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Difference between revisions of "OO Behavioral Model"

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== Project Objectives & Introduction ==
 
== Project Objectives & Introduction ==
 +
The [[OOBF_CC_20100922 | SAIF Behavioral Model]] project has superceded the OO Dynamic Model project.  Below are the old definitions and materials, which are not updated at this point.
 +
 +
 
The objective of the OO [[Dynamic Model]] project is to initially focus on common set of rules on how to deal with order management state transitions after the creation of an order.  This will cover Lab, Rx, Rad, PT, Dietary, NRS, Procedures, etc.
 
The objective of the OO [[Dynamic Model]] project is to initially focus on common set of rules on how to deal with order management state transitions after the creation of an order.  This will cover Lab, Rx, Rad, PT, Dietary, NRS, Procedures, etc.
 
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<p>
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* Two days later the order is discontinued.
 
* Two days later the order is discontinued.
  
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===Story Board Four===
 
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The doctor orders ceftazidime 1000 mg 4 times a day for 21 days and gentamicin 300 mg once daily for 3 days.
 
  
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Dr. Valery Valium, a senior staff hospital pharmacist, reviews both medication orders. She checks the sensitivity of previously cultured strains of bacteria (Pseudomonas aeruginosa) from this patient for the antibiotic regimen prescribed. She urges Dr. Chestdrummer to increase the gentamicin dose since this strain appears to be relatively insensitive and also because the levels of gentamicin attained in bronchial sputum are at risk of being inadequate (PORX_IN010670UV). Dr. Chestdrummer adjusts the gentamicin dose to 500 mg once daily (PORX_IN010650UV) (PORX_IN010660UV) . After that, Dr. Valium authorises the administration of both medications. Since ceftazidime is a chemically unstable substance once it is dissolved, she breaks up the outpatient dispensing order into several smaller dispensing orders. These will be authorized by Dr. Chestdrummer on discharge. Debbie Drip, one of the ward nurses, prepares the intravenous solutions prior to each administration. Each preparation is verified by one of her colleagues and then administered to William Coughweezer. On day five after admission William Coughweezer feels much better and is ready to leave the hospital. Dr. Chestdrummer authorizes a sufficient number of small dispensing orders and these are made available to a community pharmacist. Carolyn Compound, a pharmacy technician in the "Overwhere" community pharmacy, prepares and dispenses 12 ceftazidime iv drip solutions every 3 days until 21 days of therapy have been reached. The solutions are dispensed in special elastomer pumps that release the solution at a controlled rate, thus allowing this patient to self-administer all doses. Mr. Coughweezer reports each administration to an electronic drug chart that is accessible via the Internet (PORX_IN010610UV). Bolly Bicycle, a district nurse, visits William Coughweezer at home every three days to change the infusion canula. Dispense Community setting
 
  
 
== Activity Diagrams ==
 
== Activity Diagrams ==
  
 
== Interactions ==
 
== Interactions ==
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<ul>
 +
<li>Composite Order Cancel(POOR_IN200903UV)</li>
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<li>Composite Order Complete(POOR_IN200908UV)</li>
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<li>Composite Order Fulfillment Request(POOR_IN200901UV)</li>
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<li>Composite Order Nullify(POOR_IN200906UV)</li>
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<li>Composite Order Replace(POOR_IN200907UV)</li>
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<li>Composite Order Resume(POOR_IN200905UV)</li>
 +
<li>Composite Order Revision(POOR_IN200902UV)</li>
 +
<li>Composite Order Suspend(POOR_IN200904UV)</li>
 +
<li>Placer Composite Order Number Assigned Response(POOR_IN200911UV)</li>
 +
<li>Send Placer Composite Order Number(POOR_IN200910UV)</li>
 +
</ul>
 +
 +
== Interaction Diagram ==
 +
[[Image:POOR.jpg]]
  
 
== Trigger Events ==
 
== Trigger Events ==
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== Dynamic Model Minutes ==
 
== Dynamic Model Minutes ==
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To get access to just the Dynamic Model related minutes from past O&O meetings, please click '''[[OO Dynamic Model Minutes|here]]'''.
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To get access to just the Dynamic Model related minutes from past O&O meetings, please click [[image:Dynamic Model minutes.doc]]
 +
 
 +
'''[[OO Dynamic Model Minutes|here]]'''.
  
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<[[Orders & Observations TC]]>
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<[[Orders & Observations WG]]>

Latest revision as of 19:56, 23 September 2010

Project Objectives & Introduction

The SAIF Behavioral Model project has superceded the OO Dynamic Model project. Below are the old definitions and materials, which are not updated at this point.


The objective of the OO Dynamic Model project is to initially focus on common set of rules on how to deal with order management state transitions after the creation of an order. This will cover Lab, Rx, Rad, PT, Dietary, NRS, Procedures, etc.

Subsequently we will focus on:

  • Create set of rules on how to deal with observation state transitions
  • Synchronize with Referrals and appointments.

Approach

  • This wiki page will be used to focus our discussions.
  • We agreed to use the Publishing Database directly to maintain the necessary ballot components (Storyboards, Interactions, Trigger Events, Application Roles, State Transitions) and Visio for the Activity Diagrams. The Activity Diagrams form the core of the new Communication Process Model concept which has yet to be formally approved.
  • Creating ballotable artifacts will be the main driver, while the decisions and notes from the minutes will be input into the documentation
  • For the state machine we will start with the currently defined general state machine and then specialize the definitions and descriptions for Orders & Observations.

Michael van Campen and Garry Cruickshank will drive populating the Publishing Database based on our input, while Wendell Ocasio will put the initial Activity Diagrams into Visio based on our input.

Story Boards

Story Board One

  • Doctor orders for an inpatient coumadin, 2mg, QD, start=now, end=open.
  • Doctor reviews the lab results and determines that she needs to change the coumadin order, increasing the dosage to 3mg QD starting today (before the next scheduled administration).
  • The patient has a procedure tomorrow requiring suspension of the medication effective 00:00.
  • The patient returns from the procedure and the physician indicates resumption with the next scheduled dose.

Story Board Two

  • Patient is in ICU and doctor orders TPN with the following additives [CalciumGluconate, PotassiumChloride, MultiVitamin, SodiumChloride], at a rate of 50CC/HR.
  • During morning rounds, around 07:00, the doctor orders an MRI to be taken around 10:00 and suspends the TPN effective 09:00 through 13:00.
  • While the pharmacist reviews the patient record around 10:00, he recommends to change the TPN and increase the SodiumChloride.
  • The pharmacist enters the changes and the doctor verifies the revision.
  • The next day the doctor orders a the rate to be reduced to 25CC/HR.
  • Three days later the doctor discontinues the TPN.

Story Board Three

  • Doctor orders gentamicin sulfate 80mg IM, Q8H at 06:00, 14:00, 22:00.
  • Patients goes for a test at 13:00 and returns 17:00.
  • The 14:00 dose is now administered at 17:00 and the schedule is shifted to 17:00, 01:00, 09:00.
  • Two days later the order is discontinued.


Activity Diagrams

Interactions

  • Composite Order Cancel(POOR_IN200903UV)
  • Composite Order Complete(POOR_IN200908UV)
  • Composite Order Fulfillment Request(POOR_IN200901UV)
  • Composite Order Nullify(POOR_IN200906UV)
  • Composite Order Replace(POOR_IN200907UV)
  • Composite Order Resume(POOR_IN200905UV)
  • Composite Order Revision(POOR_IN200902UV)
  • Composite Order Suspend(POOR_IN200904UV)
  • Placer Composite Order Number Assigned Response(POOR_IN200911UV)
  • Send Placer Composite Order Number(POOR_IN200910UV)

Interaction Diagram

POOR.jpg

Trigger Events

Application Roles

State Transition Definitions

Dynamic Model Minutes

To get access to just the Dynamic Model related minutes from past O&O meetings, please click File:Dynamic Model minutes.doc

here.

<Orders & Observations WG>

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