00:00: This tutorial explains how to manage patient observation during the National
00:03: Jamboree. You will learn to admit patients, document care, and complete
00:08: the observation workflow effectively.
00:11: Observation allows patients to remain under clinical supervision while receiving
00:15: ongoing assessment and treatment.
00:17: During the National Jamboree, observation is intended for patients
00:21: expected to improve over a short period without hospital transfer.
00:26: Observation is initiated at the time of initial patient disposition, when a decision
00:30: to admit to observation is made.
00:33: Observation is only available at Jamboree Health Center,
00:36: Charlie Base Camp, Echo Base Camp, and Isolation Camp for public health concerns.
00:41: Observation should not be initiated by other clinics.
00:44: It is not a transfer function
00:49: In this example, we aregoing to admit to Jamboree Health Center. The
00:52: provider admitting to observation creates a bundled order at the time of admission.
00:56: We've
00:56: covered this in a previous workflow.
01:00: With vital signs, the drop-down allows you to select multiple checkboxes for oxygen
01:05: level and other vital signs to be recorded. Multiple medications ordered through the
01:09: bundled order set do NOT have interval dose notifications. Closed loop communication
01:14: is necessary for observation cases.
01:23: Ensure you are verifying the correct orders as you create a bundle set.
01:27: You can delete incorrect entries before saving the set.
01:30: Click the Rx Order button to access medication ordering options.
01:35: Recall that Rx orders are limited to medications within the formulary.
01:52: Click Add More button to include additional bundle orders.
01:56: Additional medications can be added before saving the set.
02:00: Add a note for the condition being treated.
02:05: Bundle orders can also be created for non rx items and processes.
02:11: Nurse or tech reassessment is one option.
02:15: Recall that non rx orders can be configured by the clinic in the admin portal.
02:29: Once your order set is saved, an order set appears for the patient.
02:33: Submit those
02:33: and the patient is now admitted to observation, with a status change on the
02:37: dashboard.
02:39: Bundle orders can be reviewed by opening the initial visit note in which the bundle
02:43: order set was created.
03:03: Use the kebab icon in the action column for the encounter.
03:06: The patient also needs to be moved to a room.
03:09: A provider needs to assign themselves to a patient.
03:13: Repeat vitals can be documented here.
03:20: Click View Visit Note 1 to review the prior encounter and to confirm the bundle
03:24: orders for the observation care.
03:27: You can also send the discharge summary from the previous visit to the patient or
03:31: patient contacts, similar to other workflows.
03:39: Click here to access additional options.
03:42: I'm going to pick up the patient as the primary provider and assign them to a room.
03:47: This is the same workflow as other clinic visits.
03:51: Enter vitals.
04:01: At least one vital sign must be entered.
04:04: The system does not validate the bundle
04:06: order set in the current version.
04:09: Once vital signs are entered,
04:11: you will save the entry
04:13: and the vital signs will record
04:16: for viewing within the patient encounter.
04:18: Click the Save button to record the entered vital signs.
04:22: And after a successful observation intake, we can continue documenting our care.
04:27: Click Enter History of Present Illness here to add patient history details.
04:32: Providers should enter a brief updated SOAP note
04:35: if seeing the patient for the first time. If you've seen the patient and are picking
04:39: up their care in a shift transition, you can see previously saved SOAP
04:43: documentation and the interval note history. An ICD-10 code needs to be entered for
04:48: the observation encounter.
04:50: Click file interval note to continue documenting care.
04:54: Interval notes can be brief and should describe key events in the observation
04:57: encounter.
04:58: Additional orders can be entered on the fly by saving the note as draft or filing an
05:03: interval note.
05:04: You can continue adding orders in this fashion
05:06: in addition to the bundle orders already available for the patient.
05:10: When you file an interval note, it soft closes the encounter.
05:13: Click orders to see the bundled order set and any additional orders.
05:18: Order verification is the same
05:20: as in previous workflows. See the order verification video for additional details.
05:26: If a nurse or tech is doing a periodic assessment, it can be documented here as with
05:30: any other order notes
05:33: These notes can be brief.
05:36: Once the patient's visit is ready to be completed, you can proceed to discharge.
05:41: Discharge the patient according to the correct disposition.
05:46: Add discharge instructions as indicated.
05:50: You must attest to your care to complete the encounter.
05:53: You can send additional discharge information to contacts.
05:57: After clicking discharge, the patient is discharged successfully,
06:01: the visit is signed, and they are removed from the room and the provider's list.
06:07: Observation should typically be reserved for conditions anticipated to improve within
06:11: a few hours. Please
06:12: refer to the clinical guide available on the staff website for guidance and
06:16: information on suitable conditions. Patients should be transferred offsite if they are
06:21: not showing improvement or require additional diagnostic testing.
06:25: This tutorial guided you through admitting a patient to observation at the Jamboree
06:29: Health Center, managing vital signs, medication orders, reassessments, and completing
06:34: the discharge process. Appropriate
06:36: observation helps avoid unnecessary hospital transfers while maintaining patient
06:41: safety.
