Technically Speaking: Timeless Software Launch, Part 2

Special thanks to guest author Vanessa Le, Clinical Education, for this week’s column. Vanessa is an ICU Clinical Informaticist who has been working tirelessly to bring the Timeless breast milk and formula tracking/ordering system online. Click here to read Timeless Part 1.

Now that the Nutrition Center (NC) is open in the Hubbard Center for Children, Timeless – the software program used to track and prepare formula and breast milk products – has launched.  The nutrition techs in the NC are now fortifying and preparing all formula and breast milk.

Why did Children’s move to this process?

  • The NC allows for a clean, dedicated space to prepare milk aseptically by techs who have specific training in this area. 
  • Measurements are much more precise in the NC; techs can measure down to a tenth of a gram versus ½ teaspoon at the bedside.
  • Timeless allows techs to label and track breast milk as they are fortifying it, thereby preventing delivery of breast milk to the wrong patient. 
  • We know exactly how much milk is in house and where it is stored, ensuring no milk is left behind at discharge.

These changes have resulted in some new workflows that will affect how quickly the NC can respond to changes in diet orders.

  • The NC will prepare breast milk (anything that requires fortification or other additives) twice daily, at 7 a.m. and 3 p.m. They will prepare individual syringes/bottles and deliver to the bedside around 10:30 a.m. and 6:30 p.m.
  • Because the breast milk syringes for the daytime feeds are prepared at 7 a.m., any changes that are made to the diet orders during rounds will not go into effect until the second batch of milk has been prepared at 3 p.m. and will not reach the baby until the 11 p.m.- midnight feed. This includes changes in calories and volume, as well as changing from a continuous drip to a gavage feeding.
  • Please consider this new NC workflow when making changes to diet orders and consider making changes overnight so those changes can take effect when the lab starts making the 7 a.m. batch of milk. Otherwise, it could be nearly 12 hours after an order was entered before the patient will receive the new milk order.
  • The nurse or certified nursing assistant will get a soft stop in Timeless when the old syringe is scanned. The nurse can verify the feeding based on the old order and continue with the feeding as planned.

This workflow does not apply to the following situations:

  • Fresh breast milk (20 cal./oz)
  • Ready to use/ready to feed formula
  • Formula prepped in the NC (the prep cycle for formula is not changing and will continue as before)

The NC team is busy preparing breast milk and working through their process on how to make this more efficient. We are asking for some grace, patience and flexibility as we accommodate to these new workflows.

Please let Vanessa or me know if you encounter any issues with breast milk or formula ordering. Thanks for all you do!

Stephen Dolter, M.D., CMIO

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