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CareConnect develops clinical content

Ancillary caregivers help vet physician order sets

Physical therapists, lab technicians, pharmacists, and other clinicians are vetting order sets – menus of optional and default orders – that have been created to work with their departmental workflows in CareConnect.

Orders are instructions given by physicians to their staff members related to patient care – for example, laboratory tests to be conducted, medications to be prescribed, or the diet a patient should be on.

Ancillary staff members began attending CareConnect Clinical Content Coordinator – Ancillary Vetting Meetings in December to give their feedback on an estimated 200 order sets that are being developed to correspond to UCLA workflows by CareConnect’s clinical content team, physician clinical content coordinators, and UCLA physicians.

“We needed feedback from the folks we give orders to so we can make sure we are communicating in the same way,” said Hawkin Woo, MD, a CareConnect clinical content coordinator. “I think CareConnect will really help us with this effort because it makes sure every nurse, doctor, pharmacist, and physical therapist speaks the same language. It will help us provide the best care to our patients.”

At a Jan. 11 meeting, the group reviewed six order sets – including those created for congestive heart failure, adult pneumonia, adult cellulitis, and colonoscopy.

“Out of those sessions we’ve been able to develop certain smart groups – and standardize orders for laboratory and pain management, for example,” said CareConnect Clinical Content Analyst Michelle Gebhardt. “It will enhance patient care while eliminating duplications and reducing the possibility of mistakes.”

Last fall, a group of clinical content coordinators – made up of eight UCLA physicians – began meeting with physicians from different departments to build the order sets and medical note templates in CareConnect.

“It has been a tough process. We were working to help the doctors decide what they want to see on the screen, in what order, and in which format. We’re integrating best practices where possible and the expert opinions of the many specialists we have at UCLA. We are trying to be as inclusive as we can so all the best ideas are included,” Woo said.

Vetting sessions for ancillary staff began in December. They will be held twice a month initially and increase in frequency as needed.

Gebhardt said it took quite a while for the ancillary group to get through order sets at its first meeting in December – taking more than an hour to get through the first order set.

“There is a balance you have to achieve. You can do some standardization – every group needs to order complete blood count and electrolytes, but we have to respect there are some departments that have specialized requirements that we can’t take away,” Gebhardt said. “The process of standardizing is not to take away but to take what we have built and add on to it in order to meet their needs.”

Lori Martinelli, clinical educator for the UCLA Health System’s respiratory therapy department, has been active in validation sessions and work groups – and now is helping to determine what will need to be in individual order sets.

“I’m actually very impressed with the process and the progress we’ve made,” Martinelli said. “Whatever we talked about in the previous meeting has been changed or fixed by the next time we meet.”

Respiratory therapy staff members currently chart in Essentris Critical Care, and Martinelli said CareConnect will streamline processes by giving them an opportunity to look at the workflows in real time.

Five main order sets were created for the department – including those for airway clearance, oxygen therapy, and lung expansion. Additional subsets were created from there.

“I’m really excited about CareConnect, and I’m proud of the work we’ve been doing as an enterprise. I think it really shows our commitment to patient care and how well we are working together to make this a great end product,” Martinelli said.

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The order set developed for adult pneumonia admission is
vetted at a CareConnect Clinical Content Coordinator -
Ancillary Vetting Meeting.

CareConnect's clinical content team, physician clinical content
coordinators, and UCLA physicians meet with ancillary staff
members to review more than 200 order sets that are being
developed for CareConnect.

CareConnect Clinical Content Coordinator Hawkin Woo, MD,
(left) and Eric Cheng, MD, (center) look on as details of an
order set are discussed.
Thomas Drake, MD, associate director of clinical laboratory,
reviews a lab order set.