A new conditional order, Outpatient in a Bed (OPIB), is available for same day surgery patients transferred to an inpatient unit for off hours discharge. This new order is intended for use in scenarios such as: the PACU department is closing and the patient cannot be kept for the full recovery period (discharges after 1900 Monday-Friday and all weekend discharges).
The PostOp RN will place the Outpatient in a Bed order with the communication type of Conditional and enter the surgeon’s name. Orders with the communication type of Conditional will not route to providers for signature. This order is specifically used to track patient movement within the organization to assist with patient flow and bed availability.
Additional Details:
- This order will be pre-selected and placed in all day surgery powerplans.
- This is not a practice change related to patient placement. In current state, PACU only provides Phase I recovery during off hours (after 1900 Monday-Friday and weekends). During off hours, patients will continue to be moved to the floor for Phase II recovery and discharge from an available med/surg bed.
- Recovering and discharging on the floor during off hours is not the same as an admission. Patients should still be discharged when they meet discharge criteria. Whether they recover in PeriOp during daytime hours or go to an inpatient unit during off hours, the timeframe for recovery and discharge should remain the same.
- The OPIB order is needed to track patient movement within Cerner. The patient accurate location allows nursing staff to obtain medications for patient through Pyxis, etc. In addition, accurate location ensures correct charges are billed.
For example, a patient sent to LSU needs to be placed in location/bed on that specific unit. This activates the patient in the unit Pyxis and allows nursing staff to obtain medications for patient, etc. - Giving RNs the ability to place a conditional OPIB order prevents patient flow delays and unnecessary phone calls to surgeons for patients who are discharged after hours.
- Day surgery and OPIB are both outpatient statuses. Families that are moved to a patient care unit for recovery/discharge will be billed as outpatients based on the Patient Status Order of OPIB. The OPIB order ensures billing to the family is not impacted by the patient being discharged from an inpatient care unit vs. being discharged from PeriOp.
Effective May 14, 2024