Labor & Delivery Flow Sheet

Labor and Delivery Encounter

The charting experience for Labor and Delivery encounter is designed to give you flexibility in how you enter data, provide support for transfer or interventions, and create parallel flows for the newborn and immediate postpartum flow.  Once you open a Labor and Delivery Flowsheet, a client is marked as "In Labor" on the main client list.

Starting the Labor and Delivery Flowsheet.

The Labor and Delivery Encounter and Flowsheet can be opened by navigating to the "Encounters" tab in the client chart.  From there, select "Start New Encounter."  From, there, you can (optional) select the Episode of Care, and select the "Labor and Delivery" Template, and the location.

Before beginning charting, you will be invited to document others who may be present at the birth.  As the provider opening and later saving the encounter, you will be present.  This feature allows you to document any Birth Assistants or Doulas who are not EHR users, but also present at the birth.  

Key Components of the flow are described below and highlighted on the screenshot.

• Timers & Reminders (1):  You can set reminders for common measurements such as Fetal Heart Tones and Contractions, and Custom Reminders for anything you may need to track during the labor and delivery phase.  When a timer nears due, you will see the alarm ring to notify you something needs attention.
• Flow Sheet Data Entry (2 & 3):  You can enter data into the flow sheet using “hot keys” (2) for frequent measurements or enter a Full Labor Update (3).  Regardless of how you enter the data, it will end up on the Labor and Delivery flow sheet.
• Transfer & Intervention Flows (4):  These specific buttons provide a dedicated charting experience and documentation support for scenarios including:
  • Arrival & Discharge Time allows the team to document the admission and discharge times for the client, as well as for supporting staff such as the doula, provider, and birth assistant.  All entries will be recorded on the flowsheet with a date and time stamp. 

  

  • Intrapartum Transfer
  • Blood Loss Measurements, including cumulative totals
  • SOS Scenarios, including Resuscitation, Shoulder Dystocia, and Hemorrhage. Shoulder Dystocia and Hemorrhage includes a duration field that automatically tracks the length of each occurrence

• Stages of Labor (5):  The flow sheet is organized into stages of labor to help with the grouping and organization of data throughout the duration of the labor.  You can move data from one stage of labor to the other, if you determine it is appropriate.  

As you enter data within the various forms, you will see the data populate on the labor and delivery flow sheet.  To save data as you go, select Below are some tips beyond directly entering data in the form:

• Saving Data on the Flowsheet:  Data is typically entered on the flow sheet via a side-panel on the right side of your screen.  As you enter data, you can save it by clicking "Add to Flowsheet."  You will see a small box on the bottom right of the screen confirming that the data was saved successfully.

• Editing a Stage of Labor:  If you do not select a stage of labor, the initial data you place into the form will go to Prodromal Labor.  If you do select a stage of labor, all other data will populate in that same stage.  You can easily change the stage of labor for a data set by selecting the three “dots” on the right side of the labor flow sheet.  To move it, simply select the stage where you want this data to move   

• Editing or Removing Data on a Flow Sheet:  You can edit or remove data that has already been entered on a flow by clicking on the time stamp in the left most column of the data point.  Doing so “re-opens” the form and you can edit the fields as needed.
  • To edit - update the field and select “edit” to save the entry on the flow sheet
  • To remove - remove/clear all of the data in the flow sheet (time stamps may stay), and select “edit.”  With no data available in the form, the entry will delete out.
  • Note, the above instructions are for “in progress encounters.”  Once the encounter is signed and locked it must be edited through the amendment flow.

• Immediate Postpartum Flow:  Once “birth” is logged into the flow sheet, an Immediate Postpartum flow for both the client and the newborn will appear.  This form is side-by-side and allows you to enter data for client and newborn in parallel.  The data forms are similar to the labor & delivery flow.

• Dx, Orders & Plan: The Dx, Orders & Plan section provides a centralized space to document diagnoses and capture client-facing summaries and instructions sent to the client portal. 
  • Providers can easily add diagnoses and document care plans 
  • The Client Summary & Instructions field allows providers to communicate updates directly to clients, with rich text formatting options and automatic notification when updates are made.