Network Downtime Procedures

 Our HIM has a database of medical record numbers so they can easily find an already assigned MRN.

They also have a database to be used to assign an MRN to new patients during an outage. The HIM downtime captain would assign MRNs.  The "new" admits get an MRN that starts with a 7 or 9 so they look nothing like one of our regular MRNs. 

That way everyone from nursing to lab to pharmacy has a number to scan. I believe that number then is the patient's 
permanent MRN. 

Our system has something very similar to what Danyel described, for POC testing we have an additional layer for those patients that simply can't wait... for example:  patient coming into the ER coding.  We have designated a "91111111" barcode that can be used in these situations where the patient can be tested and treated immediately (glucometer, iSTAT ABG/chemistries).   After the patient has had an account created the user can complete a "POC Correction form" in  which they enter in the data needed to link the unidentified test with the actual patient.  This is used to link the test to the actual patient in the middleware and  then it is pushed to the medical record.  This correction form is on the system intranet and generates an email to a POC email group where it is then addressed.
Admittedly, it is a challenge getting some of these "911111111" tests properly identified, not all floor staff submit the form as they should.
 

Yes, we have essentially the same process for emergent admits, L&D and transport. They can used a fake MRN of their choosing which helps when at a delivery of multiples, etc. Then they email me with the real MRN. I'd like to do what you have Jeremy and get a form on the intranet. We have difficult days where they forget at the end of their 12 shift or days when we've had 5 transports but we do our best!

We disable the scan-only feature b/c we are still able to generate MRNs, just not print barcodes during downtime. After the downtime, we simply link the MRN to the correct account number.