Clinical

Charting, order entry, decision support and care planning.

12 steps · 10 questions · 7 screens on this shelf

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The screens on this shelf

• Patients List
• Clinical Documentation A signed note is the legal record: it is never edited, only addended.
• Order Entry (CPOE) Orders run through decision support before they are written. A contraindication stops the order unless it is o
• Care Planning The plan, its goals and who is accountable. Goals carry a measure and a target.
• Order Sets Standing orders, so a chest-pain workup is one action rather than five.
• Decision Support Alerts Every alert that fired, and whether it was accepted or overridden. A high override rate says the alerts are be
• Clinical Quality Documentation completeness, decision-support override rate and laboratory quality.

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