PROVIDER FOCUS JUNE 2014
Hospital Policy #16 Update
IMPORTANT
With the adoption of the EPIC electronic record in March of 2012, UnityPoint Health - Des Moines suspended the consequences of non-completion of medical records.
Effective July 21, 2014, UnityPoint Health - Des Moines will resume full enforcement of CIHC Hospital Policy # 16, Medical Records Completion. All providers are advised to become familiar with this policy to avoid dictation fees and disruption of privileges. The policy may be reviewed on the UnityPoint Health - Des Moines Homepage Intranet under the Physicians tab-Medical Staff Policies, MSP 16.
All providers are advised to take the necessary actions to remove all delinquencies (especially those older than 30 days from the date of discharge) from their InBaskets. Providers with a significant number of delinquencies more than 60 days old may receive a warning letter. As always, if you need assistance with these records, the Informaticists team is available 8am to 5pm, Monday-Friday at (515) 241-5557.
Beginning July 7, 2014, providers who have deficiencies that are approaching the 30 day mark will receive notification from UnityPoint Health - Des Moines as required by Policy #16. The provider will get a pop up when signing into EPIC. Additionally, the provider’s InBasket will display a dedicated folder called Deficiency Notification Letters, indicating that the provider has incomplete medical records aging 22 or more days since discharge. Per the policy, providers are responsible only for deficiencies/delinquencies in their own InBasket.
Insulin Order Sets Update
Adult Insulin Infusion & DKA/HHS order set changes:
The DKA/HHA and Insulin Infusion order sets have changed: ADULT DIABETIC KETOACIDOSIS (DKA) - HYPEROSMOLAR HYPERGLYCEMIC STATE (HHS) TREATMENT FOCUSED [3040540] ADULT INSULIN INFUSION FOCUSED [3040551]
For patients who have an existing insulin infusion order, the recommendation is for nursing, pharmacy and the provider to work together to determine further rate adjustment based on the algorithm within the current nurse reference using the multiplier, versus using the new Adult Maintenance IV Insulin Infusion table.
These order set versions are RETIRED (no longer available) as of Tuesday, June 10th: DIABETIC KETOACIDOSIS (DKA) - HYPEROSMOLAR HYPERGLYCEMIC STATE (HHS) TREATMENT FOCUSED (3040203) INSULIN INFUSION FOCUSED (3040243)
Additional Order Set Impact: OB LABOR DIABETIC MANAGEMENT FOCUSED (3040083) – insulin infusion medication order, reference links will change to match Adult Insulin Infusion Focused – insulin calculator will be removed.
Impact: If you have the retired version saved as a user order set, you will need to create a new user order set using the new versions.
Consult Order Reminder: Consult orders are for consults only. Consult orders do not print requisitions in Lab or Radiology, so procedures may be missed during off-hours. Please enter orders for required tests instead of writing comments within a consult order.
Please contact the Clinical Informatics call phone if you have questions or need assistance, 515-241-5557.
Infection Prevention News
WHAT WOULD YOU DO? Even though at this time the MERS situation in the U.S. represents a very low risk to the general public …………BE ALERT FOR PATIENTS WITH RESPIRATORY ILLNESS TRAVELING FROM COUNTRIES IN OR NEAR THE ARABIAN PENINSULA.
A PATIENT ARRIVES TO YOUR ED/CLINIC WITH THE FOLLOWING HISTORY: 60-year-old white male physician with onset of myalgias, fever, chills and dry cough for the past 5 days. Cough has progressed and he now feels short of breath. His symptoms began while in flight home from Saudi Arabia where he provided medical care in a hospital there.
Q: With this history, what disease should be considered? A: Middle East Respiratory Syndrome (MERS). WHY: MERS is a respiratory illness caused by a coronavirus. This virus was first identified in Saudi Arabia in April of 2012. To date there have been 570 cases identified in 18 countries with 171 deaths (30% mortality rate). Two cases have been recently confirmed in the U. S. in travelers returning from Saudi Arabia after caring for an infected person. Q: Should this patient be isolated? A: YES…..Isolation in the hospital includes STANDARD, CONTACT, and AIRBORNE. WHY: Not much is yet known about this coronavirus. Consider MERS when travel in or near the Arabian Peninsula within 14 days of symptom onset OR close contact with a symptomatic traveler. In other countries, the virus has spread from person to person through close contact, such as caring for an infected person. The Centers for Disease Control recognizes the potential for the virus to spread further and cause more cases. They continue to monitor the MERS situation globally and are working with the World Health Organization and others to better understand the virus, how it spreads, the source and the risks to the public’s health.
Q: What type of lab testing is done? A: Lower respiratory specimens are preferred, but collecting nasopharyngeal and oropharyngeal specimens, as well as stool and serum, are strongly recommended depending upon the length of time between symptom onset and specimen collection. See attached for detailed specimen collection information.
For more information about MERS visit www.cdc.gov/coronavirus/mers/faq.html
New Surgeon at UnityPoint
UnityPoint Clinic – Surgery is proud to welcome Timothy Mayfield, MD, to our experienced and dedicated general surgery team.
Dr. Mayfield completed his medical training at the University of Missouri, Columbia School of Medicine. He is certified by the American Board of Surgery – General Surgery. His areas of expertise include gallbladder, hernia surgery, laparoscopic and minimally invasive surgeries.
Dr. Timothy Mayfield
UnityPoint Cardiologist abstract accepted
Craig Clark, DO, UnityPoint Cardiology, and Nelson Telles, MD, internal medicine resident at IMMC, have had an abstract accepted for presentation at the 19th World Congress on Heart Disease entitled "Correlation of Left Atrial Appendage Inflow and Outflow Velocities with the CHADS2 and CHA2DS2-VASc Scores". The presentation will take place July 28th in Boston.
Dr. Tracy Ekhardt Announcement
Dr. Tracy Ekhardt has accepted the position of Assistant Vice President of Medical Affairs for UnityPoint Health - Des Moines. As the Assistant VPMA, Dr. Ekhardt will assist with regulatory/compliance issues, overview of the credentialing/privileging criteria system, the implementation of ICD-10, management of guest-related issues, medical staff policy formation, utilization management, and “other duties as assigned”.
In her current position as a member of the Blank Children’s Hospital Pediatric Critical Care and Pediatric Sedation Teams, Dr. Ekhardt has served on the UnityPoint Health - Des Moines Credentials Committee and Practice Management Committees. She a graduate of the Physician Leadership Academy, recently earned her Master’s Degree in Medical Management.
Dr. Tracy Ekhardt
Quality in Action
Copy and paste the following link to view June edition of Quality in Action. http://intranet/mlbnet50530/documents/Quality%20in%20Action%202014/June%202014.pdf
In Stitches