Re: ADVANCE AS TOLERATED DIET ORDERS - JACHO QUESTION

[Guest guest]

How we have handled this is we have created a protocol in which if the MD

orders a DAT he/she must note an end place diet for example: Advance diet as

tolerated to regular diet. It is addressed on the protocol that 1st meal is

clear liqs, if tolerated 2cd meal is full liqs, if tolerated 3rd meal is solid

diet. If they are on a special diet and the MD ordered regular we must leave

the MD a note requesting the special diet, including if a texture change is

needed. All of the routine orders are written in this way with the diet as a

blank so MD can order a specific diet. This helps with MD compliance. JACHO

seemed satisfied with this at last visit.

ADVANCE AS TOLERATED DIET ORDERS - JACHO QUESTION

I received the following question from the EPIC team. Any information that will

help answer their question would be very much appreciated.

" Do you know of any Joint Commission standards that address Advance as Tolerated

diets? We'll need to figure out how to handle the Advance as Tolerated diets as

we go forward with the EMR and Epic orders. "

Thanks.

Ann Marie Dawson, MS, RD, CDE

Monroe Clinic Hospital

Monroe, WI 53566

Tel:

[Guest guest]

How we have handled this is we have created a protocol in which if the MD

orders a DAT he/she must note an end place diet for example: Advance diet as

tolerated to regular diet. It is addressed on the protocol that 1st meal is

clear liqs, if tolerated 2cd meal is full liqs, if tolerated 3rd meal is solid

diet. If they are on a special diet and the MD ordered regular we must leave

the MD a note requesting the special diet, including if a texture change is

needed. All of the routine orders are written in this way with the diet as a

blank so MD can order a specific diet. This helps with MD compliance. JACHO

seemed satisfied with this at last visit.

ADVANCE AS TOLERATED DIET ORDERS - JACHO QUESTION

I received the following question from the EPIC team. Any information that will

help answer their question would be very much appreciated.

" Do you know of any Joint Commission standards that address Advance as Tolerated

diets? We'll need to figure out how to handle the Advance as Tolerated diets as

we go forward with the EMR and Epic orders. "

Thanks.

Ann Marie Dawson, MS, RD, CDE

Monroe Clinic Hospital

Monroe, WI 53566

Tel:

[Guest guest]

How we have handled this is we have created a protocol in which if the MD

orders a DAT he/she must note an end place diet for example: Advance diet as

tolerated to regular diet. It is addressed on the protocol that 1st meal is

clear liqs, if tolerated 2cd meal is full liqs, if tolerated 3rd meal is solid

diet. If they are on a special diet and the MD ordered regular we must leave

the MD a note requesting the special diet, including if a texture change is

needed. All of the routine orders are written in this way with the diet as a

blank so MD can order a specific diet. This helps with MD compliance. JACHO

seemed satisfied with this at last visit.

ADVANCE AS TOLERATED DIET ORDERS - JACHO QUESTION

I received the following question from the EPIC team. Any information that will

help answer their question would be very much appreciated.

" Do you know of any Joint Commission standards that address Advance as Tolerated

diets? We'll need to figure out how to handle the Advance as Tolerated diets as

we go forward with the EMR and Epic orders. "

Thanks.

Ann Marie Dawson, MS, RD, CDE

Monroe Clinic Hospital

Monroe, WI 53566

Tel:

[Guest guest]

I've consulted with a number of facilities who are moving towards EMR

transition. You should not have an " advance as tolerated " diet. There

are a number of ways to work around this, though. Ask to connect with

your EPIC user group.

I'd be happy to answer questions off list.

Regards,

Pam Charney PhD, RD

Clinical Coordinator

Graduate Coordinated Program in Dietetics

Lecturer, Department of Epidemiology

Nutrition Sciences Program

School of Public Health and Community Medicine

Box 353410, 306-C Raitt Hall

Affiliate Associate Professor

School of Pharmacy

MS Student

Clinical Informatics and Patient Centered Technology

School of Nursing

University of Washington

Seattle, WA

charnepa@...

http://www.linkedin.com/in/pamcharney

" The person who says it can't be done should not

interrupt the person doing it " - Ethel Kennedy

> I received the following question from the EPIC team. Any

> information that will help answer their question would be very much

> appreciated.

>

> " Do you know of any Joint Commission standards that address Advance

> as Tolerated diets? We'll need to figure out how to handle the

> Advance as Tolerated diets as we go forward with the EMR and Epic

> orders. "

>

> Thanks.

>

> Ann Marie Dawson, MS, RD, CDE

> Monroe Clinic Hospital

> Monroe, WI 53566

> Tel:

>

>

[Guest guest]

I've consulted with a number of facilities who are moving towards EMR

transition. You should not have an " advance as tolerated " diet. There

are a number of ways to work around this, though. Ask to connect with

your EPIC user group.

I'd be happy to answer questions off list.

Regards,

Pam Charney PhD, RD

Clinical Coordinator

Graduate Coordinated Program in Dietetics

Lecturer, Department of Epidemiology

Nutrition Sciences Program

School of Public Health and Community Medicine

Box 353410, 306-C Raitt Hall

Affiliate Associate Professor

School of Pharmacy

MS Student

Clinical Informatics and Patient Centered Technology

School of Nursing

University of Washington

Seattle, WA

charnepa@...

http://www.linkedin.com/in/pamcharney

" The person who says it can't be done should not

interrupt the person doing it " - Ethel Kennedy

> I received the following question from the EPIC team. Any

> information that will help answer their question would be very much

> appreciated.

>

> " Do you know of any Joint Commission standards that address Advance

> as Tolerated diets? We'll need to figure out how to handle the

> Advance as Tolerated diets as we go forward with the EMR and Epic

> orders. "

>

> Thanks.

>

> Ann Marie Dawson, MS, RD, CDE

> Monroe Clinic Hospital

> Monroe, WI 53566

> Tel:

>

>

[Guest guest]

I've consulted with a number of facilities who are moving towards EMR

transition. You should not have an " advance as tolerated " diet. There

are a number of ways to work around this, though. Ask to connect with

your EPIC user group.

I'd be happy to answer questions off list.

Regards,

Pam Charney PhD, RD

Clinical Coordinator

Graduate Coordinated Program in Dietetics

Lecturer, Department of Epidemiology

Nutrition Sciences Program

School of Public Health and Community Medicine

Box 353410, 306-C Raitt Hall

Affiliate Associate Professor

School of Pharmacy

MS Student

Clinical Informatics and Patient Centered Technology

School of Nursing

University of Washington

Seattle, WA

charnepa@...

http://www.linkedin.com/in/pamcharney

" The person who says it can't be done should not

interrupt the person doing it " - Ethel Kennedy

> I received the following question from the EPIC team. Any

> information that will help answer their question would be very much

> appreciated.

>

> " Do you know of any Joint Commission standards that address Advance

> as Tolerated diets? We'll need to figure out how to handle the

> Advance as Tolerated diets as we go forward with the EMR and Epic

> orders. "

>

> Thanks.

>

> Ann Marie Dawson, MS, RD, CDE

> Monroe Clinic Hospital

> Monroe, WI 53566

> Tel:

>

>

[Guest guest]

Hello Pam,

Thanks for your response, I appreciate it.  I will forward your email to the

EPIC team.

Ann Marie

________________________________

To: rd-usa

Sent: Tuesday, July 28, 2009 10:42:41 AM

Subject: Re: ADVANCE AS TOLERATED DIET ORDERS - JACHO QUESTION

 

I've consulted with a number of facilities who are moving towards EMR

transition. You should not have an " advance as tolerated " diet. There

are a number of ways to work around this, though. Ask to connect with

your EPIC user group.

I'd be happy to answer questions off list.

Regards,

Pam Charney PhD, RD

Clinical Coordinator

Graduate Coordinated Program in Dietetics

Lecturer, Department of Epidemiology

Nutrition Sciences Program

School of Public Health and Community Medicine

Box 353410, 306-C Raitt Hall

Affiliate Associate Professor

School of Pharmacy

MS Student

Clinical Informatics and Patient Centered Technology

School of Nursing

University of Washington

Seattle, WA

charnepa@... on.edu

http://www.linkedin.com/in/pamcharney

" The person who says it can't be done should not

interrupt the person doing it " - Ethel Kennedy

> I received the following question from the EPIC team. Any

> information that will help answer their question would be very much

> appreciated.

>

> " Do you know of any Joint Commission standards that address Advance

> as Tolerated diets? We'll need to figure out how to handle the

> Advance as Tolerated diets as we go forward with the EMR and Epic

> orders. "

>

> Thanks.

>

> Ann Marie Dawson, MS, RD, CDE

> Monroe Clinic Hospital

> Monroe, WI 53566

> Tel:

>

>

[Guest guest]

Our facility is moving from Meditech to EPIC; from my understanding,

our diet orders will be in a drop down menu format and " adv diet

as tolerated " won't be an option.

Holly Mislter, RD/LD

Mercy Health Center

OKC,OK

>

> > I received the following question from the EPIC team. Any

> > information that will help answer their question would be very much

> > appreciated.

> >

> > " Do you know of any Joint Commission standards that address Advance

> > as Tolerated diets? We'll need to figure out how to handle the

> > Advance as Tolerated diets as we go forward with the EMR and Epic

> > orders. "

> >

> > Thanks.

> >

> > Ann Marie Dawson, MS, RD, CDE

> > Monroe Clinic Hospital

> > Monroe, WI 53566

> > Tel:

> >

> >