can
respond in a timely manner.


ISSUED BY:                                Lynn Vaughn, Donna Findley, Shirlee Miller
EFFECTIVE DATE:                           12/05
SUPERSEDES EFFECTIVE DATE:                4/19/99, 11/19/99, 4/02, 12/03, 10/04, 03/05
APPROVED BY:                              Plan for Care Committee, PFIS “Super Group”
PAGE:                                     Page 14 of 15
                                                       PATIENT CARE CLINICAL GUIDELINES




SUBJECT: Computer Downtime
System Up: Orders and consults which occurred during the downtime will need to be entered into
computerized order entry system by the nursing unit or clinic staff. Please note in comments section, the
word “DOWNTIME” to distinguish this as a downtime order and not as a new order or consult.

Spiritual Wellness
System Down: Consults to Spiritual Wellness will be called to the Chaplain’s Office, 22180 or the on-
call beeper 440-2412.

System Up: No follow up required.

Patient Accounting
System Down: Retain all patient charge information.

System Up: IA will enter the oldest patient charges first.

Teletracker System
Telephone System Down: The Hospitality Manager will deploy the Housekeeping Associates to the
various units/departmens and wait for instructions from the unit staff. The housekeeping associate will
complete the task and then wait for further instructions.

Pager System Down: The Hospitality Manager will inform the Housekeeping Associates to call the
Teletracking system every 5 minutes until they receive a call, and then they will proceed as normal to
complete the request. If there is not another call in the queue when the Housekeeping Associate
completes the task s/he will continue to call the TeleTracking system until s/he receives another
assignment.

Computer System Down: TeleTracking will not be available to process requests.

Tele-Tracking Dispatcher:
   1.     Call extension 1-5932 to enter a patient tracking job into the tele-tracking system
   2.     Call extension 1-5928 to enter a bed tracking job into the tele-tracking system.
   3.     The dispatcher will write the request on the log sheet and page the supervisor on
          440-1000 and 440-2552.
Units/Departments:
   1.     Contact Hospitality Desk at extension 2-2150 for transportation requests.
   2.     Contact Housekeeping at extension 2-2077 for bed/room cleaning requests.


ISSUED BY:                                Lynn Vaughn, Donna Findley, Shirlee Miller
EFFECTIVE DATE:                           12/05
SUPERSEDES EFFECTIVE DATE:                4/19/99, 11/19/99, 4/02, 12/03, 10/04, 03/05
APPROVED BY:                              Plan for Care Committee, PFIS “Super Group”
PAGE:                                     Page 15 of 15
                                         PATIENT CARE CLINICAL GUIDELINES




SUBJECT: Computer Downtime




ISSUED BY:                   Lynn Vaughn, Donna Findley, Shirlee Miller
EFFECTIVE DATE:              12/05
SUPERSEDES EFFECTIVE DATE:   4/19/99, 11/19/99, 4/02, 12/03, 10/04, 03/05
APPROVED BY:                 Plan for Care Committee, PFIS “Super Group”
PAGE:                        Page 16 of 15

				
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