source: EDIS/tags/ed/tracking-help/src/main/webapp/Triage.html@ 1240

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1<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN">
2<html>
3<head>
4<title>EDIS: Triage</title>
5<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1">
6<meta name="keywords" content="update patient information, acuity, room, area, source, patients, select patients, patient-status notifications, display board complaint, room, area, source, cancel, save, complaint, long complaint, patient information pane">
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8
9<link href="Accessible_Design.css" rel="stylesheet" type="text/css">
10</head>
11
12
13<h1 align="center"><img src="images/EDIS_ICON_Small.gif" alt="EDIS icon" width="184" height="184"><br>
14Triage View</h1>
15
16
17<h2 align="center">Add Triage Information <br/>Create a Visit in CPRS<br/>Add Patients</h2>
18<hr>
19<hr>
20<h4 align="center"><a href="#patientinformationpane">Add Triage Information</a> &#124; <a href="#createvisit">Create Visit</a> &#124; <a href="#addpatients">Add Patient</a> </h4>
21
22<p>You use the <b>Triage</b> view to edit or update information that you gather as part of the triage process. From this view, you can update patients&#146; display-board complaints; include additional, not-for-display information about their complaints (optional); update their room or area assignments; add information about their acuities; make nursing, provider, and resident assignments; update or add patients&#146; sources (offsite clinics, for example); and specify clinic locations for patients&#146; emergency-department visits. You can also add patients to the display board from the <strong>Triage</strong> view.</p>
23<p><img src="images/triage_view_general.png" alt="Screen capture: the Triage view" width="600" height="404" border="1"><br />
24The Triage view.</p>
25<h3 align="left"><a name="patientinformationpane">Adding Triage Information via the Patient Information Pane</a></h3>
26
27
28<ol>
29 <li>In the <strong>Active Patients</strong> list, select the patient whose triage information you want to enter. Keyboard: use the TAB key to locate the <strong>Active Patients</strong> list. Use the
30 DOWN ARROW key to enter the list, and use the DOWN ARROW and UP ARROW keys to locate the patient you want to select. The <strong>Patient Information</strong> pane displays current information for the selected patient.</li>
31<li>If applicable, update the patient&#146;s display-board complaint in the <b>Complaint for Display Board</b> box. <i>If you are adding the patient from the <b>Triage</b> view, you must type a display-board complaint. The application will not allow you to add the patient if the <b>Complaint for Display Board</b> box is empty.</i> Keyboard: use the TAB key to locate the <strong>Complaint for Display Board</strong> box.</li>
32<li>In the <b>Long Complaint (optional)</b> box, you may type supplementary information about the patient&#146;s display-board complaint. Keyboard: use the TAB key to locate the <strong>Long Complaint (optional) </strong>box. </li>
33<li>If applicable, open the <strong>Room / Area </strong>list and make or update the patient’s room or area assignment. (<em>Room or area information is mandatory</em>; the waiting room is the application’s default selection.) Keyboard: use the TAB key to locate the <strong>Room / Area</strong> list, and use the
34 DOWN ARROW and UP ARROW keys to select a room or area from the list. </li>
35<li>Select an acuity value from the <b>Acuity</b> list. Acuity information is mandatory for this view; if you do not select an acuity, the application will not allow you to save your updates or edits. Keyboard: use the TAB key to locate the <strong>Acuity</strong> list. Use the DOWN ARROW and UP ARROW keys to select an acuity.</li>
36
37<table><!--This table is for formatting purposes only--><tr align="top"><td valign="top"><i>Note:</i></td>
38<td><i><a name="esi"></a>EDIS supports the Emergency Severity Index (ESI) triage algorithm, which ranks patients&#146; acuities using the numbers 1 (most urgent) through 5 (least urgent). Please visit the <a href="http://www.ahrq.gov/research/esi">Agency for Healthcare Research and Quality ESI</a> Web site for more information. </i></td>
39</tr></table>
40
41<li>Open the <strong>Status</strong> list and select the patient&#146;s status. Keyboard: use the TAB key to locate the <strong>Status</strong> list. Use the DOWN ARROW and UP ARROW keys to select a status from the list. (Your site can add locally meaningful statuses. For a list and brief explaination of nationally released status selections, see the &quot;<a href="#StatusDefinitions">Definitions for Status Selections</a>&quot; section, which follows this instruction set.)</li>
42 <li>Select a provider from the <b>Provider </b> list. Keyboard: use the TAB key to locate the <strong>Provider</strong> list. Use the DOWN ARROW and UP ARROW keys to select a provider from the list. The <strong>Provider</strong> list is also available on the <strong>Update</strong> and <strong>Disposition</strong> views.</li>
43 <li>If the <strong>Resident</strong> list (controlled by a site-selectable parameter) is available, select a resident from the list. Keyboard: use the TAB key to locate the <strong>Resident</strong> list and use the
44 DOWN ARROW and UP ARROW keys to select a resident from the list. If the <strong>Resident</strong> list is available on the <strong>Triage</strong> view, it is also available on the <strong>Update</strong> and <strong>Disposition</strong> views. </li>
45
46
47 <li>Select a nurse from the <strong>Nurse</strong> list. Keyboard: use the TAB key to locate the <strong>Nurse</strong> list. Use the DOWN ARROW and UP ARROW keys to select a nurse from the list. The <strong>Nurse</strong> list is also available on the <strong>Update</strong> view. </li>
48 <table><!--This table is for formatting purposes only--><tr align="top"><td valign="top"><i>Note:</i></td>
49<td><i>When you make a nurse, resident, or provider assignment in EDIS, the application automatically creates a Patient Care Encounter (PCE) visit in CPRS&mdash;if it hasn't already done so, or unless the nurse or provider does not have an active person class in VistA. EDIS does not create visits for patients you’ve added using the <strong>Enter Name, Patient Is Not in VistA</strong> or <strong>Ambulance Is Arriving, Patient Name Is Unknown</strong> selections.</i></td>
50</tr></table>
51 <li>If applicable, add or edit the patient&#146;s source from the <b>Source</b> list. Keyboard: use the TAB key to locate the <strong>Source</strong> list. Use the DOWN ARROW and UP ARROW keys to select a source from the list.</li>
52 <li>If the <strong>Clinic</strong> list is available, select the location that you want EDIS to use for creating the patient&rsquo;s PCE visit. This list is controlled by site-selected parameters. If your site&rsquo;s emergency department has only one location, or uses only one location at any given time, this list may not be available. The list is also unavailable if a PCE visit is already associated with the patient&rsquo;s emergency-department episode of care. </li>
53 <li>Click <strong>Save</strong> to save your edits and updates or click <strong>Cancel</strong> to close the <strong>Patient </strong><b> Information</b> pane without saving your changes. <i>The <b>Save</b> button is available only after you&#146;ve added or updated information in the <b>Patient Information</b> pane.</i> Keyboard: use the TAB key to locate the <strong>Save</strong> or <strong>Cancel</strong> button. Use the SPACEBAR key to select the button. </li>
54</li>
55</ol>
56<h3><a name="StatusDefinitions"></a>Definitions for Status Selections</h3>
57<p>The EDIS technical working group (TWG) has provided the following definitions for nationally released status selections:</p>
58 <p><strong>Admitted&mdash;</strong>the patient is admitted, but is still in the emergency department.<br>
59 <strong>ED Boarding [Hold]&mdash;</strong>the patient is admitted and is designated as a holder (implying extended time in the emergency department).<br>
60 <strong>Discharged&mdash;</strong>the patient is discharged, but is still in the emergency department.<br>
61 <strong>ED Observation Unit&mdash;</strong>the patient is an observation patient under the emergency department&rsquo;s care.<br>
62 <strong>ED Patient&mdash;</strong>the patient is an emergency department patient (after triage).<br>
63 <strong>En Route/Prearrival&mdash;</strong>the patient is en route to the emergency department.<br>
64 <strong>Awaiting Triage&mdash;</strong>the patient is at the emergency department and is awaiting triage. </p>
65 <p>Other <strong>Status</strong>-list selections are site configurable.</p>
66
67<h3><a name="createvisit">Create a Visit in CPRS</a></h3>
68<p>Adding a provider (or a nurse who has an active person class in the New Person file) in EDIS automatically creates a visit in CPRS&mdash;<em>unless EDIS has already created a visit for a particular emergency-department episode of care or the staff member you assigned does not have a valid person class in VistA.</em> To reduce the possibility of creating duplicate visits, EDIS checks back one hour for Patient Care Encounter (PCE) visit entries associated with the emergency department location (or locations) specified in the VistA EDPF LOCATION parameter. (EDPF LOCATION parameter settings and&mdash;if applicable&mdash;<strong>Clinic</strong> list selections determine the location EDIS uses to create visits.)</p>
69<p>EDIS creates only one visit for each emergency-department episode of care (or encounter). You can avoid creating duplicate visits for the same episode of care by selecting the visit that EDIS creates when you complete patients’ emergency-department encounters in CPRS.</p>
70<p><img src="images/CPRS_PCE_visit_Cover_tab.jpg" alt="Screen capture: CPRS cover sheet displaying EDIS-created visit" width="548" height="417"><br />
71Adding a nurse, resident, or provider assignment in EDIS creates a Patient Care Encounter visit in CPRS.</p>
72<h3 align="left"><a name="addpatients">Add Patients from the <b>Triage</b> View</a></h3>
73<p align="left"><img src="images/add_patient_dialog_triage.png" alt="Screen capture: the Add Patient dialog, Triage view" width="600" height="546" border="1"><br />
74The <strong>Add Patient</strong> dialog box.</p>
75<P>
76 Click <b>Add Patient</b> in the upper right-hand corner of the <b>Active Patients</b> list.
77 Keyboard: use the TAB key to locate the <b>Add Patient</b> button and use the SPACEBAR key to select the button. </p>
78<table><!--This table is for formatting purposes only--><tr align="top"><td valign="top"><i>Note:</i></td>
79<td><i>EDIS does not activate the <b>Add Patient</b> button when you are already in the process of signing in or triaging a patient or updating a patient&#146;s triage information. To activate the <b>Add Patient</b> button in any of these cases, you must select <b>Save</b> to complete the sign-in or triage process, or <b>Cancel</b> to cancel the process and discard the information you&#146;ve entered.<br/>
80 <br/>
81 Keyboard: use the TAB key to locate the <b>Cancel</b> or <b>Save</b> button. Press the SPACEBAR key to select the button.</i></td>
82</tr></table>
83 <p> The application displays the <b>Add Patient</b> dialog box, which offers the following three selections: </p>
84<ul>
85<li><a href="#findpatient"><b>Search for Patient in VistA</b></a>: enables you to add patients who are already in your local VistA system</li>
86<li><a href="#noneoftheabove"><b>Enter Name, Patient Is Not in VistA</b></a>: enables you to add patients who are not in your local VistA system</li>
87<li><b><a href="#ambulancearriving">Ambulance Is Arriving, Patient Name Is Unknown</a></b>: enables you to add information for patients whose identities are unknown</li>
88</ul>
89
90<blockquote>
91
92<h3 align="left"><a name="findpatient"></a>Search for Patient in VistA</h3>
93
94<ol>
95
96<li>If necessary, select <b>Search for Patient in VistA</b>. (<b>Search for Patient in VistA</b> is the application&#146;s default selection; in most cases, you won’t need to manually select this button.) Keyboard: if the <strong>Search for Patient in VistA</strong> button isn&#146;t selected, use the TAB key to locate the selected button <strong>(Enter Name, Patient Is Not in VistA</strong> or <strong>Ambulance Is Arriving, Patient Name Is Unknown)</strong>. Use the UP ARROW key to locate the <strong>Search for Patient in VistA </strong>button and use the SPACEBAR key to select it.</li>
97<li>Type all or part of the patient’s name in the <strong>Find Patient</strong> box using this format: Surname,Firstname. For example, you can search using the patient’s surname only, or the patient’s surname and the first initial of his or her first name. You can also search using the initial letter of the patient’s surname concatenated with the last four digits of his or her Social Security number (X9999 format), the patient’s entire Social Security number (SSN), or the last four digits of his or her SSN. Keyboard: use the TAB key to locate the <strong>Find Patient</strong> box. </li>
98<li>Click <b>Search</b> or press the ENTER key. </li>
99<li>The <b>Add Patient</b> dialog box lists possible matches. Select the correct patient and press the ENTER key or click <b>Continue</b>. Keyboard: use the DOWN ARROW and UP ARROW keys to locate the correct patient. Press the ENTER key to select the patient. You can also select the patient by using the TAB key to locate the <strong>Continue</strong> button and then pressing the SPACEBAR key to select the button. </li>
100</ol>
101
102<p>The application displays the <b>Patient Information</b> pane.</p>
103
104
105<h3 align="left"><a name="noneoftheabove"></a>Enter Name, Patient Is Not in VistA</h3>
106<p>If the <b>Find Patient</b> search list does not contain a match, add the patient using the <b>Enter Name, Patient Is Not in VistA</b> selection.</p>
107
108<ol>
109
110<li>Select <b>Enter Name, Patient Is Not in VistA.</b> Keyboard: use the TAB key to locate the <strong>Search for Patient in VistA</strong> (or currently selected) button. Use the DOWN ARROW (or UP ARROW) key to locate the <strong>Enter Name, Patient Is Not in VistA</strong> button. Use the SPACEBAR key to select this button. </li>
111<li>Type the patient&#146;s name in the <b>Patient Name</b> box. Keyboard: use the TAB key to locate the <strong>Patient Name</strong> box.</li>
112<li>Click <b>Continue</b> or press the ENTER key. The application displays the <b>Patient Information</b> pane.</li>
113</ol>
114<blockquote>
115 <p><img src="images/enter_name_patient_not_vista_triage.png" alt="Screen capture: Enter Name, Patient Is Not in VistA selection" width="500" height="475" border="1"><br />
116 The <strong>Enter Name, Patient Is Not In VistA</strong> button.</p>
117<blockquote><h4>Adding Unidentified Patients</h4>
118<p>When you must add unresponsive patients whose identities you do not know, use the <strong>Enter Name, Patient Is Not in VistA</strong> selection and follow the naming protocol defined in section 12 of VHA Directive 2006-036: <em>Data Quality Requirements for Identity Management and Master Patient Index Functions</em>. (Use the name UU-UNRESPONSIVE,PATIENT for the first such patient, UU-UNRESPONSIVE,PATIENT A for the second, UU-UNRESPONSIVE,PATIENT B for the third, and so forth.) You can find the full text of this directive at <a href="http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1434">http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1434. </a></p>
119</blockquote>
120</blockquote>
121<!--<p><u><i>keyboard</i></u></p>
122<ol><li>If you&#146;ve cleared the patient&#145s name in the <b>Find Patient</b> box, retype it.</li>
123<li>Press and hold the CTRL key and press the TAB key. Release the CTRL key. Repeat this step until you bring the application&#146;s focus to the <b>None of the above -- new patient</b> button. Press the SPACEBAR key to select this button.</li>
124<li>Press the TAB key until you bring the application&#146;s focus to the <b>Cancel</b> or <b>Continue</b> button.</li>
125<li>Press the SPACEBAR key to select the button of your choice.</li>
126<li>If you select <b>Continue</b>, the application displays the <b>Patient Information</b> pane.</li></ol>-->
127
128<h3 align="left"><a name="ambulancearriving"></a>Ambulance Is Arriving, Patient Name Is Unknown</h3>
129<p>EDIS enables you to prepare for unknown patients who are arriving by ambulance or other types of emergency transportation. You can make room, provider, resident, and nurse assignments before these patients arrive.</p>
130
131
132<ol>
133<li>Select <b>Ambulance Is Arriving, Patient Name Is Unknown.</b> Keyboard: use the TAB key to locate the currently selected button <strong>(Search for Patient in VistA</strong> or <strong>Enter Name, Patient Is Not in VistA)</strong>. Use the DOWN ARROW key to locate the <strong>Ambulance Is Arriving, Patient Name Is Unknown</strong> button.</li>
134<li>Click <b>Continue.</b> The application displays the <b>Patient Information</b> pane.</li>
135</ol>
136<blockquote>
137 <p><img src="images/ambulance_arriving_selection.png" alt="Screen capture: Ambulance Is Arriving, Patient Name Is Unknown selection" width="400" height="443" border="1"><br />
138 The <strong>Add Patient</strong> dialog box with the <strong>Ambulance Is Arriving, Patient Name Is Unknown</strong> button selected. </p>
139</blockquote>
140<!--<p><u><i>Keyboard</i></u></p>
141<ol><li>From the <b>Add Patient</b> dialog box, press and hold the CTRL key and press the TAB key. Release the CTRL key. Repeat this step until you bring the application&#146;s focus to the <b>Ambulance is arriving, patient unknown</b> button.</li>
142<li>Press the SPACEBAR key to select this button.</li>
143<li>Press the TAB key to bring the application&#146;s focus to the <b>Continue</b> button.</b>
144<li>Press the SPACEBAR key to select the <b>Continue</b> button.</li></ol>-->
145<p>The <a href="IdentifyPatient.htm"><b>Identify Patient</b> </a>button, which is located on the <b>Patient Information</b> bar, allows you to identify patients who are in VistA after you&#146;ve added them as patients whose identities are unknown.</p>
146
147</blockquote>
148
149
150<h3>Related Topics</h3>
151<ul><li><a href="General.html">General Information</a></li>
152 <li><a href="Index.html">Index</a></li>
153 <li><a href="SignIn.html">Sign In View</a></li>
154<li><a href="TOC.html">Table of Contents</a></li>
155</ul>
156
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160
161</body>
162</html>
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