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comment_90226

Does any of the hospitals accept or use "Keep Ahead" Orders?

My new medical director is trying to deactivate the "keep ahead" section on the prepare order because any physician can always place an order in EPIC. Most of the time our physicians do not know what "keep ahead" means, if a physician sees "keep ahead" section, the order gets placed.  So, my C:T value has been high. 

Is it worth it to keep the "keep ahead" feature in EPIC?

 

Please share your wisdoms. Thank you!

 

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  • We do the same.  We have a few docs who still think we need to crossmatch units ahead, but we educate them at the time of order.  We keep it mostly for those times when a patient with special needs is

  • When we were performing electronic crossmatches and had Cerner there was an 'additional units' field built into the product request order. The provider was free to write whatever they wanted in that b

  • Kelly Guenthner
    Kelly Guenthner

    We allow keep ahead orders, but we do electronic crossmatch, upon issue.  So a keep ahead order, for us, is just a peek at what's on the shelf and adjusting stock, as necessary.  Additionally, hardly

comment_90238

We allow keep ahead orders, but we do electronic crossmatch, upon issue.  So a keep ahead order, for us, is just a peek at what's on the shelf and adjusting stock, as necessary.  Additionally, hardly any of our providers use keep ahead (mostly just active cardiothoracic surgeries).

comment_90240

We DO NOT allow "keep ahead" orders...........

IMHO - Keep ahead orders are............:shakefist:

comment_90247
20 hours ago, Kelly Guenthner said:

We allow keep ahead orders, but we do electronic crossmatch, upon issue.  So a keep ahead order, for us, is just a peek at what's on the shelf and adjusting stock, as necessary.

We do the same.  We have a few docs who still think we need to crossmatch units ahead, but we educate them at the time of order.  We keep it mostly for those times when a patient with special needs is scheduled for a procedure.

comment_90260

I'm trying to get rid of this practice as well (ours is called "keep on hand").  I think it is completely unnecessary.  If there is no antibody = electronic crossmatch and blood is ready immediately.  If the sample is more complicated, we already make sure we have blood crossmatched so there is no delay.  Slowly but surely....

comment_90267

We used to have a "Keep Blood on Hand" (i.e. Keep Ahead) with our old computer system, but we discontinued that when we moved to Epic.  I think it was a hold-over from "way back when" before electronic crossmatching.  It was time for it to go!

comment_90272

This is just one more example of how inertia is the most power force in the universe and how difficult it is to battle the "that's how we've always done it" mentality..

:coffeecup:

comment_90308

Same as sgoertzen - we got rid of keep ahead when we moved to Epic. I didn't even know there was a keep ahead function available in Epic! The blood bank may keep ahead by doing crossmatches on downtime for difficult crossmatches, but that's it. 

comment_90315

When we were performing electronic crossmatches and had Cerner there was an 'additional units' field built into the product request order. The provider was free to write whatever they wanted in that box but we were never going to look at it.

The nurses would sometimes come down with 'doc wants to make sure we have additional units available', if I was feeling particularly sassy I'd get up, walk over to the fridge, pull out a shelf, make a big production of looking at the units, and say 'yep.'

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