Good afternoon, all! I am one of the PGY1 pharmacy residents at HH Main. Over the last couple of months, I have been working with Gregg and Patrick to make some updates to our PKS progress notes for both vancomycin and warfarin. These updates are intended to streamline documentation, improve consistency, and enhance training workflows. The major changes are as follows:

Vancomycin Note Changes:

• Quick notes are no longer available. The vancomycin initial template should be used for all new starts. The expectation for busy second shifts and midnights at the minimum is to use the drop down bar for indication, the drop down bar for vancomycin target, fill out the dose and SCr in the table. 

• HPI and PMH sections have been combined.

• The antimicrobial table has been removed.  When reviewing the patient profile, if there is an issue with other antibiotics, this should be addressed outside of the vancomycin progress note. 

• Creatinine clearance (CrCl) is no longer included (as it changes daily). You may enter this in the progress note section if you would like.

• A serum creatinine (SCr) column has been added to encourage daily documentation.

• The checklist has been reorganized to follow a more logical training flow. 

• Vitals, labs, and cultures no longer automatically pull into the note. Pertinent information should be listed in the "progress note" section of the table.

• Dot phrases are now separated for labs, levels, and the checklist. You may activate, not activate, or delete these if you do not want them. 

• There is no longer a "progress" dot phrase — you should just copy and paste from previous note. Any new labs/levels that you would like automatically pulled can be added by using the separate dot phrases. 

Warfarin Note Changes:

• The drug interaction table has been modified to group drugs by effect: increase INR, decrease INR, or pharmacodynamic interactions (e.g., increased bleeding risk).

• Dot phrases are now separated for labs, levels, and the checklist.

• The checklist has been reorganized for a more logical training flow.

• The platelet section has been removed.

• As with vancomycin, there is no longer a "progress" note.