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patient history cards


BB.rick

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I am a new supervisor and have come here many times in the past for insight into problems.  I am still learning the best ways to see if and how changes can be made.  I work in a BB that had the same supervisor for over 30 years, so not much has changed.  Things are done a certain way "because that's always how it was done."  I have been slowly making changes to remove unnecessary and redundant work.

We currently use patient history cards for documenting antibody workups and transfusions for patients with antibodies, but we also have Meditech.  I have worked in places before with these cards, but just as a source for history they were never actively being updated.  Since we have everything in Meditech can we just stop updating the cards and creating new ones, and only use them as a source of patient history?  Is the only barrier to stopping use of them that you have an electronic record?

Thanks.

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BB.rick, I would have no problem retiring the card system in your case provided that you are regularly (daily) downloading a copy of the records to a secure, accessible file for downtime. Also, make sure all staff know how to access that data for prolonged downtime. There is no reason to have a card system with Meditech.

BTW, my previous position was in a place where the manager refused to stop using the card system. It was mainly because they were not familiar with how to access the information during Meditech downtime. Even when shown how, they still refused. It is still in use today at that site. Some battles you can't win.

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I agree with jayinsat. Explain to your people that all the info can be accessed in Medistat and make sure every tech can show you how to access the info during downtimes. Pump it up that they will no longer have to complete the cards and how much better the whole process will be. It is hard to change when you have done things the same way for years and the  techs who have been doing this process the longest, will have the most problem. It will take them a bit of time to realize the BB world will not crumble around them to not fill out these cards. They will come around and be more accepting of new changes you will make in the future. Just don't do too many things too fast at first.

We had file cabinets full of years of old cards back in the day. I am trying to remember but I think my old boss had us go thru the cards when it was slow and discard all the cards that had not been updated in 5 years to decrease the number. When that was completed she basically packed them up and sent them to storage for a period of time. They were still there but not easily accessible. We were not too sad because we pretty much hated the cards.

 

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Thank you jayinsat and DebbieL for the input!  That is what I thought, but just wanted to make sure.  We do have a backup computer that updates constantly as well.  

Luckily the techs are all wanting to make these changes too so it is easy to get them onboard.  The hardest part is making sure I do everything appropriately.  It was easy when I was a senior tech to come up with ideas on how to improve, but the execution wasn't up to me.  

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I agree with the consensus. I would however check each and every card against Meditech to ensure nothing extra is on the card, once checked (updated) make a note in Meditech and discard the card. Also keep the unused cards as they are fantastic for use during down time events and can be discarded once Meditech is updated. 

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On 5/29/2021 at 7:53 AM, Cliff said:

Does Meditech have a back up system?  We use HCLL and it writes to a downtime tool that we can use in the event of a complete network crash.  We have a local log in to that PC, not network access needed.

Yes, Meditech has a back up system that we have on a computer that is used for that sole purpose.

 

And it is also on emergency power supplies.

Edited by BB.rick
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And what are you going to do if your entire HIS/LIS/BBLIS network is down? - think hackers and ransom. You may not be able to access any of your computers/records until each and every one of them has been checked and cleared by your IT folks, individually...which is going to take time, especially if your facility is large. Unless you have something that is not connected to the network, but is backed up regularly, you are going to have to have some alternative. We are working on getting a laptop set up that is off the network but backed up periodically to supplement our 'normal' downtime records. Until that is in place we are printing a patient history from SafeTrace for every patient with antibodies, special needs, testing issues, etc. and putting them in a notebook alphabetically. Learned this the hard way.

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In terms of hacking- we have two offline PCs, one here and one at our sister hospital, that contain backups of BB data for both hospitals (dont know how often we back it up though). we were hit by ransomware last June (downtime for a week in the middle of COVID, yay)and then found out IT had connected one of those two "offlines" to the network, and it was gone.

We still had one lonely functioning PC, tho, with the entire systems' BB data, adn it got us through what was otherwise a very, very dicey time.  

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  • 1 month later...

The suggestion I got was to make it a routine maintenance task. Connect your backup computer once a week to the network and load the backup file. I talked with our IT people and they said they could set that up so it was a matter of accessing a file on a server and downloading it. The hows and whys are all magic to me, but the IT analyst I talked to wasn't at all concerned about any difficulty doing it. Then, of course, the computer has to be totally disconnected from the network or you risk exposure to bugs and hackers. WiFi shut off and/or cable disconnected.

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OK i dont really understand this, but i asked for more specifics - and our backup computers are evidently attached to the network but in a weird limited fashion where they get a solitary incoming dump every four hours, of BB data, but otherwise do not receive network activity, and have no "outgoing" channel. when we were hacked, one was due for a dump and got hacked, the other was instantly quarantined off-line and so had almost all (except the last few hours worth) of BB data.

also was just told it is also now stashed in some quarantined part of the cloud?  this is waaaay over my head in terms of IT though. sorry i cant explain it any better :-(

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