Patient Conflict Merges
What is a patient record 'Conflict'?
A conflict is created when a 'temporary' record is created at the bedside, alongside her main record within the K2 Guardian system. A temporary record is usually created when the Guardian portal cannot connect to the hospital database via the hospital network. If there is a problem with this connection, Guardian enables the clinician to continue using the system by creating a temporary record which can be merged into the woman's main K2 record after the episode of care.
In effect the woman's main record is 'missing' clinical information which is contained within the temporary record. It is imperative that the temporary record is merged into the woman's main K2 clinical record to achieve and preserve a complete document.
How can 'Conflicts' be resolved?
The main record is sent to K2 from the hospital Patient Administration System (PAS), such as Meditech, webPas, iPM etc.... The two records (the main and the temporary) can be merged via the Athena Archive Door. There are two ways in which these can be merged.
Option 1
Click on the woman's record displayed on the Archive home screen. The records that require merging can be easily identified as they will have a crossed out PAS symbol beside them;
Click on the woman's record to access. Once in the woman's record you will see a warning notice stating 'Woman not linked to PAS' and given two options; 'Resolve Now' or 'Resolve Later'.
- When 'Resolve Now' is selected the system will present options to identify the woman's main record in order to merge the temporary record with it - Hospital Number, Name and Date of Birth etc...
- Once a record is selected you can compare the two records to ensure that they belong to the same woman and same pregnancy.
- When confirmed, the system prompts the user to review the records to be merged.
- Work through the merging screens identifying which data to 'Keep'. When you have selected all information to 'keep'- select 'OK' at the bottom of the last page to complete the merge.
Merging patient pregnancies in the most part is fairly simple and straight forward, however you must take care to ensure that all the data is merged in the correct fashion. For example, when performing the merge the software will flag if some of the patient pregnancy data conflict with each other. It is then your responsibility to choose which data is correct to keep on the merged record.
Option 2
In the top right of the Archive home screen you will see a 'flashing' alert stating 'There are xx conflicts in the database. Click to resolve'. By clicking on this alert you will be presented with a list of woman's records that require merging. There is an option at the top of the screen to 'Resolve All', when selected, the system will automatically resolves all the records that do not contain any conflicting information.
Any remaining records will require a manual merge. The process to resolve these is the same as with Option 1.
Please note that if several hospitals within a group share the same database, all conflicts for the database are displayed in this view. If there is no prefix to the hospital number to differentiate between the hospitals, it can be difficult to identify which merges are required for each hospital site. If this is the case Option 1 is the preferred method to identify conflict records.
Troubleshooting - if the woman's pregnancy records won't merge
On occasion, the woman's main (PAS linked) record may not have successfully populated into K2, therefore the system cannot find a record to merge the temporary record with. In these cases you should resend the PAS message to K2. This can be done by making a spurious change within the PAS record, for example; add a space to the address then delete the space and save the 'fake' change. This will re-trigger the PAS record to update K2 which in turn will enable you to merge the temporary with the resent PAS main woman's record.
Additionally, If the EDDs for the patient pregnancies are too far apart, Athena will not be able to merge the pregnancies together.
Related Articles
Caldicott Principles of Patient Confidentiality
The Caldicott Committee's Report on the Review of Patient-Identifiable Information, usually referred to as the Caldicott Report was a review commissioned in 1997 by the Chief Medical Officer of England due to increasing worries concerning the use of ...Wrong Patient Admitted to Bedside Portal
If you discover that you have inadvertently assigned the INCORRECT patient to a bedside portal and the patient is still being monitored on that portal, you can follow these steps to re-assign the current monitoring session to the correct patient. ...Using the Archive
Opening the archive door allows you to search for and review previous cases. It is important to note that this view only shows recorded data and is not a live representation of incoming data. A list of all previous patient records in patient ID order ...Guardian Online
uardian Online is a web based service that provide consultants with view only access to currently monitored patients from their smartphone/ tablet or laptop. Important Patient Safety Notes ALWAYS check with the onsite caregiver that the patient ...PAS Interface Overview
This document provides an explanation of the PAS integration with Guardian. This document is not intended to provide a detailed explanation of the internally processes, but rather, a higher level functional explanation. The K2MS Generic HL7 ...