• Adding a New Level of Care Order - (Handout) When Indicia recommends a different Level of Care than the one specified in the provider’s Admission Bed Request order, Nurse Navigators (and others managing these situations) should follow this workflow to place a new LOC order.
• Admission Bed Request - Ambulatory Clinics - (Handout) When a UIHC ambulatory clinic provider determines that a patient requires admission to the UIHC, an Admission Bed Request order with level of care is required before Bed Planning to a UI Healthcare unit can occur. The bed request order will trigger the Admission & Transfer Center (ATC) to find a bed for the patient.
• Admission Order Requirements Prior to Patient Discharge - (Handout) CMS guidelines require that the Admission order be signed by a provider with admitting privileges PRIOR to discharge. Best Practice Advisories (BPAs) will remind staff of these requirements and will fire if the Admission order hasn’t been signed and the Patient Class is INPATIENT or OBSERVATION and/or the Level of Care is INPATIENT.
• Code Status Considerations - (Handout) Staff needing to review and better understand code statuses ordered for patients will find some explanation here as well as Key Points and Recommendations.
• Medication Reconciliation – Using Signed & Held Order Status - (Handout) Patient safety around medications given within a hospital encounter relies on several key factors, such as, review and use of home medications for ongoing treatment of chronic conditions, updating active order lists with each patient encounter, and utilization of tools within the Electronic Health Record (EHR) accurately.

Videos/eLearnings

• Med Rec Efficiency (POSS114) - (Video: 1 min) Learn how to see reconciled medications in the sidebar, and how to see inpatient meds and home meds side-by-side during discharge med rec.

Handouts

• Discharge Medication Reconciliation - (Handout) Instructions for when you are ready to discharge patients.
• Discharge Now vs Discharge Pending - (Handout) This document is a guide to utilizing the Discharge Patient order (ADT8) and new required question to capture specific criteria for a patient to meet prior to discharge or when all tasks are complete, and the patient can discharge immediately.
• Homegoing DME Orders - (Handout) When a DME order is placed, the DME supplier must be documented via a DME Acknowledgment Task in the Wrap Up activity. The choice of supplier determines what happens next: eSignature, printed form, and/or e-mail and In Basket notifications sent.
• Placing Discharge/Readmit Orders from Medication Reconciliation - (Handout) Placing orders for prior to admission (PTA) medications between encounters should be completed using the Discharge and Readmit tab in the Discharge navigator.
• Placing Service Specific Discharge Follow-Up Orders - (Handout) Discharge follow-up orders can be placed at any time during a patient’s hospital stay.  For many specialty-specific services who consult or co-manage patients during their stay, placing a follow up order earlier than the time of discharge will ensure the Patient Access Center (PAC) or scheduling staff have an opportunity to schedule the appointment prior to the patient’s discharge from the hospital.
• Provider Discharge Workflow - (Handout) When a patient is ready to be discharged, complete the Discharge Order Reconciliation before signing the Discharge Summary.
• Reviewing and Updating a Patient's Legal Status - (Handout) The legal status of a patient can be viewed in the Storyboard and provides links to historical documentation of a patient’s legal status and scanned legal documents. Certain legal statuses require continuation through order placement prompted by Best Practice Advisory (BPA) Notifications.

• Transfer Order - (Handout) A transfer order should be placed when the patient is physically moving locations (i.e., unit to unit) or is changing primary service (e.g., intensivist team to hospitalist team). When a provider completes and signs a transfer order, the order will automatically create a Bed Request.