Electronic Health Record Downtime Guidelines

o Scan the paper orders and MAR of medications administered during downtime to the pharmacy. o If area closes operations before electronic record becomes available: ▪ Use paper MAR to document all meds given during the downtime, scan to pharmacy. The concern is both continuity of care and the risk perspective (i.e., meds given with reaction and not being able to find this occurrence) as well as a billing issue. Tasks/Activities: o Complete tasks/activities that are generated after entering orders when the EHR becomes available. o Chart “NOT DONE” for tasks/activities completed during downtime and documented on paper. (Comment: Documented on paper during downtime).

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Emergency Services:

▪ General Information: Emergency Services only recovers patient information for patients remaining in those areas.

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Patient Care Documentation: o

Any patient transitioning to inpatient or observation: all documentation during downtime remains on paper. Patient care documentation will resume in the EHR when the EHR becomes available. RN to enter Absolute Information (see Appendix A) when EHR becomes available. *Depending on caregiver workload, the Lead/House supervisor will determine if additional resources are needed to recover Absolute Information. ▪ If patient is transferred during downtime, the receiving unit recovers Absolute Information when the EHR becomes available. Enter all orders written during downtime (exception: Medical Imaging and Lab. Orders will remain on downtime requisitions and entered by those departments as written). o Send the documents to HIMS for processing after they have been entered as written. ▪ Medication Orders and Administration: o Fax orders to Pharmacy if medications are not available in Pyxis. o Pharmacy to recover all faxed medication orders (note: nurse to contact pharmacy if patient is being discharged, nurse needs to be able to document meds in the EHR that were administered for timely d/c). ▪ Tasks (for remaining patients in the ED when the EHR becomes available). o Document on tasks that are generated after entering orders when the EHR becomes available. o Chart “NOT DONE” for tasks completed during downtime and documented on paper (comment: Documented on paper during downtime) ▪ Provider Orders: o ▪ RN to review all orders recovered into the EHR for patients remaining in the ED area.

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