Teaching Standard: Intraoperative EPIC Documentation Drafts & Final Manuscript
Following the completed review of the EPIC Op-Time Questions document, Kristi and I began drafting EPIC Charting Guidelines. During this drafting period Kristi also connected with the Nursing Practice Guidelines Committee to schedule an opportunity for us to present our document to the committee for review. As we began writing, Kristi and I authored organized documentation expectations for each of our own subsections. During this process we also continued to communicate and collaborate to review our references and to assure our document would be inclusive and concurrent with evidence based literature. This process yielded our first draft, a lengthy and meticulous document. We provided the stakeholders with the draft for review and it was during this review that we discovered that the document had taken on a new purpose. As a group, we found that the document had progressed past a Guideline and evolved into an innovative tool.
This initial draft was the most informative draft in this process, meaning it was revealing to the true scope and purpose of the document. It was during the initial review where the stakeholders acknowledged that this document was essentially going to be utilized as a training tool and/or reference guide for both OR staff and EPIC trainers, not for direct patient care practices. Supporting this, Kristi and I took the opportunity to review the algorithm for a UCH Guideline. During this review we became aware and concerned that our document would not fulfill the criteria required due to the lack of direct connection with the patient. However, we were confident that this document was an essential tool to support staff and to provide universal documentation practices for continuity of care. Therefore, I proactively contacted the Nursing Practice Guideline Committee to both update and reference their professional opinion of the document's transition. Collaborating with this committee provided us with reassurance of the document's transition, supporting that its purpose was not best fulfilled at a Guideline.
As a result, Kristi and I chose to pursue and continue drafting this document but with a new focus. We partnered with the stakeholders to establish that the the document would best serve by transitioning into a teaching standard tool. The documents below include EPIC Guideline Rough Draft #1 as well as the communication between the Nursing Practice Guidelines Committee, Kristi and myself.
This initial draft was the most informative draft in this process, meaning it was revealing to the true scope and purpose of the document. It was during the initial review where the stakeholders acknowledged that this document was essentially going to be utilized as a training tool and/or reference guide for both OR staff and EPIC trainers, not for direct patient care practices. Supporting this, Kristi and I took the opportunity to review the algorithm for a UCH Guideline. During this review we became aware and concerned that our document would not fulfill the criteria required due to the lack of direct connection with the patient. However, we were confident that this document was an essential tool to support staff and to provide universal documentation practices for continuity of care. Therefore, I proactively contacted the Nursing Practice Guideline Committee to both update and reference their professional opinion of the document's transition. Collaborating with this committee provided us with reassurance of the document's transition, supporting that its purpose was not best fulfilled at a Guideline.
As a result, Kristi and I chose to pursue and continue drafting this document but with a new focus. We partnered with the stakeholders to establish that the the document would best serve by transitioning into a teaching standard tool. The documents below include EPIC Guideline Rough Draft #1 as well as the communication between the Nursing Practice Guidelines Committee, Kristi and myself.
Please recognize that my subsections headers are highlighted in turquoise throughout the draft and Kristi's subsections are highlighted in yellow.
epic_charting_document_rough_draft_1.docx | |
File Size: | 583 kb |
File Type: | docx |
Drafting Continued...
Accepting this transition was an organic occurrence for the document as well as Kristi and myself. We utilized this transition to completely review both the formatting and criteria for the document as a teaching standard. We established that the purpose of this teaching standard as a training tool and/or reference guide required that the document be specific and summarized to make it efficient and user friendly. Therefore, we rationalized our information and collaborated to conform our content. The document below is the EPIC Guideline Draft #2, revealing a proficient work-in-progress document under the newly adapted teaching standard title.
Please recognize that my subsections headers are highlighted in turquoise throughout the draft and Kristi's subsections are highlighted in yellow.
epic_guideline_draft_2.docx | |
File Size: | 552 kb |
File Type: | docx |
Review of Draft #2 facilitated further development of the identity of the teaching standard tool. Analysis of this draft also assisted us in continuing to summarize content, provide rationale and to highlight essential documentation practices. At this point, under the guidance and expert opinions of the stakeholders, Kristi and I also elected to condense our formatting to make the focus even more exclusive. By condensing the formatting we were also able to condense the document as a whole, making it a well-organized tool. Also because of this change, we conceptualized future maintenance of the teaching standard through the developing additional tools. We identified that including a "Tips Sheet" with detailed Op-Time practices such as EPIC keystrokes and EPIC Downtime documentation procedures would both benefit and supplement this teaching standard well. For EPIC Guideline Draft #3, I assumed the responsibility to re-title the tool, recognize the stakeholders, author an introduction as well as identify the scope of the document. The document below reveals EPIC Teaching Standard Draft #3 and the significant alterations that were completed.
Please recognize that my subsections headers are highlighted in turquoise throughout the draft and Kristi's subsections are highlighted in yellow.
epic_teaching_standard_draft_3.docx | |
File Size: | 81 kb |
File Type: | docx |
Once the teaching standard took on identity in the new formatting, the final review of the document was minimalistic. Kristi and I continued to partner and review each other's content as well as standardized terminology throughout the document. We also collaborated with other healthcare professionals and EPIC personnel to implement recent system-wide EPIC upgrades into the teaching standard tool. During this review we collaborated and created a cover page as well as a Table of Contents to facilitate easier navigation and referencing of the document. At this time we also chose to include in-text citations to proactively supply rationale for documentation expectations and completed levels of evidence for all of our references.
With these additions, Kristi and I approved the draft as our final manuscript and distributed it to the stakeholders for review and authorization. The Teaching Standard: Intraoperative EPIC Documentation tool was disseminated to the stakeholders via Outlook with e-vote approval capabilities. The vote for approval was unanimous. The documents below address the final draft as EPIC Teaching Standard Final, references to the system-wide EPIC upgrades implementations as well as the e-vote communication for approval.
With these additions, Kristi and I approved the draft as our final manuscript and distributed it to the stakeholders for review and authorization. The Teaching Standard: Intraoperative EPIC Documentation tool was disseminated to the stakeholders via Outlook with e-vote approval capabilities. The vote for approval was unanimous. The documents below address the final draft as EPIC Teaching Standard Final, references to the system-wide EPIC upgrades implementations as well as the e-vote communication for approval.
Please recognize that my subsections headers are highlighted in turquoise throughout the draft and Kristi's subsections are highlighted in yellow.
epic_teaching_standard_final.docx | |
File Size: | 104 kb |
File Type: | docx |
epic_documentation_update.pdf | |
File Size: | 712 kb |
File Type: |
epic_documentation_standard_approval_communication.docx | |
File Size: | 24 kb |
File Type: | docx |
epic_teaching_standard_final_2.docx | |
File Size: | 122 kb |
File Type: | docx |
With unanimous approval, Kristi and I collaborated to organize the formal roll-out and education of the teaching standard tool the OR staff. As previously planned, Kristi and I elected to upload the document to the unit's education website as well as schedule agenda time to officially present the teaching standard tool in an upcoming staff meeting. During this presentation our objective will be to brief staff on the major alterations concerning each of our subsections. We plan to review a summarize PowerPoint presentation for visual learners, address questions and concerns for the auditory learners and provide consult time to support our kinesthetic learners. As this will be a progressive document and will require alterations with the continuing EPIC upgrades, Kristi and I will continue to remain encompassed and cognizant to review and maintenance of the tool.
The documents below address the most recent draft with updated count policy documentation standards, supporting how this teaching standard tool will continue to evolved. The PowerPoint presentation that will be presented by Kristi and myself for formal staff education is also below. Kristi and I collaborated to organize this presentation and created slides corresponding to the subsections we each authored.
The documents below address the most recent draft with updated count policy documentation standards, supporting how this teaching standard tool will continue to evolved. The PowerPoint presentation that will be presented by Kristi and myself for formal staff education is also below. Kristi and I collaborated to organize this presentation and created slides corresponding to the subsections we each authored.
The slides titles I created and will review during the formal presentation are highlighted in turquoise throughout the PowerPoint.
epic_teaching_standard_final_draft_complete__1_.docx | |
File Size: | 105 kb |
File Type: | docx |
teaching_standard_intraoperative_epic_documentation_pp.pptx | |
File Size: | 129 kb |
File Type: | pptx |