E-Sign off Its importance and how to do it Created by Dr. Ruth Spearing for new RMOs joining the...
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Transcript of E-Sign off Its importance and how to do it Created by Dr. Ruth Spearing for new RMOs joining the...
![Page 1: E-Sign off Its importance and how to do it Created by Dr. Ruth Spearing for new RMOs joining the organisation.](https://reader036.fdocuments.net/reader036/viewer/2022062722/56649f385503460f94c544d2/html5/thumbnails/1.jpg)
E-Sign off
Its importance and how to do it
Created by
Dr. Ruth Spearing for new RMOs joining the organisation
![Page 2: E-Sign off Its importance and how to do it Created by Dr. Ruth Spearing for new RMOs joining the organisation.](https://reader036.fdocuments.net/reader036/viewer/2022062722/56649f385503460f94c544d2/html5/thumbnails/2.jpg)
BackgroundBackground
• Previously paper results Previously paper results
• Often late results e.g. swab/blood Often late results e.g. swab/blood cultures/sensitivities came back after patient cultures/sensitivities came back after patient has left hospitalhas left hospital
• Difficult for the significance of results to be Difficult for the significance of results to be recognised without knowledge of the patientrecognised without knowledge of the patient
• Meant that both the patient and the doctor was Meant that both the patient and the doctor was at riskat risk
![Page 3: E-Sign off Its importance and how to do it Created by Dr. Ruth Spearing for new RMOs joining the organisation.](https://reader036.fdocuments.net/reader036/viewer/2022062722/56649f385503460f94c544d2/html5/thumbnails/3.jpg)
HistoryHistory• 2008 – group lead by clinicians requested all
results become electronic and that paper results be phased out
• Wide consultation/ working group of RMOs/SMOs/Admin colleagues
• Came into place March 2009
• Widely accepted as a major step forward
• HOWEVER – recently recognised lack of teaching of how to sign off and the expectations upon team members
![Page 4: E-Sign off Its importance and how to do it Created by Dr. Ruth Spearing for new RMOs joining the organisation.](https://reader036.fdocuments.net/reader036/viewer/2022062722/56649f385503460f94c544d2/html5/thumbnails/4.jpg)
How to do E-sign off
• Each day accept all results you are happy with and have actioned
• On joining a run it is essential that you know what the run wants you to sign off
• Should be clear in the induction information for the run - if not please feedback to us
![Page 5: E-Sign off Its importance and how to do it Created by Dr. Ruth Spearing for new RMOs joining the organisation.](https://reader036.fdocuments.net/reader036/viewer/2022062722/56649f385503460f94c544d2/html5/thumbnails/5.jpg)
Check what your team wants
• Most other teams want you to sign anything you feel comfortable with and to refer on the rest
• Surgeons generally don’t want histology signed
• Nephrology don’t want anything signed by RMOs!
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Standard view of Concerto with unsigned results
![Page 7: E-Sign off Its importance and how to do it Created by Dr. Ruth Spearing for new RMOs joining the organisation.](https://reader036.fdocuments.net/reader036/viewer/2022062722/56649f385503460f94c544d2/html5/thumbnails/7.jpg)
Cumulative reports allow comparison to previous results
![Page 8: E-Sign off Its importance and how to do it Created by Dr. Ruth Spearing for new RMOs joining the organisation.](https://reader036.fdocuments.net/reader036/viewer/2022062722/56649f385503460f94c544d2/html5/thumbnails/8.jpg)
Click button to accept
![Page 9: E-Sign off Its importance and how to do it Created by Dr. Ruth Spearing for new RMOs joining the organisation.](https://reader036.fdocuments.net/reader036/viewer/2022062722/56649f385503460f94c544d2/html5/thumbnails/9.jpg)
You can always “Unaccept”
![Page 10: E-Sign off Its importance and how to do it Created by Dr. Ruth Spearing for new RMOs joining the organisation.](https://reader036.fdocuments.net/reader036/viewer/2022062722/56649f385503460f94c544d2/html5/thumbnails/10.jpg)
If unsure of significance, “Refer”
![Page 11: E-Sign off Its importance and how to do it Created by Dr. Ruth Spearing for new RMOs joining the organisation.](https://reader036.fdocuments.net/reader036/viewer/2022062722/56649f385503460f94c544d2/html5/thumbnails/11.jpg)
To ensure your older results are all checked you need “Clinician
Enquiry”
• Important because e.g. sensitivities may change, blood cultures may become positive
Some tests just take several days/weeks to come through
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Clinician Enquiry button is down the side
![Page 13: E-Sign off Its importance and how to do it Created by Dr. Ruth Spearing for new RMOs joining the organisation.](https://reader036.fdocuments.net/reader036/viewer/2022062722/56649f385503460f94c544d2/html5/thumbnails/13.jpg)
At the beginning of each run set up your “Clinician Enquiry”
Set up for the team or specific consultant
Possibly also to have different saved searches for time periods – e.g. <24 hrs and >24 hrs
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![Page 15: E-Sign off Its importance and how to do it Created by Dr. Ruth Spearing for new RMOs joining the organisation.](https://reader036.fdocuments.net/reader036/viewer/2022062722/56649f385503460f94c544d2/html5/thumbnails/15.jpg)
Creating a pre-defined search
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Enter Inpatient or Outpatient etc
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Once set up, easy to search
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Changing your routine screen to “cumulative” by clicking on Preferences on the Eclair page and then clicking on cumulative and then save.
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![Page 20: E-Sign off Its importance and how to do it Created by Dr. Ruth Spearing for new RMOs joining the organisation.](https://reader036.fdocuments.net/reader036/viewer/2022062722/56649f385503460f94c544d2/html5/thumbnails/20.jpg)
Remember all results can be audited
• You must never look at results of patients whose care you are not involved with.
• You can lose your employment and your medical registration if you do.
• Make sure that you log out each and every time you walk away from the computer.
• It is easy to check who has previously looked at the results as shown on the next slide….
![Page 21: E-Sign off Its importance and how to do it Created by Dr. Ruth Spearing for new RMOs joining the organisation.](https://reader036.fdocuments.net/reader036/viewer/2022062722/56649f385503460f94c544d2/html5/thumbnails/21.jpg)
….click on “Observation Details” and …..
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..then “Audit”. This will show who else has viewed the results.
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Graph form can be valuable - click “Graph Report”
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Final points• Number of unsigned off results fed back to
the CDs regularly.• Results from ED follow the patient when
admitted- other results don’t.• Hope to get electronic ordering of lab and
radiology and e-sign off for radiology in the not too distant future.
• Still concerns we aren’t doing e-sign off well enough as yet for e-ordering to be brought in.
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Good Luck- Enjoy your time here
• An 8 minute video on Electronic Sign Off can be accessed from the CDHB Intranet:
http://intraweb/custsup/eso/documents/WinkFile/eclair%20final.htm
• If you have concerns about e-sign off or anything – ask your other team members, CD or feel free to contact me at: