ADT Downtime Workflow

Admission and Bed Coordination Center

Labor and Delivery

In the event that MiChart goes down, clinic operations will continue. Front Desk staff will follow these
procedures to ensure a seamless clinical experience for our patients during downtime. You are to begin
the downtime process if MiChart is unavailable for 5 minutes or more.

SRO (Shadow Read Only) application is available if MiChart production is down.

1. Production MiChart goes Down – you will be kicked off the system if you haven’t already logged
off
2. Once Production is Down – Log back in
a. This is the SRO (Shadow Read Only) application
b. It is a snapshot of Production as of the time it was taken down
c. It is view only, and will not receive any updates

Downtime Workstations are an option to view census reports

1. Log in to the Downtime PC. The workstation will be identified with a sticker, identifying it as the
downtime computer.

2. To Access the Downtime Census Logs:

 START<Programs<MiChart<Downtime Printing
 Password (Case Sensitive) MiChart
3. Click – Select Reports

ADT House Census – Current House Census

ABCC OSH Transfers
UM_ADT Bed Planning Log – Expected Today
UM_ADT Bed Planning Log – Expected Tomorrow

Note: You may also view a report without printing it

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 Downtime Process

BCA – Business Continuity Planning: The term “business continuity” signifies that, even during
downtime and downtime recovery, an organization can provide consistent and uninterrupted patient
care.

Downtime MRNs

 Downtime MRNs will only be used when one of the following is true:
o 1) The user is unable to find the patient’s existing MRN in SRO or BCA PCs.
1. If, during recovery, we find that the patient did actually have an existing MRN,
we will merge the two together. For the majority of cases, we will keep the
original MRN as the active MRN, leaving the downtime MRN as historical.

o 2) The patient is completely new and is a walk-in during downtime.

 Due to the limitations of the above stated scenarios, we will use many less downtime MRNs than we
will downtime CSNs.

 Process
 MiChart ADT/Prelude will be the gate keeper of downtime MRNs
o Departments will contact MiChart ADT/Prelude when they need downtime
MRNs.
 ABCC will use Teletracking (PreAdmit Tracking) for bed availability and notification to
EVS of bed status (dirty, stat, clean).
 ABCC and L&D will print their Downtime MRN report, and file it in a place accessible for
staff.
 MiChart ADT/Prelude will create a spreadsheet to track the range that has been
distributed to each area.
 MiChart ADT/Prelude will be the gate keeper for reserving additional downtime MRNs.

 Downtime MRN Range

 Setting a specific numeric range would allow the MiChart user to easily recognize that a
patient was assigned a downtime MRN.

Downtime CSNs

 Downtime CSNs should be assigned to new encounters that are created or scheduled during
downtime. Examples include: walk-in encounters in outpatient areas, new ED arrivals and direct
admissions. Because CSNs are encounter-specific, we will use more of them in comparison to
downtime MRNs, which are patient-specific.
 Process
 MiChart ADT/Prelude will be the gate keeper of downtime CSNs
o Departments will contact MiChart ADT/Prelude when they need downtime
CSNs.
 ABCC is the gate keeper for all bedded patients; L&D is responsible for all L&D and
Newborn patients.

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  Emergency Department staff will be responsible for running their own reports of
existing downtime CSNs that MiChart ADT/Prelude reserves for the ED area and for
keeping paper documentation in synch with their assigned downtime CSNs.
 Outpatient areas will be responsible for their respective areas and for keeping paper
documentation in synch with their assigned downtime CSNs.
 MiChart ADT/Prelude will be the gate keeper for reserving additional downtime CSNs.

 Downtime CSN range

 Downtime CSNs can be defined at a more granular level than service area (UMHS, UHS,
and Joint Venture). Numeric ranges should be set for specific locations and/or
departments.

Downtime Operational Process – What happens while MiChart is Down

 L&D is responsible for their activity.

 Inpatient units will contact ABCC for the following activities:
Transfers/Discharges
 Patient name / MRN/CSN
 Transferring “from” and “to” locations
 Date
 Time
Expected admissions
o Inpatient units will contact ABCC when the patient arrives.
o ABCC and L&D track on paper forms, documenting:
 Patient name / MRN/CSN
 Unit location (Room / Bed)
 Admission Date
 Admission Time

Recovery Workflows –When the MiChart’s Production environment (PRD) becomes Available

 The system will be put into Downtime Recovery mode

 Log into MiChart- Downtime -
o Click on the Citrix Icon on the Tool Bar at the Bottom of your monitor

Select MiChart – Downtime

 Enter all of your downtime activity. Any additional activity that comes in during this
time period can be entered using the standard workflow.

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 o Use Dowtime Patient Station as needed to enter Downtime MRN/CSN.
 Once you have completed all of your downtime entry, contact the conference line as
provided in the e-mail notification regarding the downtime

 ABCC and L&D staff will reenter all of their downtime activity
o Discharges will be entered first.
o Transfers will be completed in chronological order.
o Admissions, L&D Assessments, Newborns
ED Admits – If Admit Step 1 &2 have not been completed.
Use Event Management to Insert update to update the Patient Class,
Service and Accommodation Code.
 ED arrivals will be re-entered by select ED staff.

DOWNTIME MRN:

1. Select Downtime Patient Station

2. Search for patient using Patient Lookup
3. If this is a new patient, the ID Generation pop up box will appear
A. Select “Enter a Downtime ID”
B. Enter the “Downtime MRN
4. Click Accept.

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New L&D Assessment or New Preadmission

1. Select New L&D Assessment or New Preadmission

2. Enter Downtime CSN in in Downtime CSN Entry pop up box.

3. Click Accept
4. Continue workflow as normal.

Triage Clerks (764-8134) will contact Brandon Clerk (763-4111) if or when there is a baby that will be
going to Brandon to give them the Downtime MRN and CSN.

Entering Downtime MRN & CSN for a Newborn baby

NOTE – Mother needs to be admitted first.

Follow the normal workflow for Delivery of baby.

1. Select the Downtime Add Button, if the baby was given a Downtime MRN and
CSN. If no numbers were assigned, follow the normal workflow and click the
Add button.
A. Select “Enter a Downtime ID”
B. Enter the Downtime MRN

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2. Click Accept

3. The Downtime CSN Entry Box appears

4. Enter the Downtime CSN
5. Click Accept

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 6. You will have to select the Mother to Copy existing registration from.

7. Click Next
8. Now you can either Pend the Baby or complete the Newborn Admission.

9/2013