MGH Provider Order Entry (POE) has been modified for use in the Emergency Department (ED). When written on a patient who is on the EDIS treatment area board, the write function creates orders for use in the ED only. ED orders should not be used in transferring the patient to ED Observation or admitting the patient to an inpatient unit. Orders written in ED Observation, on the other hand, can be transferred with the patient to an inpatient unit.
Admission from the ED—Any order written on a patient who is selected from the EDIS treatment area board is flagged <ED order only> in its summary display, and "Attention clinicians: This order is for Emergency Department use only" in its detail (zoom) display. Orders flagged for use in the ED only should not be used outside the main emergency treatment areas. Clinicians in the ED should write pre-admission orders for patients who are going to either the ED Observation unit or and inpatient care unit. When the pre-admission orders are activated, AFTER the patient arrives in observation or on the inpatient unit, the orders written for use in the main ED are automatically inactivated. See Working with Pre-Admission Orders.
Arrival without admission orders—If a patient from the ED arrives in observation or on an inpatient unit with no pre-admission orders, providers writing new inpatient orders are prompted to inactivate all orders previously written in the main ED. Often, a single click completes the inactivation process. However, if the ED orders include an update to the patient's allergy record, this must be resigned by an MD, NP, PA, or CNM. These providers are notified of the ED allergy record, then prompted to sign.
The prompt to inactivate also appears when nurses or operations staff open the RN review and transcribe orders list for new inpatients with active ED orders. Because nurses, OAs, OCs, PCAs, and PCIAs cannot resign, if there is a record that requires this, they must wait until the admitting orders are written to continue reviewing or transcribing orders.
See also: