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<div> <p style="font-size:12pt; line-height:115%; margin:0pt 0pt 10pt"> <span style="color:#ff0000; font-family:Calibri; font-size:12pt; font-weight:bold">Procedure Pass-Patient not fit for surgery.</span> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <span style="font-family:Calibri; font-size:11pt">In current state, anesthesiologist opens “Anesthesiologist Preoperative Orders”</span> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <img src="/plugins/servlet/benryanconversion?pageId=37716110&amp;attachment=PAU-Procedure+Pass-Fit+for+Surgery.doc&amp;name=37879857&amp;val=/image-1.jpeg" width="470" height="261" alt="" style="border:none"/> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <span style="font-family:Calibri; font-size:11pt"> </span> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <span style="font-family:Calibri; font-size:11pt">Hard stop at “Fit for surgery”.   In this example, we are saying that the patient is NOT fit for surgery.</span> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <img src="/plugins/servlet/benryanconversion?pageId=37716110&amp;attachment=PAU-Procedure+Pass-Fit+for+Surgery.doc&amp;name=37879857&amp;val=/image-2.jpeg" width="464" height="274" alt="" style="border:none"/> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <span style="font-family:Calibri; font-size:11pt"> </span> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <span style="font-family:Calibri; font-size:11pt"> </span> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <span style="font-family:Calibri; font-size:11pt"> </span> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <span style="font-family:Calibri; font-size:11pt"> </span> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <span style="font-family:Calibri; font-size:11pt">This order does not talk to anything in the system.  In current state, the RN must retrieve this order to see if the patient is truly fit for surgery.</span> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <img src="/plugins/servlet/benryanconversion?pageId=37716110&amp;attachment=PAU-Procedure+Pass-Fit+for+Surgery.doc&amp;name=37879857&amp;val=/image-3.jpeg" width="273" height="325" alt="" style="border:none"/> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <br/> <img src="/plugins/servlet/benryanconversion?pageId=37716110&amp;attachment=PAU-Procedure+Pass-Fit+for+Surgery.doc&amp;name=37879857&amp;val=/image-4.jpeg" width="273" height="431" alt="" style="border:none"/> <br/> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <span style="font-family:Calibri; font-size:11pt"> </span> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <span style="font-family:Calibri; font-size:11pt">The “</span> <span style="font-family:Calibri; font-size:11pt; font-weight:bold">order review</span> <span style="font-family:Calibri; font-size:11pt">” shows up as blank until you tell the system what you want. In this case I told the system to look back 72 hours.</span> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <span style="font-family:Calibri; font-size:11pt"> </span> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <span style="font-family:Calibri; font-size:11pt"> </span> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <span style="font-family:Calibri; font-size:11pt"> </span> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <span style="font-family:Calibri; font-size:11pt"> </span> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <span style="font-family:Calibri; font-size:11pt"> </span> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <span style="font-family:Calibri; font-size:11pt"> </span> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <span style="font-family:Calibri; font-size:11pt"> </span> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <span style="font-family:Calibri; font-size:11pt"> </span> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <span style="font-family:Calibri; font-size:11pt"> </span> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <span style="font-family:Calibri; font-size:11pt"> </span> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <span style="font-family:Calibri; font-size:11pt"> </span> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <span style="font-family:Calibri; font-size:11pt">It finds my ACTIVE order.  Notice how the order says “Patient fit for surgery” because this is the name of the order. Now the RN must query the order under “Order Report”</span> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <img src="/plugins/servlet/benryanconversion?pageId=37716110&amp;attachment=PAU-Procedure+Pass-Fit+for+Surgery.doc&amp;name=37879857&amp;val=/image-5.jpeg" width="625" height="284" alt="" style="border:none"/> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <span style="font-family:Calibri; font-size:11pt">Now you can see the comment that was written.  Under, “Order Questions”, you see the question, “Patient fit for surgery” and the answer, “NO”</span> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <img src="/plugins/servlet/benryanconversion?pageId=37716110&amp;attachment=PAU-Procedure+Pass-Fit+for+Surgery.doc&amp;name=37879857&amp;val=/image-6.jpeg" width="625" height="370" alt="" style="border:none"/> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <span style="font-family:Calibri; font-size:11pt"> </span> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <span style="font-family:Calibri; font-size:11pt">The way the process is intended to flow is as follows:</span> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <span style="font-family:Calibri; font-size:11pt">Under “</span> <span style="font-family:Calibri; font-size:11pt; font-weight:bold">Procedure Info</span> <span style="font-family:Calibri; font-size:11pt">”, the MD must navigate down to the “</span> <span style="font-family:Calibri; font-size:11pt; font-weight:bold">Upcoming Procedure</span> <span style="font-family:Calibri; font-size:11pt">” and click on the link “</span> <span style="font-family:Calibri; font-size:11pt; font-weight:bold">Do Not Proceed</span> <span style="font-family:Calibri; font-size:11pt">”.</span> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <img src="/plugins/servlet/benryanconversion?pageId=37716110&amp;attachment=PAU-Procedure+Pass-Fit+for+Surgery.doc&amp;name=37879857&amp;val=/image-7.jpeg" width="422" height="333" alt="" style="border:none"/> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <span style="font-family:Calibri; font-size:11pt">It is quite clear at this point and the comment box needs to be populated.</span> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <img src="/plugins/servlet/benryanconversion?pageId=37716110&amp;attachment=PAU-Procedure+Pass-Fit+for+Surgery.doc&amp;name=37879857&amp;val=/image-8.jpeg" width="624" height="224" alt="" style="border:none"/> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <span style="font-family:Calibri; font-size:11pt"> </span> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <span style="font-family:Calibri; font-size:11pt"> </span> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <span style="font-family:Calibri; font-size:11pt"> </span> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <span style="font-family:Calibri; font-size:11pt"> </span> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <span style="font-family:Calibri; font-size:11pt">Notice how it is quite clear under “</span> <span style="font-family:Calibri; font-size:11pt; font-weight:bold">Tasks</span> <span style="font-family:Calibri; font-size:11pt">” that the procedure should not proceed.</span> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <img src="/plugins/servlet/benryanconversion?pageId=37716110&amp;attachment=PAU-Procedure+Pass-Fit+for+Surgery.doc&amp;name=37879857&amp;val=/image-9.jpeg" width="346" height="234" alt="" style="border:none"/> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <span style="font-family:Calibri; font-size:11pt">The next step would be to open “Procedure Pass”.</span> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <img src="/plugins/servlet/benryanconversion?pageId=37716110&amp;attachment=PAU-Procedure+Pass-Fit+for+Surgery.doc&amp;name=37879857&amp;val=/image-10.jpeg" width="310" height="232" alt="" style="border:none"/> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <span style="font-family:Calibri; font-size:11pt">The comment is there, and you select the “Do Not Proceed” box.</span> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <img src="/plugins/servlet/benryanconversion?pageId=37716110&amp;attachment=PAU-Procedure+Pass-Fit+for+Surgery.doc&amp;name=37879857&amp;val=/image-11.jpeg" width="332" height="230" alt="" style="border:none"/> </p> <p style="font-size:11pt; line-height:115%; margin:0pt 0pt 10pt"> <span style="color:#ff0000; font-family:Calibri; font-size:11pt">As per the paper world, clear communication with the patient and the surgeon is required.</span> </p> </div>
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