EPIC Efficiency

1. EPIC Foundations: Moves That Save Hours

These speed principles apply everywhere:

A. Master Your Workspace

• F2 → moves to the next data field

• Ctrl + Space → auto-complete SmartLists

• .name → insert your signature

• Right-click on tabs → pop-out windows (labs, notes, vitals side-by-side)

B. Always Use 3 Panels (Your “Command Center”)

Most efficient residents keep these open at once:

1. Chart Review → Notes, Imaging, Labs

2. Navigator → H&P, Progress Notes, Admission

3. Order Entry → with your favorite order sets + macros

This allows you to read → think → order without switching pages constantly.

2. EMAR (Medication Administration Record)-How to Master It Fast

What EMAR Shows

• What has been given

• When it was given

• Meds due or overdue

• Pending PRNs

• IV drips + rates

• Missed doses

• Pain/response to analgesics

Essential Filters

• Time-range filter: “8 hours,” “24 hours,” “Since admission”

• “Administered” vs “Due” views

• IV infusions only

• PRN meds only

Speed Workflow

1. Click MAR

2. Switch to “Time Bar View” → fastest visual overview

3. Hover over doses to see reason given + RN comments

4. Double-click any med → opens details + order

5. Use “Linked flowsheets” to see pain score with PRNs

Clinical Use

• Confirm if antibiotics actually started

• Check timing of insulin, opioids, fluids

• Check if ED gave fluids/pressors already

• See if PRNs were ineffective (e.g., Tylenol ×2 with no improvement)

• Trend drips (heparin, propofol, insulin)

3. Review of Systems (ROS) and PMH Built for Speed

A. PMH Efficiency: “Chart Review → Histories”

Look at:

• PMH

• PSH

• Family Hx

• Social Hx

• Medications

• Allergies

Speed Tip

Use this SmartLink to pull them instantly:

.HXMED
.HXPSH
.HXFAM
.HXSOC
.ALLERG

or use a combined SmartPhrase:

.mypmh

Example content:

Past Medical History:
@PMH@

Past Surgical History:
@PSH@

Family History:
@FAMHX@

Social History:
@SOCHX@

These populate instantly.

4. EOS (End of Shift) Notes : The Fastest Templates

Purpose

End-of-shift notes need to be:

• concise

• safe

• covering overnight events

• clear for day team handoff

Your EOS Macro

Create a SmartPhrase:

.EOSNOTE

With this template:

**Overnight Events:**
- @EVENTS@

**Active Problems:**
1. @PROB@
2. @PROB@
3. @PROB@

**Pending Items for Day Team:**
- @PENDING@

**FYI / Operational:**
- Code status: @CODE@
- Abnormal vitals overnight: @VITALS@
- Last labs: @LABS@

**Plan to start the day:**
- @PLAN@

Analysis

The key is to focus on what the day team needs to know and what remains unsafe.

5. Flowsheet Mastery — The Fastest Data Review in Epic

Flowsheets show:

• vitals

• I/O

• scores (NIHSS, CIWA, RASS)

• nursing notes

• neuro checks

• wound care

• glucose log

• weights

Crucial Features

• “Filter rows” — show ONLY what you need

• “Group by system” — vitals, neuro, cardio

• “Recent changes only (highlighted events)”

Fast Interpretation

• Click Vitals → Graph

• Trend fever curve, HR, BP, O2

• Expand Intake/Output → Last 24 hours

• Check SpO2 with O2 device + FiO2

Speed Hack

Create a favorite flowsheet view:
“ICU basics” or “Medicine admission”

6. Labs — Smart, Fast, and Organized

A. Filter Tips

• “Since admission”

• “Last 24 hours”

• “Abnormal only”

• “Graph view” for Hgb, creatinine, LFTs, trops

B. Use the Lab Combo Panels

• BMP

• CMP

• CBC

• ABG/VBG

• Cardiac enzymes

• Sepsis set

C. SmartLinks for Notes

Use these:

.LASTLABS
.LASTBMP
.LASTCBC
.LASTVBG
.LASTABG
.LASTTROP

Example:

**Labs (most recent):**
@LABS@

7. Imaging — Learn to Pull Findings in Seconds

1. Go to Chart Review → Imaging

2. Click the study

3. Press “View Report” to see radiologist interpretation

4. Use SmartLink:

@LASTIMG@
@LASTXR@
@LASTCT@
@LASTUS@

Example:

Imaging Summary:
@LASTIMG@

Speed Tip

Pin Imaging to left-side “Favorites.”

8. SmartPhrases / Macros You MUST Use

A. Admission Note Macro

.ADMITHPIPRO

Includes:

• HPI

• PMH/PSH/Meds

• ED Course

• Review of systems

• Physical exam

• Problem list + plan

B. Problem List Speed Macro

.PROBLIST

**Problem:**
Assessment:
Plan:
- 
- 
- 

C. Daily Progress Note Macro

.MYPROGRESS

**Subjective:**
- 

**Objective:**
Vitals:
@LASTVITALS@
I/Os:
@IOLAST24@
Labs:
@LABS@
Imaging:
@LASTIMG@

**Assessment & Plan:**
1.
2.
3.

D. Discharge Summary Macro

.MYDC

9. Orders — Speed Techniques

Favorites List

Add:

• Admission orders

• DVT prophylaxis

• Diet + activity

• AM labs

• IV fluids

• Pain/fever PRNs

• Insulin sliding scales

• Nausea meds

• EKG

• CXR

• Blood cultures

• Heparin drip

• CIWA/COWS protocol

• Hypoglycemia protocol

Order Shortcuts

• Search med by dose (“5 mg” or “25 mg”)

• Search by problem (“pneumonia”)

• Use order panels (CHF, AKI, sepsis, COPD)

10. The “Resident Speed Map” — The Fastest Path for Each Task

A. Admission

1. Chart Review

2. ED sign-out

3. Note template inserted

4. Open labs + imaging side-by-side

5. Orders entered as you type the plan

6. Finish note

B. Morning Progress Note

1. Labs

2. Vitals

3. Overnight events

4. Updated problem list

5. Orders

6. Note

C. Cross-Cover

1. Vitals → labs → MAR → flowsheet

2. Assess issue

3. Quick note if needed

4. Targeted orders

11. Common SmartPhrase “Codes” You Can Copy Into Epic

These work in MOST hospitals:

@LASTLABS@
@LASTVITALS@
@LASTIMAGING@
@PROB@
@DIAG@
@PMH@
@PSH@
@MED@
@ALLERG@
@EDCOURSE@
@ROS@
@HPI@

If they don’t work, your hospital uses local custom links—ask IT for your site-specific list.

12. Advanced Efficiency Tricks

A. Dot Phrases to Auto-Update as You Work

E.g.,

.zzstable

Patient remains hemodynamically stable: BP @BP@, HR @HR@, SpO2 @SPO2@ on @O2@.
No acute events overnight.

B. Prebuilt A/P Blocks

Create templates for:

• Chest pain

• Sepsis

• AKI

• HF

• COPD exacerbation

• Pneumonia

• Hyperkalemia

• Hypoglycemia

Then just edit specifics.