Project Status
    Informative Ballot R1 – Sept 2011
       Reconciliation completed Sept WGM 2011
       Reconciliation edits to storyboards 75% completed      
               (J. Snyder/M. Dittloff) 
       To Do:  Reconciliation updates to model & diagrams
          Primarily to revise/merge Pediatric => Enteral
    Informative Ballot R2 – May 2012
       Adding New Storyboards to provide more complete 
         picture of nutrition content
       In progress – working with SME committee
  New Nutrition Storyboards
    Acute / LTC Food Allergy 
    Acute / LTC Food Intolerance
    Food Preference
    Revise Request Dietitian Consultation
    New Sub-Flow: Nutrition Care Process
       Nutrition Assessment 
       Nutrition Diagnosis (Problem)
       Nutrition Interventions
       Nutrition Monitoring & Evaluation
  Acute / LTC Food Allergy
        Adam Everyman is admitted to Green Acres Retirement 
   Home after being discharged from Good Health Hospital. 
   While reviewing Adam’s medical records transferred from 
   Good Health Hospital and taking an updated patient 
   history, Aaron Attending confirms that Adam Everyman has 
   an allergy to eggs that initially manifests as hives quickly 
   followed by anaphylactic shock.  Aaron Attending adds the 
   food allergy to the allergy list area of the patient record of 
   the EHR system and documents it as severe (critical) 
   noting the associated adverse reactions of hives followed 
   by anaphylaxis. The food allergy is now readily visible to 
   anyone who reviews the chart, including the nurse staff, 
   pharmacists, and ancillary departments. 
  Acute / LTC Food Allergy – cont.
      The EHR system sends an electronic message via the 
   interface to the FNMS notifying Food and Nutrition Services 
   of Adam Everyman's food allergy to eggs along with the 
   clinician’s assessment of the severity/criticality and a 
   summary of the reported adverse reaction symptoms. 
      The FNMS acknowledges receipt of the new allergy order 
   and updates Adam’s record in the FNMS.  The FNMS is able 
   to identify food products with eggs and remove them from 
   Adam Everyman’s menu.  Eggs are now prevented from 
   being served to Adam Everyman, minimizing the risk of Adam 
   Everyman experiencing hives or anaphylactic shock due to 
   egg exposure during this stay at Green Acres Retirement 
   Home.
  Acute / LTC - Food Intolerance
      Adam Everyman is discharged from Good Health 
   Hospital and admitted to Green Acres Retirement Home. 
   While reviewing medical records transferred from Good 
   Health Hospital and taking an updated patient history 
   Aaron Attending identifies that Adam Everyman has food 
   intolerance to lactose. When questioned about this, Adam 
   Everyone states that he avoids milk and dairy due to GI 
   cramping and diarrhea.  Aaron Attending updates the 
   appropriate section of the EHR and documents the lactose 
   intolerance along with the adverse reactions reported by 
   the patient.  He also enters a lactose-free nutrition order.