1. Several calls came in asking how to write an ad hoc report against the Service Master (SM), and report on Common and Labeler Segment fields. Looking at a data file picture, the Labeler Segments is portrayed as a descendent of the Common Segment. Not so, as far as the Unimap is concerned. The two segments are actually "aside" each other. For this reason you will experience a disjoint access situation. The good news is, you usually can ad hoc the two segments together. It is a bit tricky, and you may not be able to sort the report on the field you desire. If the sort is the issue, you could always pull the file to disk and sort via a spreadsheet utility. The trick is ....’HOSP CD’ at the columns level and then ‘SERVICE MASTER AVAILABLE IND SEG HAS ALL’ for the remaining qualifiers. All the detail is then put in the ‘SUBCOLUMNS’. Here are two examples (thanks to ad hoc queen, Nancy Dodson, for her insight on this):

2. The MAR/IVAR From Automated Charting has a built-in feature to print a refreshed MAR/IVAR whenever the user:

• charts back into a permanent copy,
• charts against a discharged IP, or
• charts against an OP in a bed released from a bed.

CHPPOC21 figures out the beginning MAR/IVAR window and places the date in %OCBD. The pathway evaluates whether %OCBD is valued. If it is, the pathway moves the date into %OCMARBD and prints an MAR/IVAR. When modifying the MAR form default TCLs, remember to also changed T-OCPTMI01 called by this pathway to default the hospital’s MAR/IVAR documents.

3. Some keyboards to not have the ‘cent’ sign. This causes problems when trying to create a document name for printing out a profile (model forms to print profiles use the ‘cent’ sign in the first position). To get around this, make up a document with any name. On screen GEPROF02, in addition to specifying %RECORD, also specify %OUTPADD to be equal to the new document name. Using this technique will allow you to create a document name without using the ‘cent’ sign. Thanks to Pat Seidl for this suggestion.

4. You cannot shift a PRN order on INVISION. For the most part, there is no need to do so, since there are no occurrences that need shifting. However, if you are charting, you may wish to shift a PRN order to change the Order Start D/T. The scenario is: the physician writes an order at 10AM. The order is eventually taken off the chart, eventually picked up by the Rx, and eventually entered into the system. Now it’s 2PM. The pathway defaults %SYSTIME for the start time (2PM). Nursing, however, borrowed and administered the dose at 11AM and now needs to chart the dose for 11AM. They will not be able to do so because you cannot chart a dose with an admin time less than the start time. Since you cannot shift the order, you cannot chart it for 11AM. To get around this, set PRN order start time (C1214) default back by 4 hours (WHERE ALL OF C1220 IS VAL AND C1220 EQ ‘PRN’ AND %SYSTIME GT 0400 THEN C1214=%SYSTIME - 00240 ELSE WHERE ALL OF C1220 IS VAL AND C1220 EQ ‘PRN’ THEN C1213=%SYSDATE - 00001, C1214=%SYSTIME - 00240) and place in Enter Order and Renew pathways in the TCLs that default order start time.

5. To take advantage of CHPPO190’s feature to process nurse station-specific frequencies, you need

to use ‘NRS’ as the performing department in the Service Master. If you desire a nurse station specific frequency, you should enter the frequency exception in PRDFQ in the format, xxxxyyyyyyyy where ‘xxxx’ is the nurse station name and ‘yyyyyyyy’ is the frequency. CHPPO190 will evaluate C1487 (Ord Perf Dept) in the AUDA (unloaded from C2118, Sm Performing Dept). If C1487=NRS, then CHPPO190 will take the nurse station name from the AUDA, concatenate with the daily frequency (C1215) and use this as the key look-up in PRDFQ. If no entry is found, CHPPO190 will use the ‘ALL yyyyyyyy’ entry. If C1487 is valued to anything other than ‘NRS’, CHPPO190 will use that performing department concatenation with daily frequency to find a ‘department specific’ entry in PRDFQ, else, CHPPO190 will use the ‘ALL yyyyyyyyy’ entry.

Ideally, pharmacy should try to use the ‘ALL’ entries in PRDFQ, with ‘NRS’ downloaded as the performing department in C2118 in the SM. If you are absolutely sure you will never use nurse station specific frequencies, you do not necessarily need ‘NRS’ as the SM performing department. Remember, ‘NRS’ does not mean ‘Nursing’ for the performing department. It is a reserved literal for CHPPO190 to processes ‘NuRse Station ‘ specific frequencies.

One client downloaded ‘PHM’ as the performing department, thinking they would never use nurse station-specific frequencies. Later, they decided they wanted to use nurse station-specific frequencies. Instead of changing all 2,000+ services to use ‘NRS’ in C2118, they placed a TCL in the enter order pathway to switch C1487 from ‘PHM’ to ‘NRS’. While this faked the enter order pathway (i.e., CHPPO190) into processing nurse station specific frequencies, the later implementation of Shift Med/IV was thwarted. Apparently, Shift Med/IV looks back to the SM for the performing department in C2118 and does not go by what is in the AUDA (we tried setting C1487=NRS in the AUDA in Shift Med/IV, but it did not work).

Another client who downloaded ‘PHM’ for the performing department and later desired to use nurse station-specific frequencies, conditionally changed C1215 (Ord Freq Daily) to another frequency with times for the nurse station being processed. This technique will work, but only if the frequency exceptions are manageable.

6. To use bolding (or any special font) on pharmacy labels:

• Find the string command (i.e., Control Sequence) on your printer (see printer manual) for turning on and off the appropriate command (you can use bolding, larger font size, double strike, offset strike, underline, etc.).
• Go into PRPRT and assign a special character (one that will not be used in a normal Rx label); the same character will be used for turning the special font on and off.
• Enter your On Control Sequence and Off Control Sequence in PRPRT associated with the special character.
•  
• In Document Builder, under Image Revision, say ‘Y’ to the question, Do You Want A Use Special Printing For This Document and enter PRPRT as the profile to be used.
• Go into your document and place the special character before and after the field you wish to bold.
• The print subsystem will recognize the special character as it prints the form and will turn on the appropriate font on the printer. When it sees the special character the second time, it will turn off the font.

As you change printers, remember you may have to use a new Control Sequence appropriate for that printer.