Downtime

Downtimes occur when systems are unavailable during two instances:

  • Planned downtimes for maintenance and upgrades.

  • Unscheduled downtimes due to technical issues.

Preparation ahead of any downtime is essential to ensure patient safety and maintain continuity of care when critical systems are unavailable.

Epic Downtime Resources

Epic Downtime Manual

Comprehensive role- and service-line based processes and functions required to maintain patient care during a downtime and recovery process.

Learn more.

Downtime Order Sets

Printable versions of order sets available in Epic. Intended as a guide during downtime when handwriten orders on blank order forms are needed.

Learn more.

Epic Downtime Quick Reference Checklist

A condensed snapshot of the most essential information you need to know in the event of scheduled or unscheduled Epic downtime.

Learn more.

Epic Downtime CSN Numbers

Pre-designated CSN number ranges, that flag if a patient was admitted/arrived during a downtime, are assigned by your facility’s Downtime CSN site administrator.

Contact your administator for more information.

Downtime Calendar

Click each item to expand for more details.

Staples Supplier Website: 3 p.m. Thursday, May 30 – 3 p.m. Friday, May 31

The Staples Supplier website will be offline for 24 hours. Please plan accordingly. Contact SCM Support (SCMSupport@houstonmethodist.org) if you have questions.

LMS: 11 p.m. Saturday, May 25 – 12 a.m. Sunday, May 26

LMS won’t be available during these times due to maintenance.

Press Ganey iRound: 5–9 p.m. Saturday, May 25

The iRound application from Press Ganey will be unavailable due to routine updates.

 For both downtimes – ensure your rounds are documented by submitting forms before or after the downtime. Contact your local PEX Specialist with any questions.

Epic Downtime Forms

Review and download these resources.
Click to expand the list of available forms.

Blood

Pre-Transfusion

 

Post-Transfusion

ED Nursing

Inpatient Nursing

Lab Services

OR / Surgery

Patient Education

To select patient education tools during a downtime.

How to Prepare for an Epic Downtime

Before the downtime:

Review and download these resources.

Before the downtime begins, save your work and log out of Epic.

After the downtime:

Radiology and Cardiology:

  • Enter orders in Epic based on the downtime paper requisitions/downtime log.
  • Process orders using standard workflows and prepare them for interpretation.
  • Downtime studies will be read using the defined interpretation method for each department.

Medical Devices:

  • Manually enter all vital sign data captured during the downtime when Epic is back up.
  • Any new vital sign data collected after the downtime will automatically integrate with Epic.

During the downtime:

Use Epic Read-Only to view data. Access Epic Read-Only from your desktop or through access.houstonmethodist.org. If you don’t see the Epic Read-Only icon, click here for instructions on how to add it to your desktop.

Document the following on paper:

  • Lab: Use downtime requisitions.
  • Pharmacy: Use paper orders.
  • Radiology and Cardiology:
    • No orders will process to PACS or the transcription system.
    • Use paper requisitions and log procedures performed on the downtime documentation form.
    • Interpretation of studies will be managed per each department’s defined downtime process.
  • Medical devices: Data will not flow into Epic from mobile vital signs machines, dialysis machines, bedside monitors, ventilators and anesthesia carts.
  • VICU: Epic Read-Only will not receive Caregility alerts and camera links will not be available. Use the Caregility portal.
    • Sickbay risk scores that include lab data will be impacted and the New Admission Queue will not be available.
    • MultiMon will continue to display bedside monitor and vent data, but new admits will not display the patient name.
  • For HM West CTM: Sickbay will not display names of new patients until after the downtime.

Epic Read-Only

Available on most Epic-enabled workstations and through the Apps Portal. This is a view-only system, so new documentation or orders can’t be added. Data is up to date as of the time when Epic went down. You’ll have limited access to patient data, but can still view active orders and the MAR, print patient labels and arm bands.

BCA Web

Access essential downtime reports from any workstation when you have internet access but Epic and Epic Read-Only are not available. View and print a current census or limited clinical summaries with data for each patient, including active orders, recent results and vitals. Also provides a printable downtime MAR for each patient and a respiratory patient summary.

Reports are automatically updated every 30 minutes for ICU patients and every two hours for non-ICU patients. Department Appointment Reports (including patient schedules for the next four weeks) for outpatient and PCG/SPG clinics are updated daily.

BCA Printing / Downtime Computer

Similar reporting functionality as BCA Web, but available from your unit’s designated downtime computer when internet access is not available. Your unit’s device will also have access to reports for sister units above and below you, in the event their system has issues. Because the computer is hardwired to a designated printer, you can mass print all reports for your unit and distribute patient data to the appropriate clinicians or staff.

Frequently Asked Questions

Click each question to expand or close the answer.

How will I know how long a downtime will last?

For periodic planned downtimes, like the Epic Quarterly Update and others, advance notice will be published in IT Matters and Physician Connect and may be communicated through the IT service operations team for your entity.

Frequently, the nature of any unplanned downtime makes estimates of a recovery timetable hard to determine. Communications will be shared with leaders and staff on a regular basis to provide downtime status updates. These messages may come by email, text or phone, depending on the incident’s severity and availability of messaging channels.

Can I see the documentation I completed just before the system went down?

Use Epic Read-Only or the reports in BCA Web/BCA Print to view essential data and documentation from each patient’s chart. The data in Epic Read-Only is up to date to the time just before Epic went down. The reports in BCA Web are updated every 30 minutes before a downtime for ICU patients and every two hours for non-ICU patients. Outpatient scheduling reports are generated daily.

Can I still scan medications using Rover when Epic is down?

During a downtime, Epic is not receiving new data. So any barcode scanning you may do will not register with the system. You will need to manually notate any medications you administer on the printed MAR report and update Epic when the system is recovered.

Where do I complete my documentation while waiting for Epic to come back up?

Use the paper forms available in your unit’s downtime kit to document patient care during a downtime. Any notes you make on BCA Web reports can also be considered part of a patient’s record. You will use these to update Epic when the system comes back up and your paper notes will be scanned into Epic by the health information team for record keeping.

What do I need to do when Epic is available again?

Each unit and department has different responsibilities following a downtime. Do not throw away any paper forms with patient care notes. Follow the recovery steps in your Epic Downtime Manual or any instructions provided by your manager or facility leadership.

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